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Cancer of unknown primary (CUP) is a metastatic syndrome with an unidentifiable primary tumor even after comprehensive clinical and pathological investigations, accounting for approximately 2%-5% of all newly diagnosed cancers. CUP has some common features including aggressiveness, early dissemination and poor prognosis. With the application of novel molecular tests and drugs, the diagnostic value of gene expression assay and genomic tests in characterizing the molecular features has become increasingly prominent, and new treatment options such as molecular-guided targeted therapy and immunotherapy have become available. This article reviewed the clinical trials of CUP reported at 2023 European Society for Medical Oncology (ESMO) Congress.

Background and purpose: The prognosis of malignant melanoma (MM) in China and Asia is significantly worse than that of European and American populations, mainly because acral melanoma (AM) is inferior to cutaneous melanoma (CM) in terms of biological behavior, clinical features, prognosis, and efficacy of drugs (mainly immunotherapy). Certain changes have occurred in the last 5 years in the choice of surgical and drug-adjuvant treatment for MM. This study retrospectively analyzed the survival outcomes of Chinese CM and AM patients after surgical treatment in a single cancer center for the past five years. Methods:Data of melanoma patients undergoing surgical treatment were retrospectively collected from 2017 to 2021 in Fudan University Shanghai Cancer Center. The basic clinical characteristics, pathological features, lymph node tumor burden and survival information were carefully collected from medical document. Patients with mucosal subtype, unknown primary sites, or follow-up less than 6 months were excluded. Survival analysis and multivariable Cox regression analysis were performed to explore prognosis and associated risk factors. Results:Totally 585 patients were enrolled, including 397 AM and 188 CM patients. The median age was 59 (19-89) years, and 54% were female. AM and CM patients differed in gender, age, primary tumor location, gene mutation distribution and adjuvant therapy, but not in tumor burden associated factors including the Breslow thickness, ulceration and lymph node involvment. The median follow-up time was 24 months, and the median relapse-free survival (mRFS) was 36 months, with 1-year and 2-year RFS of 75.6% and 61.2%, respectively. However, there was no statistically significant difference in prognosis between the two subtypes. Primary ulceration (HR=2.265, 95% CI: 1.257-4.080), NRAS mutation (HR=1.816, 95% CI: 1.211-2.725) and advanced N stage (HR of N1, N2 and N3 versus N0 were 1.850, 4.085 and 4.191, respectively) were independent prognostic risk factors for RFS in AM; while the protective factors were female (HR=0.636, 95% CI: 0.433-0.933) and upper extremity primary lesions (HR=0.259, 95% CI: 0.105-0.639). Independent risk factors for RFS in CM included primary ulceration (HR=4.073, 95% CI: 1.718-9.654), and later N stage (HR=5.482, 95% CI: 2.385-12.601 for N3 stage). Conclusion: High tumor burden of primay lesion still deteriorates overall outcomes for both AM and CM, while harboring NRAS mutation might suggest even worse outcome for AM.

Background and purpose: For cutaneous and acral malignant melanoma, sentinel lymph node biopsy (SLNB) is an effective tool to evaluate the situation of regional lymph node metastasis and to determine the pathological stage. As an important part of the standard procedure for surgical diagnosis and treatment, SLNB has been recommended in major guidelines and already has a ten-year clinical application. Since the introduction of targeted therapy and immune therapy for malignant melanoma in 2017, the prognosis of patients has been significantly improved. This study aimed to collect the clinical data of Chinese malignant melanoma cases in recent five years so as to discover, in the era of new drug treatment, the significance of sentinel lymph node (SLN) status in clinical application and its influence on survival outcome. Methods: Data of 381 patients with histologically diagnosed malignant melanoma were retrospectively collected from 2017 to 2021 in Fudan University Shanghai Cancer Center. SLNB was performed with wide resection of the primary lesion for each case, and follow-ups of at least 6 months were taken afterwards. Lymphoscintigraphy or methylene blue dye was applied for identification of SLN. Results: A total of 381 patients were included. The mean Breslow thickness was 3.10 mm, among the 381 patients, 69.8% with acral lesion, 59.7% with ulceration, 34.6% with positive SLN, and the median relapse-free survival (RFS) was 17 months. Patient’s survival was significantly influenced by SLN status. Patients with more than 2 biopsied SLN had significantly better RFS in subgroups of N1a stage and T4 stage. There was no significant difference in RFS between patients who received complete lymph node dissection (CLND) and those who did no, and the latter even showed better RFS in subgroups of SLN biopsied number >2 and SLN micrometastasis diameter

The corona virus disease 2019 (COVID-19) pandemic continues to severely impact healthcare systems around the world, and patients with cancer are even worse affected owing to compromised immune status and greater exposure risk. In the present review, we retrieved the relevant literature including guidelines and consensuses directly related to the purpose of this study from the PubMed database, and then summarized the research data on cancer and COVID-19, aiming to discuss the personal protection, systemic anti-cancer therapy, outcome of co-infection, and the clinical management strategy in this population. We found that patients with malignant tumors had a higher chance of suffering COVID-19, co-infection of whom had an even worse clinical prognosis, especially for those with lung cancer or hematologic cancers. Systemic chemotherapy may delay the clearance of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) virus of human body, and thus have a negative impact on the clinical outcomes of COVID-19, while certain endocrine therapy and targeted drugs having limited or no impact. There has been no sufficient evidence for the impact of immune checkpoint therapy on the outcomes of COVID-19 till now. It is of great value to strengthen the personal protection of patients, adjust the anti-tumor treatments rationally and optimize the clinical management processes.

The hot blast distribution has a great effect on the smooth operation of the blast furnace (BF). The standard deviation of blast volume of every tuyere (SD-BVT) is generally considered as an indicator for evaluating the uniformity of hot blast distribution. Based on the simulation, under the condition that all tuyeres have the same diameter, four circumferential symmetrical areas with large blast volume appear at 0, 90, 180 and 270 deg in Ansteel No. 1 BF, the value of SD-BVT is 1.32. In order to improve the uniformity of hot blast distribution, the diameter of the tuyeres with the largest blast volume in these four areas is reduced by 5 mm in actual production, the value of SD-BVT is changed to 3.24, which indicates that the uniformity of blast volume distribution is deteriorated, and this result is inconsistent with actual production. The oxygen in hot blast reacts with the coke in front of tuyere to produce carbon monoxide, which determines the coke consumption rate in the BF. As the hot blast distribution is non-uniform, the burden height is varied in the BF. So, according to the four areas with large blast volume and four areas with small blast volume in the BF, the BF is divided into eight areas and the standard deviation of areal burden height (SD-ABH) is used to evaluate the hot blast distribution. The calculation results show that, the value of SD-ABH is 0.41 under the tuyeres have the same diameter, but the value of SD-ABH reduced to 0.33 in actual production, indicating a 20% increase in the uniformity of areal burden height. This result confirms the reasonableness of the on-site operation and demonstrates the effectiveness of this method. [ABSTRACT FROM AUTHOR]

The swirling flow generated by the swirling chamber of the split swirling flow tundish can effectively promote the collision and growth of inclusions. The split swirling flow tundish can promote the removal of inclusions by improving the flow field. In this work, the CFD-PBM coupling model was applied to simulate the transport, aggregation, and floating removal of inclusions in the split swirling flow tundish, and compared with a same-size T-type tundish. The results indicated that the swirl flow can effectively promote the collision-coalescence of inclusions. Comparing the flow field of the split swirl tundish and the T-type tundish, the dead flow fraction of the two tundishes is similar, but the plug flow fraction of the split swirling flow tundish is 4.5% larger than the T-type tundish. Monitoring the volume concentration of inclusions at the outlet of the two tundishes, the inclusion removal rate of the T-shaped tundish and split swirling flow tundish are 29.28% and 34.33%, respectively. Therefore, the split swirling flow tundish is stronger than the T-shaped tundish in removing inclusion. Especially in the removal of small inclusions, the number density of 1.00–28.64 µm inclusions at the outlet of the split swirling flow tundish is 29.97%–65.91% lower than the T-type tundish, the split swirling flow tundish enhances the removal of small inclusions. [ABSTRACT FROM AUTHOR]

In brain-computer interface (BCI) systems, challenges are presented by the recognition of motor imagery (MI) brain signals. Established recognition approaches have achieved favorable performance from patterns like SSVEP, AEP, and P300, whereas the classification methods for MI need to be improved. Hence, seeking a classification method that exhibits high accuracy and robustness for application in MI-BCI systems is essential. In this study, the Sparrow search algorithm (SSA)-optimized Deep Belief Network (DBN), called SSA-DBN, is designed to recognize the EEG features extracted by the Empirical Mode Decomposition (EMD). The performance of the DBN is enhanced by the optimized hyper-parameters obtained through the SSA. Our method's efficacy was tested on three datasets: two public and one private. Results indicate a relatively high accuracy rate, outperforming three baseline methods. Specifically, on the private dataset, our approach achieved an accuracy of 87.83%, marking a significant 10.38% improvement over the standard DBN algorithm. For the BCI IV 2a dataset, we recorded an accuracy of 86.14%, surpassing the DBN algorithm by 9.33%. In the SMR-BCI dataset, our method attained a classification accuracy of 87.21%, which is 5.57% higher than that of the conventional DBN algorithm. This study demonstrates enhanced classification capabilities in MI-BCI, potentially contributing to advancements in the field of BCI. [ABSTRACT FROM AUTHOR]