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Adjuvant therapy (AT) and neoadjuvant therapy (NAT) are standard treatments for pancreatic ductal adenocarcinoma (PDAC) depending on the status of the disease. However, whether AT improves survival after NAT and radical resection in all TNM stages remains unclear. We utilized the Surveillance, Epidemiology, and End Results (SEER) database (2010–2019) for PDAC patients who underwent radical surgery and applied Pearson's chi-square test, multivariate and univariate Cox regression, Kaplan-Meier plot, Log-rank tests, and propensity score matching (PSM) for analysis. Given PSM after enrolling 13,868 PDAC patients, significant differences in survival were identified between AT and neoadjuvant therapy plus adjuvant therapy (NATAT) (p = 0.023) as well as between NAT and NATAT (p < 0.001). According to the AJCC 8th TNM stage, a survival advantage associated with NATAT was exclusively observed in stage III and IV disease, except for T4N0M0. Some stage IV patients receiving NATAT exhibited comparable survival to their counterparts without metastasis. In this retrospective cohort study, we demonstrated that patients harboring tumors in late TNM stages, including N2 resectable PDAC, might have better survival from NATAT, and that certain patients with M1 disease might still benefit from comprehensive systemic therapy and radical resection. [ABSTRACT FROM AUTHOR]

Abstract\nHIGHLIGHTSCFRP laminates are commonly used in aircraft structures due to their high structural efficiency. The phenomenon-based failures of CFRP laminates have poor predictability for the complex failure process with buckling and matrix fractures. This work carried out seven shear tests of CFRP laminates. It also attempts to reveal its failure characteristic points by directly modeling the measured strain data based on the relative deformation distribution catastrophe. The failure characteristic points are revealed by constructing the stressing state modes/parameters and applying the clustering analysis criterion, whose accuracy can be verified by comparing the shear failure characteristic points of nondestructive/impacted CFRP laminates.Conduct 7 nondestructive/impacted CFRP laminates shear tests.Construct the modes and characteristic parameters characterizing the shear-stressing state of CFRP laminates.Applying clustering analysis criterion to reveal the characteristic loads of CFRP laminates.Verify the accuracy and robustness of the characteristic loads. [ABSTRACT FROM AUTHOR]

As the number of patients increases, physicians are dealing with more and more cases of degenerative spine pathologies on a daily basis. To reduce the workload of healthcare professionals, we propose a modified Swin-UNet network model. Firstly, the Swin Transformer Blocks are improved using a residual post-normalization and scaling cosine attention mechanism, which makes the training process of the model more stable and improves the accuracy. Secondly, we use the log-space continuous position biasing method instead of the bicubic interpolation position biasing method. This method solves the problem of performance loss caused by the large difference between the resolution of the pretraining image and the resolution of the spine image. Finally, we introduce a segmentation smooth module (SSM) at the decoder stage. The SSM effectively reduces redundancy, and enhances the segmentation edge processing to improve the model’s segmentation accuracy. To validate the proposed method, we conducted experiments on a real dataset provided by hospitals. The average segmentation accuracy is no less than 95%. The experimental results demonstrate the superiority of the proposed method over the original model and other models of the same type in segmenting the spinous processes of the vertebrae and the posterior arch of the spine. [ABSTRACT FROM AUTHOR]