Presence of tumour capsule on contrast-enhanced CT is associated with improved outcomes of stereotactic body radiation therapy in hepatocellular carcinoma patients

Purpose Stereotactic body radiation therapy (SBRT) is a novel local therapy for the treatment of hepatocellular carcinoma (HCC). While effective, there is currently noreliable radiological marker to guide patient selection. In this study, we investigated the prognostic value of capsule appearanceon contrast-enhanced computed tomography (CT) for patients undergoing SBRT. Materials and Methods Between 2006 and 2017, 156 consecutive patients with Child-Pugh score class A/B and HCC ≥5cm that underwent SBRT were retrospectively analysed. Baseline triple-phase CTs of the abdomen were reviewed for the presence of capsule appearances and correlated with objective response rate (ORR), overall survival (OS), and pattern of treatment failure. Results Capsule appearance on CT was present in 83 (53.2%) patients.It was associated with improved ORR by Response Evaluation Criteria in Solid Tumours (RECIST) (60.2% vs 24.7%; p<0.001) andModified Response Evaluation Criteria in Solid Tumours(mRECIST) (ORR 78.3% vs 34.2%; p<0.001). The presence of a capsule was also associated with superior 2-year local control (89.1% vs. 51.4%; p<0.001) and 2-year OS (34.1% vs. 14.8%, p<0.01). Hepatic out-field failure was the dominant mode of progression, which was less common in patients with intact capsule (54.2% vs. 60.3%, p=0.01). Conclusion Capsule appearance on CT could potentially be a non-invasive prognostic marker for selecting HCC patients undergoing SBRT. Larger cohort is warranted to validate our findings

Lupus nephritis in Chinese children--a territory-wide cohort study in Hong Kong

We report a multicenter study of Chinese children in Hong Kong with systemic lupus erythematosus (SLE) nephritis. Children were included if: they fulfilled the ACR criteria, had significant proteinuria or casturia, were Chinese and younger than 19 years and had been diagnosed with SLE between January 1990 and December 2003. Investigators in each center retrieved data on clinical features, biopsy reports, treatment and outcome of these patients. There were 128 patients (eight boys, 120 girls; mean age: 11.9+/-2.8 years). About 50% presented with multisystem illness and 40% with nephritic/nephrotic symptoms. Negative anti-dsDNA antibodies were found in 6% of the patients. Renal biopsy revealed WHO Class II, III, IV and V nephritis in 13 (10%), 22 (17%), 69 (54%) and 13 (10%) patients, respectively. The clinical severity of the nephritis did not accurately predict renal biopsy findings. The follow-up period ranged from 1 to 16.5 years (mean+/-SD: 5.76+/-3.61 years). During the study five patients died (two from lupus flare, one from cardiomyopathy, two from infections). Four patients had endstage renal failure (ESRF) (one died during a lupus flare). All deaths and end-stage renal failure occurred in the Class IV nephritis group. Chronic organ damage was infrequent in the survivors. The actuarial patient survival rates at 5, 10 and 15 years of age were 95.3, 91.8, and 91.8%, respectively. For Class IV nephritis patients, the survival rates without ESRF at 5, 10, and 15 years were 91.5, 82.3 and 76%, respectively. The survival and chronic morbidity rates of the Chinese SLE children in the present study are comparable to those of other published studies.postprin

The Misallocation Problem of Subsidized Housing: A Lesson from Hong Kong

Providing affordable housing has become one of China’s key national policy agenda items. The shared-equity model in Hong Kong, implemented since the late 1970s, has assisted many families in owning a home in the public housing market. However, little attention has been paid to their welfare after acquiring their subsidized units. This study aims to examine how shared-equity homeownership distorts residential mobility through in-kind subsidies. Panel data analysis reveals that the more in-kind subsidies owners receive, the longer they would hold on to their units in spite of spatial mismatches. Private owners, on the other hand, would trade their units without such distortion. Conceptually, the lower mobility of assisted owners could be interpreted as a new source of misallocation in Glaeser and Luttmer’s welfare analysis. Practically, this throws into question the sustainability of a subsidizing homeownership policy: does the government ultimately want assisted homeowners to move from public housing to private housing in the future (for which high mobility would be intended)? If so, new thinking on how to make in-kind subsidies transferable is needed

Policy Implications for Promoting the Adoption of Cogeneration Systems in the Hotel Industry: An Extension of the Technology Acceptance Mode

The use of cogeneration systems in the hotel industry leads to economic and environmental benefits, but its acceptance in the industry remains low. Hence, this study aimed to examine the factors that influence cogeneration system acceptance amongst hotel management. A cogeneration system acceptance model (CoSAM) was proposed by integrating the technology acceptance model with perceived cost, perceived benefit, risk perception, environmental awareness and facilitating conditions. The validity of the CoSAM was investigated using structural equation modelling based on 499 data points collected from hotel management personnel. Results showed that the intention to use the systems of hotel management personnel was positively determined by attitude towards using cogeneration systems, which was directly affected by perceived usefulness, risk perception and perceived benefit. Moreover, with perceived usefulness as a mediator, facilitating conditions and environmental awareness indirectly influenced attitude towards using cogeneration systems positively, while perceived cost indirectly influenced the attitude negatively. Based on the findings of this study, policy implications for promoting the adoption of cogeneration systems in the hotel industry were provided, thus saving energy and reducing the energy costs of hotels. This study is the first to remarkably contribute an in-depth understanding of the factors affecting cogeneration system acceptance to the literature

Five-year effectiveness of short messaging service (SMS) for pre-diabetes

Abstract Objective An observational post-randomized controlled trial (RCT) design was adopted to evaluate the long-term sustainability and maintenance of improved glycemic control, lipid profile, reduced progression to diabetes at 3-year following a 2-year short messaging service (SMS). We performed a naturalistic follow-up to the 104 participants of SMS intervention, a 2-year randomized controlled trial comparing the SMS to non-SMS for pre-diabetes. All participants were arranged screening for diabetes at 5-year assessment. Primary outcome of this post-RCT study was cumulative incidence of diabetes whereas secondary outcomes were the change in biometric data over a 5-year period. Results After a mean 57-month follow-up, 19 (18.3%) were lost to follow-up after the RCT period. Progression to diabetes occurred in 20 and 16 patients among the intervention and control group respectively, with no significant between-group difference (8.06 and 7.31 cases per 100 person years, respectively; Hazard Ratio in the intervention group, 1.184; 95% confidence interval, 0.612 to 2.288; p-value = 0.616). No significant effect of SMS on reduction in diabetes was observed in overall and pre-defined subgroups. The SMS intervention preserved the clinical benefits within the trial period but failed to transform from treatment efficacy to long-term effectiveness beyond 2 years after intervention. Trial registration ClinicalTrials.gov Identifier NCT01556880, retrospectively registered on March 16, 201

Different mechanisms of risperidone result in improved interpersonal trust, social engagement and cooperative behavior in patients with schizophrenia compared to trifluoperazine

Aim: Atypical antipsychotic treatment (e.g. risperidone) has been found to improve social functioning more than standard antipsychotic treatment. However, it is unclear which specific social behaviors are implicated in this improvement. The current study employed an interactive puzzle game to examine how social behaviors contribute to the improvement of social functioning by comparing patients receiving risperidone with those receiving trifluoperazine

Centrioles generate a local pulse of Polo/PLK1 activity to initiate mitotic centrosome assembly

Mitotic centrosomes are formed when centrioles start to recruit large amounts of pericentriolar material (PCM) around themselves in preparation for mitosis. This centrosome “maturation” requires the centrioles and also Polo/PLK1 protein kinase. The PCM comprises several hundred proteins and, in Drosophila, Polo cooperates with the conserved centrosome proteins Spd-2/CEP192 and Cnn/CDK5RAP2 to assemble a PCM scaffold around the mother centriole that then recruits other PCM client proteins. We show here that in Drosophila syncytial blastoderm embryos, centrosomal Polo levels rise and fall during the assembly process—peaking, and then starting to decline, even as levels of the PCM scaffold continue to rise and plateau. Experiments and mathematical modelling indicate that a centriolar pulse of Polo activity, potentially generated by the interaction between Polo and its centriole receptor Ana1 (CEP295 in humans), could explain these unexpected scaffold assembly dynamics. We propose that centrioles generate a local pulse of Polo activity prior to mitotic entry to initiate centrosome maturation, explaining why centrioles and Polo/PLK1 are normally essential for this process

The Effect of Centrifugal Force in Quantification of Colorectal Cancer-Related mRNA in Plasma Using Targeted Sequencing

In our previous study, we detected the effects of centrifugal forces on plasma RNA quantification by quantitative reverse transcription PCR. The aims of this study were to perform targeted mRNA sequencing and data analysis in healthy donors' plasma prepared by two centrifugation protocols and to investigate the effects of centrifugal forces on plasma mRNA quality and quantity. Targeted mRNA sequencing was performed using a custom panel with 108 colorectal cancer-related genes in 18 healthy donors' plasma that prepared by (1) 3,500 g for 10 min at 4°C and (2) 1,600 g for 10 min at 4°C followed by 16,000 g for 10 min at 4°C. Results showed that plasma ribosomal RNA was detected in 16/18 (88.9%) 3,500 g and 6/18 (33.3%) 1,600 g followed by 16,000 g centrifuged plasma. For targeted sequencing, 75/108 (69.4%) and 86/108 (79.6%) genes were detected in 3,500 and 1,600 g followed by 16,000 g, respectively, while 16/108 (14.8%) genes were not detected in both centrifugations. Detailed analysis showed that 2 of 108 (1.85%) genes showed lower expressions in 3,500 g than in 1,600 g followed by 16,000 g. The median expressions of genes in 3,500 g were positively correlated with the expressions in 1,600 g followed by 16,000 g (R2 = 0.9471, P &lt; 0.0001, Spearman rank correlation). Meanwhile, plasma samples were not distinctively clustered based on centrifugal forces according to hierarchical clustering. Targeted mRNA sequencing and subsequent data analysis were performed in this study to investigate the effects of two different centrifugal forces that are commonly used in plasma collection. Our targeted sequencing results help to understand the centrifugal force effects on plasma mRNA, and these findings show that the centrifugation protocol for plasma mRNA research using targeted sequencing can be standardized which facilitates multicenter studies for comparison and quality assurance in the future