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Voyage charterparty arrangement (VCA) for river shipping is a common agreement between a shipowner and a charterer regarding the transportation of specific cargoes from one port to another via a tramp vessel. Optimizing VCA with the essential terms such as laytime and sailing speed of the vessel, is a crucial task for both parties to reduce potential disputes and achieve win-win outcomes. This paper models the problem from two perspectives: the VCA negotiation stage and execution stage. Firstly, according to the given probability distribution of port time, the theoretically optimal laytime is obtained by using textbook formulation of newsvendor problems (NVP). On this basis, considering the concerns about the inaccuracy of the given probability distribution and the adjustment measures taken by charterers and shipowners in reality, an integrated adjustment model is constructed to determine the optimal laytime in the VCA negotiation stage. Secondly, taking into account the vessel's uncertain lock crossing time, an operations coordination model with information sharing of the berth plan is established to obtain the optimal sailing speed under a certain confidence level in the VCA execution stage. Finally, a case study of chartering tramp vessels on the Yangtze River validates the applicability and effectiveness of the models proposed in this paper, and some important management insights are derived. The results show that establishing lower optimal speed limits and relatively shorter laytime when signing a contract with the shipowner of green river vessels is reasonable for the charterer. By notifying the shipowner of the berth plan after the green river vessel crosses through the lock, the charterer can avoid higher demurrage costs due to speeding-up. Operations coordination would be mutually beneficial without abusing the contract terms. Compared to traditional river vessels, it's more reasonable to reduce the benefits allocated to charterers from the deceleration of green river vessels by shipowners. • Optimizing voyage charterparty arrangement (VCA) for river tramp shipping. • Combining with judgmental adjustments in the optimal laytime model. • Establishing an operations coordination model by considering streamflow and uncertain lock crossing time. • Providing differentiated VCA strategies for green and traditional river vessels. [ABSTRACT FROM AUTHOR]

To develop and validate a simple metabolic score (Metabolic score, MS) for use in evaluating the prognosis of gastric cancer (GC) patients and dynamically monitor for early recurrence. We retrospectively collected general clinicopathological data of patients who underwent radical gastrectomy for GC between September 2012 and December 2017 in the Department of Gastric Surgery of the Fujian Medical University Union Hospital. Using a random forest algorithm to screen preoperative blood indicators into the Least absolute shrinkage and selection operator (LASSO) model, we developed a novel MS to predict prognosis. Data of 1974 patients were used to develop and validate the model. Total cholesterol (TCHO), bilirubin (TBIL), direct bilirubin (DBIL), and 15 other metabolic indicators had significant predictive value for the prognosis using the random forest algorithm. In the overall population, 533 patients (27.0%) had high and 1441 (73%) had low MS status. High MS status was related to tumor progression. The KM curves of 3-year OS and RFS for training set patients showed low MS had a better prognosis than high MS (OS: 79.4% vs 59.7%, P < 0.001; RFS: 76.0% vs 56.2%, P < 0.001). We have developed and validated MS to predict the long-term survival of GC patients and allow early monitoring of recurrence. This will provide physicians with simple, economical, and dynamic tumor monitoring information. Synopsis We've developed and validated MS to predict the long-term survival of GC patients and allow early monitoring of recurrence. This will provide economical, and dynamic tumor monitoring information. [ABSTRACT FROM AUTHOR]

This study aims to analyze the effect of textbook outcome (TO) on the long-term prognosis and adjuvant chemotherapy (AC) compliance of patients with gastric cancer (GC) in a single institute. Consecutive patients who underwent radical gastrectomy with pathological stage I-III at Union Hospital of Fujian Medical University from January 2010 to June 2017 were included. TO was defined as receiving a complete-potentially curative status, ≥15 lymph nodes examined, hospital stay ≤21 days, and freedom from intraoperative and postoperative complications, re-intervention in 30 days, 30-day readmission to the hospital or intensive care unit, and 30-day postoperative mortality. Totally 3993 patients were included, of which 3361 (84.2%) patients achieved TO. The overall, disease-specific, and recurrence-free survival of patients achieving TO were significantly better than those of patients without achieving TO (all P < 0.05). The total number of AC cycles was greater and the interval from surgery to first AC was shorter in the TO group compared with the Non-TO group. Age >65 years old, open surgery, pT3-4 stage, and total radical gastrectomy (TG) were identified as related high-risk factors for failure to achieve TO. Laparoscopic surgery facilitated TO achievement in high-risk groups. TO is a reliable indicator of favorable prognosis of patients with GC and contributes to postoperative chemotherapy compliance. Age ≤65 years old, non-TG, pT1-2 stage, and laparoscopic surgery may promote the achievement of TO. [ABSTRACT FROM AUTHOR]

Few studies have reported the association between the pattern and time point of recurrence in different groups stratified by age in postoperative survival of patients with gastric cancer. The clinicopathological data and recurrence data of 2028 patients with GC who underwent curative surgery from January 2010 to March 2015 were enrolled in this study. Patients were grouped according to age: young group (YG) (≤45 years old) (n = 180) and non-young group (OG) (>45 years old) (n = 1848). A total of 2028 patients were enrolled. The young group had better 5-year OS and DFS than the non-young group. In peritoneal recurrence, the cumulative incidence of recurrence in YG was higher than that in OG (P < 0.001). In distant recurrence, the cumulative incidence of recurrence YG was always lower than that of OG (P = 0.004). Recurrence hazard function varied over time between the two groups:in the peritoneal metastasis, the recurrence hazard for YG was higher and earlier than that of OG and the YG was observed during five years after surgery with two recurrence peaks in 8.5 months and in 41.5 months. In distant recurrence, the recurrence hazard for OG had an earlier and higher single peak than that of YG (6.0 months). The recurrence characteristics of patients with gastric cancer after curative resection between young group and older group are different. Personalized follow-up strategies should be developed according to the age and time point after operation for the early detection of recurrence and making decision for further treatment. [ABSTRACT FROM AUTHOR]

Effective classifiers for the prediction of individual adjuvant chemotherapy (AC) benefits are scarce. This study aimed to construct a useful classifier to predict the AC benefit and recurrence hazard based on preoperative hematological indices through a multicenter database. Multivariate analysis revealing GCRF (comprehensive deep learning classifier) as an independent prognostic factor associated with overall survival (OS) and disease-free survival (DFS). Locally advanced gastric cancer (LAGC) patients are categorized into the high-risk group (HRG) and low-risk group (LRG). In HRG, OS and DFS of the AC group are significantly higher than those of the non-AC group (all p˂0.05), whereas in LRG, OS and DFS of the AC group are comparable to those of the non-AC group (all p > 0.05). Furthermore, combined GCRF with 8th AJCC TNM staging system, only 650 (51.1%) patients can benefit most from AC among 1273 patients with pStage II-III. From the perspective of recurrence pattern, the recurrence rate of HRG is significantly higher than that of LRG in any recurrence type, including local recurrence, peritoneal recurrence, and distant recurrence (all p˂0.05). Furthermore, the mean time to peritoneal recurrence and lung metastasis in HRG is earlier than that in the LRG (p = 0.028 and 0.011, respectively). In summary, our novel classifier based on deep learning preoperative hematological indices can predict not only the AC benefit of LAGC patients, but also the recurrence hazard after surgery. This classifier is expected to be an effective supplement to the 8th AJCC TNM staging system for the prediction of AC benefits and is helpful for clinical decision in AC individual administration. Further large-scale western studies are warranted. [ABSTRACT FROM AUTHOR]

• we found that the materials with higher dielectric constants and higher dielectric conductivities allow for fast carrier movement and low consumption, which enhances the photocurrent signal and thus the electric field, leading to an enhanced SPR phenomenon. • The fiber Surface plasmon resonance (SPR) sensor based on TiO2 and bilayer Au nanoparticles (Au-NPs) sensitization is offered. • The sensitivity of the sensor reaches 9715 nm/RIU at refractive indices of 1.332–1.341. The fiber Surface plasmon resonance (SPR) sensor based on titanium dioxide(TiO 2) and Au nanoparticles (Au-NPs) sensitization is offered as a practical means of increasing the sensitivity and figure of merit (FOM). Through finite element simulation and experimental testing, it is found that in TiO 2 with high dielectric constant and high dielectric conductivity, the carrier movement is fast and consumption is low, which enhances the photocurrent signal and leads to charge redistribution, thus enhances the electric field; while the Au-NPs will stimulate the stronger Localized Surface plasmon resonance (LSPR) phenomenon, and both of them will undergo electric field resonance coupling. The sensitivity of the sensor is higher because its surface electric field is 3.67 times stronger than the conventional Au film sensor. When exposed to external conditions, the sensitivity can reach 9715 nm/RIU within the refractive index (RI) at 1.33213–1.34055, which is 4.69 times higher than a conventional Au film sensor. The FOM can reach 57.8 RIU-1, which is 2.05 times higher than the conventional Au film sensor. In addition, TiO 2 and Au-NPs on the surface of the sensor are less prone to collapse, and the stability test results show that the relative standard deviation (RSD) is 0.5929 %, which exhibits good reliability and stability. The structure of the sensor is very simple, relatively easy to fabricate, and has good applicability in the field of biochemical testing. [ABSTRACT FROM AUTHOR]

Liver cancer is a prevalent malignant tumor with high global incidence and mortality rates. Accurate segmentation of liver tumors is crucial for clinical diagnosis and treatment. In this study, we propose a novel network architecture called MSML-AttUNet, which achieves accurate segmentation and detection of liver tumors, fulfilling the diverse clinical demands. The network utilizes multi-layer dilated convolutions for multi-scale feature extraction, extending the receptive field of the convolutional kernel to encompass a wider scope of contextual information. To address diverse clinical needs, MSML-AttUNet introduces a multi-task learning strategy. On top of tumor segmentation, the network employs this strategy to predict multi-scale tumor boundaries, and detect the presence of tumors in the images. Simultaneously, we design a weighted joint loss function to balance the importance of different tasks and facilitate more precise localization and segmentation of tumor regions. Finally we upgrade the classical attention mechanism to the CBAM (Convolutional Block Attention Module) dual attention mechanism. CBAM can model both spatial and channel dimensions simultaneously, better capturing crucial features in the images. Experimental results demonstrate the superior performance of MSML-AttUNet in liver tumor segmentation tasks, achieving a Dice coefficient of 0.8774. This study presents a novel approach for liver tumor segmentation and detection in clinical settings, offering broad application prospects. • Multi-task learning strategies can meet the diverse needs of clinical practice and improve the efficiency of doctors. • MSML-AttUNet simultaneously achieves the task of tumor detection and predicts tumor boundaries at different scales while performing tumor segmentation. • MSML-AttUNet integrates information from different levels and types, enhancing the understanding of the network and the representation of image features. [ABSTRACT FROM AUTHOR]

• Scheduled route design considering navigational restrictions is studied. • Two models with node or arc variables modelling empty containers are proposed. • Linearization techniques are applied to obtain tolerance level-optimal solution. • The NP-hardness, two models equivalent and solution properties are proven. • The management opinions are given by real data scenes on the Yangtze River. This paper addresses the problem of designing scheduled route for river liner shipping services with empty container repositioning. Given estimated weekly demands, the goal is to determine ports to be called and the ship schedule, while considering navigational restrictions, in order to maximize a shipping company's profit. In this decision-making process, we propose a novel integrated approach that enables the shipping company to optimize liner service routes and ship schedule simultaneously, taking into account empty container repositioning. Two mixed integer programming models, the arc-based model and the node-based model, are established to simulate this problem, and linearization techniques are applied to solve the integrated models. We prove the strict equivalence of the two models and discuss the properties of the optimal solutions. Numerical experiments based on the Yangtze River are conducted to test the applicability of these methods. We find that in the case of unsplittable demands, modeling the shipping of empty containers based on node variables significantly outperforms the approach based on arc variables in terms of computation time and accuracy. Additionally, we provide recommendations to guide the tactical decisions of liner shipping companies. [ABSTRACT FROM AUTHOR]

• A framework for the economic feasibility analysis of green river ships is proposed. • Theory guiding carbon tax formulation for inland waterway transport is contributed. • Novel ideas to promote river LNG-fuelled ships development are explored. • Yangtze River case based on realistic data and multiple scenarios is examined. Inland waterway transportation, with its advantages of large volume and low cost, holds tremendous potential for driving national or regional economic development. Meanwhile, it generates huge emissions through the use of traditional petroleum fuels. To accelerate green shipping growth, employing green energy-powered river ships and implementing policies have become urgent tasks. We construct a novel voyage cost model based on navigation characteristics and investigate the economic feasibility of LNG-fuelled river ships under two proposed carbon tax schemes (fixed vs. progressive). Taking the Yangtze River as an example, we analyze the shipping cost in three transportation systems-bulk cargo, container, and dangerous goods. The results indicate: (1) LNG-fuelled river ships with appropriate deadweight tonnage and deployment on longer routes exhibit favorable economic performance. (2) Progressive carbon tax scheme performs better than fixed one in promoting green shipping. (3) Carbon tax policies should be formulated based on different routes, ship types and sizes. [ABSTRACT FROM AUTHOR]

The effects of the dynamics of serum tumor markers (CA72-4, CEA, CA19-9, CA125 and AFP) before and after neoadjuvant chemotherapy (NACT) on the prognosis of gastric cancer(GC) patients remain unclear. The training set contained 334 GC patients from Fujian Medical University Union Hospital (FJMUUH) and 113 GC patients in Qinghai University Affiliated Hospital (QhUAH) were used as an external validation set. Tumor marker regression load (ΔTMRL) indicator, including ΔCA72-4, ΔCEA, ΔCA19-9, ΔCA125, and ΔAFP, is defined as [(postNACT marker– preNACT marker)/preNACT marker]. Tumor marker regression load score (TMRLS) consists of ΔCA72-4, ΔCEA and ΔCA125. The predictive performance of the nomogram-TMRLS was evaluated using the area under the receiver operating characteristic(ROC) curve(AUC), decision curve analysis(DCA), and C-index. Patients from FJMUUH were divided into two groups, TMRLS-low and TMRLS-high, determined by R package maxstat. Survival analysis revealed a higher 3-year overall survival(OS) in the TMRLS-low than in the TMRLS-high group. The TMRLS-high group who received postoperative adjuvant chemotherapy(AC) showed a significantly higher 3-year OS rate than those who did not. Multivariate COX regression analysis indicated that TMRLS was an independent prognostic factor for OS. A nomogram for predicting OS based on TMRLS showed a significantly higher C-index and AUC than the ypTNM stage. The above results were also found in the QhUAH external validation cohort. TMRLS is a novel independent prognostic factor for GC who underwent NACT and a radical gastrectomy. Furthermore, the TMRLS-high group, who received postoperative AC, may achieve better survival outcomes. Notably, the predictive performance of the nomogram-TMRLS significantly outperformed that of the ypTNM stage. [ABSTRACT FROM AUTHOR]

Artificial neural network models have a strong self-learning ability and can deal with complex biological information, but there is no artificial neural network model for predicting the benefits of adjuvant chemotherapy in patients with gastric cancer. The clinicopathological data of patients who underwent radical resection of gastric cancer from January 2010 to September 2014 were analyzed retrospectively. Patients who underwent surgery combined with adjuvant chemotherapy were randomly divided into a training cohort (70%) and a validation cohort (30%). An artificial neural network model (potential-CT-benefit-ANN) was established, and its ability to predict the potential benefit of chemotherapy was evaluated by the C-index. The prognostic prediction and stratification ability of potential-CT-benefit-ANN and the eighth American Joint Committee on Cancer staging system were compared by receiver operating characteristic curves and Kaplan-Meier curves. In both the training and validation cohort, potential-CT-benefit-ANN shows good prediction accuracy for potential adjuvant chemotherapy benefit. The receiver operating characteristic curve showed that the prediction accuracy of potential-CT-benefit-ANN was better than that of the eighth American Joint Committee on Cancer staging system in all groups. The calibration plots showed that the predicted prognosis of potential-CT-benefit-ANN was highly consistent with the actual value. The survival curves showed that potential-CT-benefit-ANN could stratify prognosis well for all groups and performed significantly better than the eighth AJCC staging system. The potential-CT-benefit-ANN model developed in this study can accurately predict the potential benefits of adjuvant chemotherapy in patients with stage II/III gastric cancer. The benefit score based on potential-CT-benefit-ANN can predict the long-term prognosis of patients with adjuvant chemotherapy and has good prognostic stratification ability. [ABSTRACT FROM AUTHOR]

[Display omitted] • A series of new formylpiperazine-based ferroptosis inhibitors was designed and synthesized. • These derivatives were evaluated for their effects against Erastin-induced ferroptosis HUVECs. • Compound 26 to have better anti-ferroptosis activity and microsomal stability than Fer-1. • Compound 26 is a promising lead compound for treating ferroptosis-related vascular diseases. In this study, a series of new formylpiperazine-derived ferroptosis inhibitors were designed and synthesized based on the structure of a known ferroptosis inhibitor, ferrostatin-1 (Fer-1). The anti-ferroptosis activity of these synthetic compounds in human umbilical vein endothelial cells (HUVECs) induced by Erastin was evaluated. It was found that some of the new compounds, especially compound 26 , showed potent anti-ferroptosis activity, as evidenced by its ability to restore cell viability, reduce iron accumulation, scavenge reactive oxygen species, maintain mitochondrial membrane potential, increase GSH levels, decrease LPO and MDA content, and upregulate GPX4 expression. Moreover, compound 26 exhibited superior microsomal stability than Fer-1. The present results suggest that compound 26 is a promising lead compound for the development of new ferroptosis inhibitors for the treatment of vascular diseases. [ABSTRACT FROM AUTHOR]

Preoperative sarcopenia is associated with prognosis in patients with gastric cancer (GC); however, studies with 10-year survival follow-up are lacking. Consecutive patients with GC who underwent radical gastrectomy between December 2009–2012 were included retrospectively. Preoperative sarcopenia was diagnosed using computed tomography skeletal muscle index. The Kaplan–Meier method estimated overall survival (OS) and relapse-free survival (RFS). Cox proportional hazard regression analysis determined the prognostic factors for OS and RFS. In total, 781 patients with GC were included; among these, 207 (26.5%) had preoperative sarcopenia. Patients with sarcopenia had significantly lower 10-year OS and RFS than patients without sarcopenia (39.61% vs. 58.71% and 39.61% vs. 57.84%, respectively). Further, preoperative sarcopenia was an independent risk factor for 10-year OS (HR = 1.467; 95% confidence interval [CI]: 1.169–1.839) and RFS (HR = 1.450; 95% CI: 1.157–1.819). Patients with sarcopenia had a higher risk of death and recurrence in the first 10 years postoperatively than patients without sarcopenia. Additionally, the risk of death (HR = 2.62; 95% CI:1.581–4.332) and recurrence (HR = 2.34; 95% CI:1.516–3.606) was the highest in the 1st postoperative year and remained relatively stable thereafter. Further, postoperative adjuvant chemotherapy significantly improved 10-year OS (p = 0.006; HR = 0.558) and RFS (p = 0.008; HR = 0.573) in patients with TNM stage II–III GC that presented with sarcopenia. Preoperative sarcopenia remained an independent risk factor for postoperative very long-term prognosis of GC. Postoperative adjuvant chemotherapy improved the long-term outcomes of stage II–III patients with sarcopenia. [ABSTRACT FROM AUTHOR]

and purpose: For gastric cancer patients with peritoneal metastasis (GCPM), there is no universally accepted prognostic staging system. This study aimed to validate the predictive ability of the 15th peritoneal metastasis staging system (P1abc) of the Japanese Classification of Gastric Carcinoma (JCGC). The data of 309 GCPM patients from July 2007 to July 2017 were retrospectively analyzed. This study compared the prognosis prediction performances of P1abc, the previous JCGC PM staging (P123) and Gilly staging systems. The survival curve revealed a significant difference in overall survival (OS) predicted by P1abc, P123 and Gilly staging (all P < 0.05), and the survival of the two adjacent substages were well distinguished by P1abc but not by P123 and Gilly staging. Both P123 and Gilly staging were substituted with P1abc staging in a 2-step multivariate analysis. The results showed that P1abc staging was superior to both P123 and Gilly staging in its discriminatory ability (C-index), predictive accuracy (AIC) and predictive homogeneity (likelihood ratio chi-square). A stratified analysis by different therapies indicated that for the P1a and P1b patients, OS following palliative resection combined with palliative chemotherapy (PRCPC) was better than that after palliative resection (PR) or palliative chemotherapy (PC) alone (P < 0.05). For the P1c patients, OS after receiving PC was significantly superior to that after receiving PRCPC or PR (P = 0.021). P1abc staging is superior to P123 and Gilly staging in predicting the survival of GCPM patients. Surgeons can provide these patients with appropriate treatment options according to the corresponding substages within P1abc. [ABSTRACT FROM AUTHOR]

As the main transportation channel, the huge shipping volumes of inland rivers lead to significant emissions from ships. Inland shipping has an increasing demand for the development of green ships. Liquid natural gas (LNG) is considered to be an ideal marine fuel because of its many advantages. This paper aims to assess the economy and CO 2 emission reduction of LNG-fuelled ships on inland waterway transportation, under the context that the uniqueness of inland waterway transportation, as well as cargo transportation regulations and policies are taken into account. Firstly, considering the preferential policies for LNG-fuelled ships and the mandatory use of shore power for oil-fuelled ships, we proposed a fuel consumption calculation formula and established economic and emission assessment models for inland ships. Then, we examined these models with simulation examples of three main cargo types, i.e. dry bulk, containers and dangerous goods, transported on the Yangtze River. The optimal ranges of LNG-fuelled ship size were given under various credible scenarios designed according to the transportation systems. The results show: (1) The optimal range of dead-weight tonnage (DWT) of LNG-fuelled ships for dry bulk, container and dangerous goods are between 3,000–5,000 DWT, 3,000–4,000 DWT and 2,000–3,000 DWT, respectively. (2) LNG-fuelled dry bulk ships of about 10,000 DWT or more are uneconomical compared to oil-fuelled ships of the same tonnage. (3) Smaller LNG-fuelled ships, such as dry bulk ships of less than 1,500 DWT, container and dangerous goods ships of less than 2,000 DWT, or ships serving longer routes of approximately more than 1,000 km have most significant unit CO 2 emission reduction than oil-fuelled ships of the same tonnage. (4) Excessive waiting time at locks will reduce the economic feasibility and unit CO 2 emission reduction of LNG-fuelled ships. Finally, we obtained a series of important management significances by simulating the changes of some variable parameters in real situations. These conclusions can provide some theoretical foundations for the development of LNG-fuelled or other green ships in inland waterways, and guide the government in formulating policies to promote the green transformation of the inland shipping industry. • A fuel consumption calculation formula of inland ships (FCCF-IS) is proposed. • The assessment models are established based on the preferential policies and special navigation conditions. • The methodology is examined for Yangtze River inland waterway networks. • Customized models, Realistic data, and multiple scenarios are study advantages. [ABSTRACT FROM AUTHOR]

This paper addresses the container ship routing problem in inland waterway liner transportation. Given estimated weekly full container shipping demands between port pairs and the potential empty container demands at each port, our goal is to design the container ship route and determine the amount of foldable and standard empty containers to be shipped between each port pair in the context of navigational restrictions, so as to maximize the profit of the shipping services. To save possible leasing or storage costs of empty containers at various ports and meet navigational restrictions, the release of foldable containers and the repositioning of empty containers were taken into account in the decision. Two mixed integer programming models are established to optimize ship route and shipping strategies under splittable and unsplittable demands. The models are further improved by projecting arc variables for simulating the transportation of empty containers, and the improved model has fewer decision variables and higher computational efficiency. Numerical experiments based on the Yangtze River are conducted to test the applicability of methods. Finally, some reference recommendations are presented. • Two MIP models, arc or node variables to model empty containers. • Foldable containers and navigational restrictions are considered jointly. • The NP-hardness, two models equivalent and solution properties are proven. • The model performance and management opinions are derived. [ABSTRACT FROM AUTHOR]

The number of randomized controlled trials (RCTs) investigating the systemic treatment of gastric or gastroesophageal junction adenocarcinoma (GA-RCTs) is increasing. We aimed to describe the characteristics and evaluate the clinical benefit of GA-RCTs over the past 20 years. We searched for RCTs of systemic treatment in GA published in eight major journals between 2001 and 2020 in PubMed. From the included studies, the characteristics and results of GA-RCTs were extracted. Clinical benefit was assessed using the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS). About 93 RCTs with 38365 patients were included. Seventy-one (76.3%) studies received external funding, with an increase from 27.3% (2001–2005) to 94.1% (2016–2020). RCTs on targeted therapy and/or immunotherapy have also increased over time, but only 14 (41.2%) were restricted to specific biomarkers. Forty-four (47.3%) studies met their primary endpoint (defined as positive RCTs), but median overall survival has not improved over time. Moreover, only 16 (36.4%) studies met the ESMO-MCBS threshold. RCTs whose study design and results met the ESMO-MCBS thresholds has not increased over time (p = 0.827 and p = 0.733, respectively). GA-RCTs are increasingly focused on targeted therapy and/or immunotherapy, and are more likely to receive external funding. However, the effect size has not shown significant improvement in the past 20 years. Only a few RCTs with positive results met ESMO thresholds. Future RCTs should prioritize the clinical benefits and provide direct evidence to optimize and reform GA treatment practices. [ABSTRACT FROM AUTHOR]

Background: Robotic-assisted gastrectomy (RAG) has been rapidly adopted for gastric cancer (GC) treatment. However, whether RAG provides any significant outcome/cost advantages over laparoscopy-assisted gastrectomy (LAG) for the experienced laparoscopist remains unclear.Methods: A retrospective review of a prospectively collected database identified 768 consecutive patients who underwent either RAG (n = 103) or LAG (n = 667) for GC between July 2016 and June 2017 at a large center. A 1:3 matched propensity score analysis was performed. The short-term outcomes and hospital costs between the two groups were compared.Results: A well-balanced cohort of 404 patients was analyzed (RAG:LAG = 1:3 match). The mean operation times were 226.6 ± 36.2 min for the RAG group and 181.8 ± 49.8 min for the LAG group (p < 0.001). The total numbers of retrieved lymph nodes were similar in the RAG and LAG groups (means 38 and 40, respectively, p = 0.115). The overall and major complication rates (RAG, 13.9% vs. LAG, 12.5%, p = 0.732 and RAG, 3.0% vs. LAG, 1.3%, p = 0.373, respectively) were similar. RAG was much more costly than LAG (1.3 times, p < 0.001) mainly due to the amortization and consumables of the robotic system. According to cumulative sum (CUSUM), the learning phases were divided as follows: phase 1 (cases 1-21), phase 2 (cases 22-63), and phase 3 (cases 64-101), in the robotic group. The surgical stress (SS) was higher in the robotic group compared with the laparoscopic group in phase 1 (p < 0.05). However, the SS did not differ significantly between the two groups in phase 3.Conclusions: RAG is a feasible and safe surgical procedure for GC, especially in the post-learning curve period. However, further studies are warranted to evaluate the long-term oncological outcomes and to elucidate whether RAG is cost-effective when compared to LAG. [ABSTRACT FROM AUTHOR]

Objective To determine the relative safety and efficacy of 3D laparoscopic gastrectomy and 2D laparoscopic surgery in patients with gastric cancer. Background There is still a lack of randomized controlled trials regarding the safety and efficacy of 3D versus 2D laparoscopic surgery for gastric cancer. Methods A large-scale, phase 3, prospective, randomized controlled trial was conducted. ( ClinicalTrials.gov number NCT02327481). Results A total of 438 patients were randomized (3D group: 219 cases; 2D group: 219 cases) between January 1, 2015, and April 1, 2016; 19 patients were excluded. Finally, data from 419 patients were analyzed (3D group: 211 cases; 2D group: 208 cases). There were no differences between the 2 groups regarding the operation time (3D versus 2D, 176 ± 35 min vs. 174 ± 33 min, P  = .562). The intraoperative blood loss in the 3D group was somewhat less than in the 2D group (61 ± 83 mL vs. 82 ± 119 mL, P  = .045). Further analysis suggested that the use of 3D laparoscopic surgery was a protective factor against excessive blood loss (≥200 mL). Conclusion 3D laparoscopic gastrectomy did not shorten the operation time compared with 2D laparoscopic gastrectomy, but provided the benefit of less intraoperative blood loss and a lesser occurrence of excessive bleeding than the conventional 2D laparoscopic gastrectomy; the clinical value of the difference is limited. [ABSTRACT FROM AUTHOR]

Alzheimer’s disease (AD) is the most common age-dependent neurodegenerative disorder, characterized by a progressive dysfunction of central neurons, and senescence-accelerated mouse prone 8 (SAMP8), a spontaneous AD mouse model, appears to be an excellent model to investigate the process of AD. Previous studies have indicated that neuronal excitability is impaired in transgenic AD mice. In this study, the cognition of SAMP8 mice was tested using the passive avoidance task and Morris water maze; whole-cell current-clamp recordings were used to evaluate the neuronal excitability, including the resting membrane potential, the number of action potentials, and after-hyperpolarization; and the voltage-dependent Ca 2+ current in hippocampal slices was measured using whole-cell voltage-clamp recordings. We found that compared to the young mice, the performance in the learning and memory behavior tasks was impaired in aged mice, and the hippocampal CA1 pyramidal neurons of the aged mice showed a significantly depolarized resting membrane potential, increased numbers of action potentials after injection of depolarizing current, and increased after-hyperpolarization after the action potentials. Consistent with the above changes, the voltage-dependent Ca 2+ current was larger in aged mice than in young mice. These data suggested that the aged SAMP8 neurons were hyperexcitable, and the alterations in the voltage-dependent Ca 2+ current of aged neurons occurred in parallel to the elevation in excitability. [ABSTRACT FROM AUTHOR]

The oxidative depolymerizations of Shenfu subbituminous coal (SSBC) and its thermal dissolution insoluble (TDI), which obtained by thermal dissolution (TD) in 1-methylnaphthalene at 320 °C, were investigated with H 2 O 2 aqueous solution as oxidant under different conditions. Their products were characterized by FTIR, ultimate analyses and acidic functional groups determination. Further, the detailed comparison of oxidative depolymerizations of SSBC and its TDI was carried out with 20% H 2 O 2 at 60 °C. The water solubles (WSs) were esterified, and subsequently analyzed by GC/MS in order to understand the macromolecular structural features of SSBC. The results revealed that compared with SSBC, the TDI contained more phenolic hydroxyls and showed higher oxidation reactivity. It suggested that the phenolic hydroxyl should be the active site of oxidative depolymerization, and thermal dissolution generated substantial phenolic hydroxyls in TDI by the rupture of C al –OAr. The WS from the oxidation of SSBC mainly consists of monocyclic aromatic acids, while the WS from TDI contains much amount of alkanoic acids and α,ω-dicarboxylic acids. Especially the substantial oxalic acid and malonic acid identified in the WS from TDI suggested that significant amount of the aromatic rings in the macromolecules of SSBC could be coupled directly or connected by monomethylene bridge. [ABSTRACT FROM AUTHOR]

An equiaxed grained as-cast strip and a columnar grained as-cast strip was produced by using twin-roll strip casting, respectively. Both as-cast strips mainly containing 0.71 wt%Si and 0.44 wt%Al were cold rolled and annealed with or without the hot rolling prior to cold rolling. Microstructure, texture evolution along the whole processing routes and the magnetic properties were investigated in detail. It was found that the equiaxed grained strip was characterized by almost random texture while the columnar grained strip was dominated by strong λ-fiber (<001>‖ND) texture. After cold rolling and annealing, all the final sheets of both the as-cast strips showed extremely weak γ-fiber (<111>‖ND) recrystallization texture. In addition, the finally annealed sheets of the equiaxed grained strip were dominated by relatively weak λ-fiber and strong Goss ({110}<001>) recrystallization texture while those of the columnar grained strip were dominated by much stronger λ-fiber and much weaker Goss recrystallization texture regardless of whether the hot rolling was adopted before cold rolling, thus the former showed much lower magnetic induction than the latter. On the other hand, even though the finally annealed sheets of the equiaxed grained strip showed a little more homogeneous recrystallization microstructure with a little bigger grain size than those of the columnar grained strip in the case of no hot rolling, a much higher iron loss was displayed. By contrast, in the case of hot rolling, the former exhibited a little lower iron loss than the latter as a result of the more significant increase in grain size and λ-fiber recrystallization texture. The introduction of the hot rolling could increase the grain size, strengthen λ-fiber texture and weaken Goss texture of the finally annealed sheets of both the as-cast strips, leading to a much improvement in both the magnetic induction and iron loss. [ABSTRACT FROM AUTHOR]