Le carcinome intracanalaire de la prostate : indication potentielle pour la radiothérapie adjuvante

Contexte : Le carcinome intracanalaire de la prostate (IDC-P) est une variante de cancer de la prostate (CaP) qui est retrouvée au sein des formes usuelles. Plusieurs études observent que l’IDC-P possède une biologie qui lui est unique et qui répond différemment aux traitements normalement offerts aux patients atteints d’une maladie avancée. La réponse au traitement chez les hommes atteints d’un CaP localisé avec IDC-P n’a pas encore été étudiée. Objectif : Vérifier l’impact de la radiothérapie adjuvante (RTAJD) chez les patients avec un CaP localisé et du IDC-P. Méthodes : Nous avons effectué une étude rétrospective d’hommes avec un CaP localisé traité par prostatectomie radicale (PR) avec ou sans RTAJD, de deux centres (1993-2015). Les critères d’exclusion étaient l’utilisation d’un autre type de traitement avant la récidive biochimique (BCR), et un APS détectable à la suite du dernier traitement. L’issue primaire était la BCR. Les patients étaient réunis selon le traitement (PRseule/PR+RTAJD), le statut d’IDC-P et la présence de facteurs de haut-risque (FHR) : Groupes de grade 4 et 5, marges positives, stade pT3. Résultats : Nous avons révisé 293 PR (suivi médian de 99 mois, avec 63 BCR). Quarante-huit patients (16,4%) étaient traités par PR+RTAJD. Une régression de Cox multivariée pour la BCR indique que l’IDC-P avait l’impact le plus important comparativement aux autres FHR (HR=2,39, 95%CI : 1,44-3,97), tandis que la RTAJD montre un effet protecteur (HR=0,38, 95%CI : 0,17-0,85). Chez les patients IDC-P[+], l’impact de la RTAJD sur le risque de BCR était supérieur comparativement à l’impact chez les patients IDC-P[–]. Les patients IDC-P[+] qui n’ont pas reçu de RTAJD avaient la pire courbe de survie sans BCR (log-rank P=0,023). ii De plus, l’impact de l’IDC-P sur la survie sans BCR était équivalent à l’impact de ≥1 FHR (log-rank P=0,995). Conclusion : Les hommes avec de l’IDC-P n'ayant pas reçu de RTAJD avaient les pires taux de BCR, et l’IDC-P démontre le même impact sur le risque de BCR que les FHR actuellement utilisés comme indications pour la RTAJD. Si validés, nos résultats suggèrent que la RTAJD devrait être considérée chez les hommes avec de l’IDC-P.Background: Intraductal carcinoma of the prostate (IDC-P) is a variant of prostate cancer (PC) that can be found amongst usual forms. Studies observed that IDC-P has a different biology and response pattern to treatments usually offered to patients with advanced disease. Treatment response for localised PC with IDC-P has never been studied. Objective: To test the impact of adjuvant radiotherapy (ART) in patients with localized PC and IDC-P. Methods: We performed a retrospective study of men with localized PC treated by radical prostatectomy (RP) with or without ART, from two centers (1993–2015). Exclusion criteria were the use of another type of treatment prior to BCR, and detectable PSA following RP or ART. Primary outcome was BCR. Patients were grouped by treatment (RPonly/RP+ART), IDC-P status, and presence of high-risk features (HRF: Grade Groups 4–5, positive margins, pT3 stage). Results: We reviewed 293 RP specimens (median follow-up 99 months, 63 BCR). Forty-eight patients (16.4%) were treated by RP+ART. Multivariate Cox regression for BCR indicated that IDC-P had the strongest impact compared to other HRF (HR=2.39, 95%CI:1.44-3.97), while ART reduced the risk of BCR (HR=0.38, 95%CI: 0.17-0.85). The protective effect of ART was superior in IDC-P[+] patients, when compared to IDC-P[–] patients. IDC-P[+] patients who did not receive ART had the worst BCR-free survival (log-rank P=0.023). Furthermore, IDC-P had the same impact on BCR-free survival as ≥1 HRF (log-rank P=0.955). Conclusion: Men with IDC-P who did not receive ART had the highest BCR rates, and IDC-P had the same impact as ≥1 HRF, which are often used as ART indications. Once validated, ART should be considered in patients with IDC-P

Environment Impacts and Composition - Biotoxic Activity in Natural Hydrocarbon Raw Materials & Processed Products

The paper aims to figure out What are environment impacts and composition - biotoxic activity in natural hydrocarbon raw materials and processed products. By using descriptive method for primary model, synthesis methods and process analysis and analysis of difficulties and discussion, The study of this problem point that, to assess the environmental impact of hydrocarbons on the biosphere, an accurate knowledge of the physical properties and chemical composition of oil and gas. Numerous tragic examples of accidents, such as those associated with a leak hydrogen sulfide gases. Hydrogen sulfide, due to its higher density relative to air settles in the lowlands of the relief, accumulating in calm weather in concentrations up to lethal. This leads to the death of animals and the death of people. The latter could be avoid by going to elevated windward areas, i.e., knowing the physical properties of this toxic gas

Klf4 protects thymus integrity during late pregnancy

Pregnancy causes abrupt thymic atrophy. This atrophy is characterized by a severe decrease in the number of all thymocyte subsets and qualitative (but not quantitative) changes in thymic epithelial cells (TECs). Pregnancy-related thymic involution is triggered by progesterone-induced functional changes affecting mainly cortical TECs (cTECs). Remarkably, this severe involution is rapidly corrected following parturition. We postulated that understanding the mechanisms of pregnancy-related thymic changes could provide novel insights into signaling pathways regulating TEC function. When we analyzed genes whose expression in TECs was modified during late pregnancy, we found a strong enrichment in genes bearing KLF4 transcription factor binding motifs. We, therefore, engineered a Psmb11-iCre : Klf4lox/lox mouse model to study the impact of TEC-specific Klf4 deletion in steady-state conditions and during late pregnancy. Under steady-state conditions, Klf4 deletion had a minimal effect on TEC subsets and did not affect thymic architecture. However, pregnancy-induced thymic involution was much more pronounced in pregnant females lacking Klf4 expression in TECs. These mice displayed a substantial ablation of TECs with a more pronounced loss of thymocytes. Transcriptomic and phenotypic analyses of Klf4-/- TECs revealed that Klf4 maintains cTEC numbers by supporting cell survival and preventing epithelial-to-mesenchymal plasticity during late pregnancy. We conclude that Klf4 is essential for preserving TEC’s integrity and mitigating thymic involution during late pregnancy

M^2UNet: MetaFormer Multi-scale Upsampling Network for Polyp Segmentation

Polyp segmentation has recently garnered significant attention, and multiple methods have been formulated to achieve commendable outcomes. However, these techniques often confront difficulty when working with the complex polyp foreground and their surrounding regions because of the nature of convolution operation. Besides, most existing methods forget to exploit the potential information from multiple decoder stages. To address this challenge, we suggest combining MetaFormer, introduced as a baseline for integrating CNN and Transformer, with UNet framework and incorporating our Multi-scale Upsampling block (MU). This simple module makes it possible to combine multi-level information by exploring multiple receptive field paths of the shallow decoder stage and then adding with the higher stage to aggregate better feature representation, which is essential in medical image segmentation. Taken all together, we propose MetaFormer Multi-scale Upsampling Network (M$^2$UNet) for the polyp segmentation task. Extensive experiments on five benchmark datasets demonstrate that our method achieved competitive performance compared with several previous methods

When Intervention Becomes Imperative: A Case Report of Spontaneous Vulvar Edema During Pregnancy

Spontaneous idiopathic vulvar edema during the second trimester is a rare condition. The approach to managing this condition involves relieving symptoms, identifying underlying causes, and implementing appropriate treatment. Managing such cases during pregnancy is challenging because of concerns for potential adverse fetal outcomes. Conservative management expects the condition to be relieved spontaneously postpartum, whereas invasive treatment offers a more rapid resolution. Treatment choices are controversial because each method has its pros and cons and influences the delivery process to a certain extent. Surgical drainage becomes a viable option when patients are not responsive to medications. We report a case of spontaneous massive vulvar edema in a 22-year-old primigravida in her 23rd week of pregnancy. After ruling out other notable causes of vulvar edema, we decided to intervene using an invasive procedure because she complained of progressive symptoms and discomfort. Subsequently, the edema subsided postprocedure, and the patient experienced successful labor with no complications. This report aims to alert clinicians that drainage attempts should be considered in pregnant patients with worsening symptoms

GRADIENT KIẾN TẠO HIỆN ĐẠI KHU VỰC NINH THUẬN VÀ LÂN CẬN

The estimation of the present day tectonic movement and tectonic gradient (strain rate) has an important practical signification in the assessment of active fault and seismic hazards for the selection of Ninh Thuan nuclear power plant. Based on the three campaigns of GPS measurement between 2012 - 2013, we used BERNESE 5.0 software to determine present day slip rates of 13 stations in ITRF08 frame. The GPS stations move eastwards at the slip rates of 22 - 25 mm/yr, southwards at the velocities of 5 - 10 mm/yr. The standard errors in latitudinal and longitudinal directions are 1.2 mm/yr and 0.9 mm/yr, respectively. Combined with GPS data from the project of the study on actual geodynamics in Tay Nguyen TN3/06, we determined the strain rate ranging from 50 to 100 nanostrains with the standard error of 50 nanostrains. The direction of  maximum compressive strain rate is from northwest - southeast to east - west.Đánh giá vận tốc chuyển động kiến tạo hiện đại và gradient kiến tạo hiện đại có ý nghĩa thực tiễn quan trọng trong việc đánh giá đứt gãy hoạt động nguy hiểm động đất phục vụ xây dụng nhà máy điện hạt nhân Ninh Thuận. Trên cơ sở đo 3 chu kỳ GPS vào các năm 2012 - 2013, sử dụng phần mềm BERNESE 5.0, chúng tôi đã xác lập được vận tốc chuyển động kiến tạo hiện đại tại 13 điểm đo GPS trong khu vực lân cận bao gồm kéo dài từ Nha Trang tới đảo Phú Quý. Vận tốc chuyển dịch kiến tạo hiện đại về phía đông thay đổi từ 22 - 25 mm/năm và chuyển dịch về phía nam với vận tốc giao động từ 5 - 10 mm/năm trên hệ tọa độ toàn cầu ITRF08. Sai số vận tốc chuyển dịch kiến tạo về phía đông giao động trong khoảng 1,2 - 1,5 mm/năm và về phía nam giao động trong khoảng 0,9 - 1,2 mm/năm. Liên kết với giá trị đo GPS từ đề tài nghiên cứu địa động lực hiện đại khu vực Tây Nguyên mã số TN3/T06, chúng tôi đã xác định được giá trị vận tốc biến dạng giao động từ 50 nano tới 100 nano biến dạng với sai số giao động trong khoảng 50 nano biến dạng. Trục biến dạng nén cực đại giao động theo phương thay đổi từ bắc nam sang đông bắc - tây nam. Trục biến dạng căng cực đại có phương thay đổi từ tây bắc - đông nam sang phương đông - tây

MULTI-CRITERIA DECISION-MAKING FOR ELECTRIC BICYCLE SELECTION

Electric bicycle is a vehicle which is used widely in all the citys and provinces of Vietnam. However, it’s hard to choose “the most suitable” or “the best” type of electric bicycle because each type has different criteria (parameters). To choose out the best option, we need to consider all the alternatives at once. That is called multi-criteria decision-making. This research used three multi-criteria decision-making methods include SAW method, MARCOS method and PSI method to choose from seven bestselling types of electric bicycle on the market in 2022. All the methods which were used chose out the same best electric bicycle type and the same worst bicycle type. And so, among seven types of electric bicycle which include M133 mini, M133 Sport 2022, Aima 133AM, Nijia – PA4, DK 133M, Yadea iGo and Yadea i3, the best type is Aima 133AM, in contrast, Yadea iGo is considered the worst type. Things that need to be done in the folowing researches were proposed in the last part of this paper

Computational Pathology: A Survey Review and The Way Forward

Computational Pathology CPath is an interdisciplinary science that augments developments of computational approaches to analyze and model medical histopathology images. The main objective for CPath is to develop infrastructure and workflows of digital diagnostics as an assistive CAD system for clinical pathology, facilitating transformational changes in the diagnosis and treatment of cancer that are mainly address by CPath tools. With evergrowing developments in deep learning and computer vision algorithms, and the ease of the data flow from digital pathology, currently CPath is witnessing a paradigm shift. Despite the sheer volume of engineering and scientific works being introduced for cancer image analysis, there is still a considerable gap of adopting and integrating these algorithms in clinical practice. This raises a significant question regarding the direction and trends that are undertaken in CPath. In this article we provide a comprehensive review of more than 800 papers to address the challenges faced in problem design all-the-way to the application and implementation viewpoints. We have catalogued each paper into a model-card by examining the key works and challenges faced to layout the current landscape in CPath. We hope this helps the community to locate relevant works and facilitate understanding of the field's future directions. In a nutshell, we oversee the CPath developments in cycle of stages which are required to be cohesively linked together to address the challenges associated with such multidisciplinary science. We overview this cycle from different perspectives of data-centric, model-centric, and application-centric problems. We finally sketch remaining challenges and provide directions for future technical developments and clinical integration of CPath (https://github.com/AtlasAnalyticsLab/CPath_Survey).Comment: Accepted in Elsevier Journal of Pathology Informatics (JPI) 202

Acceptance and user experiences of a wearable device for the management of hospitalized patients in COVID-19–designated wards in Ho Chi Minh City, Vietnam: action learning project

Background: Wearable devices have been used extensively both inside and outside of the hospital setting. During the COVID-19 pandemic, in some contexts, there was an increased need to remotely monitor pulse and saturated oxygen for patients due to the lack of staff and bedside monitors. Objective: A prototype of a remote monitoring system using wearable pulse oximeter devices was implemented at the Hospital for Tropical Diseases in Ho Chi Minh City, Vietnam, from August to December 2021. The aim of this work was to support the ongoing implementation of the remote monitoring system. Methods: We used an action learning approach with rapid pragmatic methods, including informal discussions and observations as well as a feedback survey form designed based on the technology acceptance model to assess the use and acceptability of the system. Based on these results, we facilitated a meeting using user-centered design principles to explore user needs and ideas about its development in more detail. Results: In total, 21 users filled in the feedback form. The mean technology acceptance model scores ranged from 3.5 (for perceived ease of use) to 4.4 (for attitude) with behavioral intention (3.8) and perceived usefulness (4.2) scoring in between. Those working as nurses scored higher on perceived usefulness, attitude, and behavioral intention than did physicians. Based on informal discussions, we realized there was a mismatch between how we (ie, the research team) and the ward teams perceived the use and wider purpose of the technology. Conclusions: Designing and implementing the devices to be more nurse-centric from their introduction could have helped to increase their efficiency and use during the complex pandemic period