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Abstract: Purpose: Although Recepteur d’Origine Nantais (RON), a member of the MET receptor tyrosine kinase family, is overexpressed and constitutively active in some primary tumors and tumor cell lines, its expression pattern and clinical significance in colorectal cancer are not well documented. Methods: By using immunohistochemical staining, we examined RON and MET expression in 135 colorectal cancer specimens and investigated the association of the immunoreactivity of both receptors with colorectal cancer clinical parameters and prognosis. Results: We found moderate to strong expression in 99 cases (73 percent) for RON and 97 cases (72 percent) for MET. Univariate analysis showed that increased immunoreactivity of RON or MET was associated with shorter patient survival and that moderate to strong coexpression of both receptors was associated with a significantly worse prognosis. Multivariate Cox analysis showed that the risk of tumor recurrence for patients with high-RON/high-MET expression was approximately 11 times greater than for patients with low-RON/low-MET expression (P = 0.001). In addition, RON and MET expression levels were positively correlated (P ≤ 0.001; τ = 0.306). Conclusions: The crosstalk between RON and MET in colorectal cancer seems important. Evaluating the expression patterns of RON and MET was predictive of clinical outcome for patients with colorectal cancer.

ObjectiveA common difficulty at the end of life (EOL) is to determine an appropriate service model, such as hospice share care (HSC), hospice inpatient care (HIC) and hospice home care (HHC). This study aimed to recommend the appropriate hospice delivery model based on the physical, psychosocial and spiritual needs of patients referred for hospice care.MethodsThis cohort study included patients who received only one kind of hospice delivery model between 2006 and 2020. Data were analysed with descriptive statistics, Fisher’s exact test, non-parametric analysis of variance, Kaplan-Meier curves and Cox proportional hazards model that determined the patients’ clinical characteristics for a hospice delivery model and overall survival.ResultsA total of 8874 hospice patients were recruited, of which 7076 (79.7%) were HSC patients, 918 (10.4%) were HIC patients and 880 (9.9%) were HHC patients. There were significant differences in the physical symptoms and demographic, psychosocial and spiritual factors among the three groups (p<0.001). The patients who received the HHC were less to have dyspnoea (18.5%) and dysphagia (28.7%). The HIC patients showed higher severity of symptoms and experienced greater psychosocial distress (73.2%). The HSC is appropriate for noncancer patients . Patients with cancer were associated with less dyspnoea (32.4%) and dysphagia (46.5%). Patients with lung cancer who received the HHC had better survival than those who received other types of hospice care (HR=0.75, 95% CI: 0.66 to 0.86, p<0.001).ConclusionsThis study provides guidance regarding the appropriate hospice service model, based on individualised palliative needs, targeting improvement in EOL care.

Background: Obesity increases surgical risks in various abdominal surgeries and its impact on open pancreaticoduodenectomy (OPD) and minimally invasive pancreaticoduodenectomy (MIPD) remains unknown. This study aimed to compare the surgical outcomes of OPD and MIPD in obese and non-obese patients by propensity score matching (PSM) analysis during the implementation of MIPD. Methods: We retrospectively reviewed all pancreaticoduodenectomies from December 2014 to May 2021. Obesity was defined as body mass index > 25 kg/m2according to World Health Organization International Obesity Task Force. PSM was used to minimize the selection bias of MIPD. Results: Among 462 pancreaticoduodenectomies (339 OPDs, 123 MIPDs), there were 313 patients in the non-obese group (MIPD: 78, OPD: 235) and 149 patients in the obese group (MIPD: 45, OPD: 104). After PSM, there were 70 MIPD/106 OPD patients in the non-obese group and 38 MIPD/54 OPD patients in the obese group. The obese MIPD patients had more fluid collection (36.8% vs 9.8%, p= 0.002), a higher Clavien–Dindo (CD) grade (p= 0.007), more major complications (42.1% vs 14.8%, p= 0.004), and longer operative times (306 min vs 264 min, p&lt; 0.001) than the obese OPD patients. The non-obese MIPD patients had lower CD grades (p= 0.02), longer operative times (294 vs 264 min, p&lt; 0.001), and less blood loss (100 mL vs 200 mL) than the non-obese OPD patients. MIPD was a strong predictor of major complication (CD ≥ 3) in obese patients (odds ratio 3.11, 95% CI: 1.40–6.95, p= 0.005). Conclusions: Minimally invasive approaches deteriorate the CD grade, fluid collection, and major complications in obese patients undergoing pancreaticoduodenectomy during the initial development period. Non-obese patients may benefit from MIPD over OPD in terms of less blood loss and lower CD grades. The impact of BMI on MIPD should be considered when assessing the surgical risks. Graphical abstract:

Urinary tract infections (UTIs) are the most common bacterial infection in young children. This study aimed to formulate nomogram plots for clinicians to predict UTIs in children aged <3 years by evaluating the risk factors for UTIs in these children.

To investigate whether indicators of cortical excitability are good biomarkers of seizure controllability in temporal lobe epilepsy (TLE). Three groups of subjects were recruited: those with poorly controlled (PC) TLE (N= 41), well‐controlled (WC) TLE (N= 71), and healthy controls (N= 44). Short‐ and long‐latency recovery curves were obtained by paired‐pulse transcranial magnetic stimulation. Linear mixed effect models were used to study the effects of group, interstimulus interval (ISI), and antiepileptic drugs on long‐interval intracortical inhibition (LICI) and short‐interval intracortical inhibition (SICI) and intracortical facilitation (ICF). The mixed effect model that did not incorporate antiepileptic drugs showed that group and ISI were significant factors for LICI and SICI/ICF. LICI in the healthy control group was greater than in the two epilepsy groups, and the difference was significant at ISIs of 50, 150, and 200 msec. In contrast, SICI/ICF in the PC group was greater than in the healthy control and WC groups, and the difference was significant at an ISI of 15 msec. However, due to large variance, it was difficult to identify a cutoff value with both good sensitivity and good specificity. Incorporating the information of antiepileptic drugs to the mixed effect model did not change the overall results. Although LICI and SICI/ICF parameters were significantly different at the group level, they may not be suitable biomarkers for the controllability of TLE at the subject level.

This study aimed to assess the effect of atosiban on in vitro fertilization (IVF) pregnancy outcome among women with both endometriosis and adenomyosis, and compared it to that of patients with endometriosis but without adenomyosis and that of patients with tubal factor only.

Abnormalities in atrial myocardium increase the likelihood of arrhythmias, including atrial fibrillation (AF). The deposition of misfolded protein, or amyloidosis, plays an important role in the pathophysiology of many diseases, including human cardiomyopathies. We have shown that genes implicated in amyloidosis are activated in a cellular model of AF, with the development of preamyloid oligomers (PAOs). PAOs are intermediates in the formation of amyloid fibrils, and they are now recognized to be the cytotoxic species during amyloidosis. To investigate the presence of PAOs in human atrium, we developed a microscopic imaging-based protocol to enable robust and reproducible quantitative analysis of PAO burden in atrial samples harvested at the time of elective cardiac surgery. Using PAO- and myocardial-specific antibodies, we found that PAO distribution was typically heterogeneous within a myocardial sample. Rigorous imaging and analysis protocols were developed to quantify the relative area of myocardium containing PAOs, termed the Green/Red ratio (G/R), for a given sample. Using these methods, reproducible G/R values were obtained when different sections of a sample were independently processed, imaged, and analyzed by different investigators. This robust technique will enable studies to investigate the role of this novel structural abnormality in the pathophysiology of and arrhythmia generation in human atrial tissue.

Abstract: Sample size determination is essential to planning clinical trials. Jung (2008) established a sample size calculation formula for paired right-censored data based on the logrank test, which has been well-studied for comparing independent survival outcomes. An alternative to rank-based methods for independent right-censored data, advocated by Pepe and Fleming (1989), tests for differences between integrated weighted Kaplan–Meier estimates and is more sensitive to the magnitude of difference in survival times between groups. In this paper, we employ the concept of the Pepe–Fleming method to determine an adequate sample size by calculating differences between Kaplan–Meier estimators considering pair-wise correlation. We specify a positive stable frailty model for the joint distribution of paired survival times. We evaluate the performance of the proposed method by simulation studies and investigate the impacts of the accrual times, follow-up times, loss to follow-up rate, and sensitivity of power under misspecification of the model. The results show that ignoring the pair-wise correlation results in overestimating the required sample size. Furthermore, the proposed method is applied to two real-world studies, and the R code for sample size calculation is made available to users. [Copyright &y& Elsevier]

In order to analysis thermal stress of mass concrete accurately, material properties of mass concrete are studied by numerical simulation method, and the equivalent age is introduced to describe the mechanical properties of concrete. The calculation models of concrete mechanical parameters are summarized, and then the calculation procedures are established on the basis of equivalent age. In this way, the temperature and temperature history are considered in these models. Meanwhile, the governing equation and computer program of the thermal stress based on the equivalent age are developed. The comparison of the numerical example using proposed method and conventional FEM method shows that the proposed method performs more adaptable and accurate.

Sample size determination is an important issue in the experimental design of biomedical research. Because of the complexity of RNA-seq experiments, however, the field currently lacks a sample size method widely applicable to differential expression studies utilising RNA-seq technology. In this report, we propose several methods for sample size calculation for single-gene differential expression analysis of RNA-seq data under Poisson distribution. These methods are then extended to multiple genes, with consideration for addressing the multiple testing problem by controlling false discovery rate. Moreover, most of the proposed methods allow for closed-form sample size formulas with specification of the desired minimum fold change and minimum average read count, and thus are not computationally intensive. Simulation studies to evaluate the performance of the proposed sample size formulas are presented; the results indicate that our methods work well, with achievement of desired power. Finally, our sample size calculation methods are applied to three real RNA-seq data sets.

Abstract: In clinical trials, information about certain time points may be of interest in making decisions about treatment effectiveness. Therefore, rather than comparing entire survival curves, researchers may wish to focus the comparison on fixed time points with potential clinical utility. For two independent samples of right-censored data, compared survival probabilities at a fixed time point by studying a number of tests based on transformations of the Kaplan–Meier estimators of the survival function. To compare the survival probabilities at a fixed time point for paired right-censored data or clustered right-censored data, however, their approach requires modification. In this paper, we extend the statistics to accommodate possible within-pair and within-cluster correlation. We use simulation studies to present comparative results. Finally, we illustrate the implementation of these methods using two real data sets. [ABSTRACT FROM AUTHOR]