7,088 research outputs found

    Tropomyosin receptor kinase inhibitors in the management of sarcomas.

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    Purpose of review Genetic aberrations resulting in tropomyosin receptor kinase (TRK) fusion proteins can drive oncogenesis and are postulated to occur in up to 1% of solid tumours. However, TRK fusions in adult sarcomas are rare and there is a significant challenge in identifying patients with sarcomas harbouring TRK fusions in the clinical setting. Despite a recent European Society of Medical Oncology consensus article regarding screening of tumours for TRK fusions, economical and practical limitations present a barrier to widespread screening of sarcomas.Recent findings Larotrectinib and entrectinib are pan-TRK inhibitors which have both received FDA approval for the management of solid tumours harbouring NTRK fusions. Initial results of a number of clinical trials have demonstrated promising efficacy and safety data, including dramatic and durable responses in patients with sarcomas. As such, TRK inhibitors represent a promising treatment option in a small cohort of adult sarcoma patients, where currently treatment options are limited. The emergence of acquired resistance is a concern associated with TRK inhibitor therapy and a number of second-generation agents targeting TRK kinase mutations driving acquired resistance have entered early-phase clinical trials.Summary With the growing appreciation of the implications of TRK fusions, this review will summarize the emerging clinical trial data of TRK inhibitors in sarcomas. Although in their infancy, clinical trial results are encouraging, and as further results and analyses are released, we will have a greater understanding of their impact on clinical practice and the management of patients with sarcomas

    Sample entropy analysis of EEG signals via artificial neural networks to model patients' consciousness level based on anesthesiologists experience.

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    Electroencephalogram (EEG) signals, as it can express the human brain's activities and reflect awareness, have been widely used in many research and medical equipment to build a noninvasive monitoring index to the depth of anesthesia (DOA). Bispectral (BIS) index monitor is one of the famous and important indicators for anesthesiologists primarily using EEG signals when assessing the DOA. In this study, an attempt is made to build a new indicator using EEG signals to provide a more valuable reference to the DOA for clinical researchers. The EEG signals are collected from patients under anesthetic surgery which are filtered using multivariate empirical mode decomposition (MEMD) method and analyzed using sample entropy (SampEn) analysis. The calculated signals from SampEn are utilized to train an artificial neural network (ANN) model through using expert assessment of consciousness level (EACL) which is assessed by experienced anesthesiologists as the target to train, validate, and test the ANN. The results that are achieved using the proposed system are compared to BIS index. The proposed system results show that it is not only having similar characteristic to BIS index but also more close to experienced anesthesiologists which illustrates the consciousness level and reflects the DOA successfully.This research is supported by the Center forDynamical Biomarkers and Translational Medicine, National Central University, Taiwan, which is sponsored by Ministry of Science and Technology (Grant no. MOST103-2911-I-008-001). Also, it is supported by National Chung-Shan Institute of Science & Technology in Taiwan (Grant nos. CSIST-095-V301 and CSIST-095-V302)

    The Cambridge Prognostic Groups for improved prediction of disease mortality at diagnosis in primary non-metastatic prostate cancer: a validation study.

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    Purpose: To validate a new 5-tier prognostic classification system to better discriminate cancer specific mortality in men diagnosed with primary non-metastatic prostate cancer. Patients and Methods: We applied a recently described 5 strata model (Cambridge Prognostic Groups-CPG) in 2 international cohorts and tested prognostic performance against the current standard 3 strata classification of low, intermediate or high-risk disease. Diagnostic clinico-pathological data of men from Prostate Cancer Data Base Sweden (PCBaSe) and the Singapore Health Study were used. The main outcome measure was prostate cancer mortality (PCM) stratified by age group and treatment modality. Results: The PCBaSe cohort included 72,337 men, of whom 7,162 died of prostate cancer. The CPG model successfully classified men with different risks of PCM with competing risk-regression confirming significant intergroup distinction (p<0.0001). The CPGs were significantly better at stratified prediction of PCM compared to the current 3-tier system (C-Index 0.81 vs. 0.77, p<0.0001). This superiority was maintained for every age group division (p<0.0001). Also in the ethnically different Singapore cohort of 2,550 men with 142 prostate cancer deaths, the CPG model outperformed the 3 strata categories (C-Index 0.79 vs. 0.76, p<0.0001). The model also retained superior prognostic discrimination in treatment sub-groups - Radical prostatectomy (n=20,586): C-Index 0.77 vs. 074, radiotherapy (n=11,872): C-Index 0.73 vs. 0.68, and conservative management (n=14,950): C-Index 0.74 vs. 0.73. The CPG groups that sub-divided the old intermediate (CPG2 vs. CPG3) and high-risk categories (CPG4 vs.CPG5) significantly discriminated PCM outcomes after radical therapy or conservative management (p<0.0001). Conclusion: This validation study of nearly 75,000 men, confirms that the CPG 5-tiered prognostic model has superior discrimination in predicting prostate cancer death over the 3-tier model across different age and treatment groups. Crucially, it identifies distinct sub-groups of men within the old intermediate-risk and high-risk criteria who have very different prognostic outcomes We therefore propose adoption of the CPG model as a simple to use but more accurate prognostic stratification tool to help guide management for men with newly diagnosed prostate cancer

    In situ reconstruction of long-term extreme flooding magnitudes and frequencies based on geological archives

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    © 2019 Extreme flooding magnitudes and frequencies are essentially related to assessment of risk and reliability in hydrological design. Extreme flooding and its discharge are highly sensitive to regional climate change. Presently, its discharge can be reconstructed by a geological archive or record along the river valley. Two units of typical extreme flooding deposits (EFDs) carrying long-term information preserved in the Holocene loess–palaeosol sequence were found at Xipocun (XPC), which is located in Chengcheng County, China. It is situated in the downstream section of the Beiluohe (hereafter BLH) River. Based on multiple sedimentary proxy indices (grain-size distribution (GSD), magnetic susceptibility (MS), and loss-on-ignition (LOI), etc.), EFDs were interpreted as well-sorted clayey silt in suspension. They were then deposited as a result of riverbank flooding in a stagnant environment during high water level. Through the Optically Stimulated Luminescence (OSL) dating technique and stratigraphic correlations, chronologies of two identified extreme flooding periods were 7600–7400 a B.P. and 3200–3000 a B.P. Two phases of extreme flooding occurrence under climate abnormality scenarios were characterized as having high frequencies of hydrological extremes in river systems. According to simulation and verification using the Slope–Area Method and Hydrologic Engineering Center's River Analysis System (HEC-RAS) model, the extreme flooding discharges at the XPC site were reconstructed between 9625 m 3 /s and 16,635 m 3 /s. A new long-term flooding frequency and peak discharge curve, involved gauged flooding, historical flooding at Zhuangtou station and in situ reconstructed extreme flooding events, was established for the downstream BLH River. The results improve the accuracy of low-frequency flooding risk assessment and provide evidence for predicting the response of fluvial systems to climate instability. Thus, this improves the analysis of the BLH River watershed

    A potential risk of overestimating apparent diffusion coefficient in parotid glands

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    Objectives: To investigate transient signal loss on diffusion weighted images (DWI) and overestimation of apparent diffusion coefficient (ADC) in parotid glands using single shot echoplanar DWI (EPDWI). Materials and Methods: This study enrolled 6 healthy subjects and 7 patients receiving radiotherapy. All participants received dynamic EPDWI with a total of 8 repetitions. Imaging quality of DWI was evaluated. Probability of severe overestimation of ADC (soADC), defined by an ADC ratio more than 1.2, was calculated. Error on T2WI, DWI, and ADC was computed. Statistical analysis included paired Student t testing and Mann-Whitney U test. A P value less than 0.05 was considered statistically significant. Results: Transient signal loss was visually detected on some excitations of DWI but not on T2WI or mean DWI. soADC occurred randomly among 8 excitations and 3 directions of diffusion encoding gradients. Probability of soADC was significantly higher in radiotherapy group (42.86%) than in healthy group (24.39%). The mean error percentage decreased as the number of excitations increased on all images, and, it was smallest on T2WI, followed by DWI and ADC in an increasing order. Conclusions: Transient signal loss on DWI was successfully detected by dynamic EPDWI. The signal loss on DWI and overestimation of ADC could be partially remedied by increasing the number of excitations. © 2015 Liu et al.published_or_final_versio

    Nutrients removal performance and sludge properties using anaerobic fermentation slurry from food waste as an external carbon source for wastewater treatment

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    © 2018 Elsevier Ltd Enhancement of nitrogen and phosphate removal using thermophilic fermentation slurry from food waste (FSFW) as external carbon source was investigated. Based on the batch tests, the soluble and particulate fractions of the FSFW acted as easily and slowly biodegradable carbon sources, respectively, and the fermented slurry showed the combined nutrients removal properties of soluble and solid organics. During the long-term operation of a sequencing batch reactor (SBR) with FSFW for wastewater treatment, the sludge particle size increased obviously, the bacterial metabolic capacity improved significantly, and some functional microorganisms were enriched selectively, which significantly promoted the nitrogen removal efficiency (approximately 90%) by enhancing the anoxic denitrification and simultaneous nitrification and denitrification (SND) processes. Moreover, high phosphate removal efficiency (above 98%) was achieved through the aerobic and anoxic phosphate accumulation processes. Thus, using the FSFW as supplementary carbon source is a suitable solution for both food waste disposal and wastewater treatment

    Spectroscopic characteristics of dissolved organic matter from aquaculture wastewater and its interaction mechanism to chlorinated phenol compound

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    © 2017 In present study, the characteristics of dissolved organic matter (DOM) from aquaculture wastewater and its interaction to 4-chlorophenol (4-CP) was evaluated via a spectroscopic approach. According to EEM-PARAFAC analysis, two components were derived from the interaction samples between DOM and 4-CP, including humic-like and fulvic-like substances for component 1 and protein-like substances for component 2, respectively. The fluorescence intensity scores of two PARAFAC-derived components decreased with increasing 4-CP concentration. Synchronous fluorescence coupled to two-dimensional correlation spectroscopy (2D-COS) implied that DOM fractions quenched different degrees and occurred in the order of fulvic-like and humic-like fractions > protein-like fraction. Moreover, the quenching mechanisms were mainly caused by static quenching process. It was also found from Fourier transform infrared spectroscopy that the main functional groups for interaction between 4-CP and DOM were O–H stretching and C[dbnd]O stretching vibration. The obtained results provided a spectroscopic approach for characterizing the interaction between organic pollutant and DOM from aquaculture wastewater

    Effect of additional food waste slurry generated by mesophilic acidogenic fermentation on nutrient removal and sludge properties during wastewater treatment

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    © 2019 Elsevier Ltd Fermentation slurry from food waste (FSFW) generated by acidogenic fermentation at mesophilic temperature was utilized to improve the nutrients removal from wastewater. Organic acids (such as lactate and volatile fatty acids) in the FSFW behaved as readily biodegradable carbon sources, while the particulate and macromolecular organics acted as slowly biodegradable carbon sources during denitrification processes. The FSFW dosage significantly influenced the nitrogen removal performance, and a C/N ratio (in terms of chemical oxygen demand to nitrogen ratio) of 8 could achieve complete denitrification in the batch tests. In a sequencing batch reactor (SBR) using FSFW for long-term wastewater treatment, extracellular polymeric substances (EPS) gradually accumulated, sludge particle size significantly increased, and microbial communities were selectively enriched, which contributed to promoting the nitrogen (>80%) and phosphate (90.1%) removal efficiencies. Overall, the FSFW produced by acidogenic fermentation under mesophilic temperature served as an excellent intermediary between FW valorization and wastewater treatment

    Flexible and Accurate Simulation of Radiation Cooling with FETD Method

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    Thermal management and simulation are becoming increasingly important in many areas of engineering applications. There are three cooling routes for thermal management, namely thermal conduction, thermal convection and thermal radiation, among which the first two approaches have been widely studied and applied, while the radiation cooling has not yet attracted much attention in terrestrial environment because it usually contributes less to the total amount of thermal dissipation. Thus the simulation method for radiation cooling was also seldom noticed. The traditional way to simulate the radiation cooling is to solve the thermal conduction equation with an approximate radiation boundary condition, which neglects the wavelength and angular dependence of the emissivity of the object surface. In this paper, we combine the heat conduction equation with a rigorous radiation boundary condition discretized by the finite-element time-domain method to simulate the radiation cooling accurately and flexibly. Numerical results are given to demonstrate the accuracy, flexibilities and potential applications of the proposed method. The proposed numerical model can provide a powerful tool to gain deep physical insight and optimize the physical design of radiation cooling
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