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BACKGROUND: Hospital workers have been under intense psychological pressure since the COVID-19 outbreak. We analyzed the psychological status of hospital staff in the late period of the COVID-19 to provide a basis for the construction of global health care after the COVID-19 outbreak. METHODS: We used online surveys to assess participants' self-reported symptoms at the late stage of the outbreak. This study collected data on sociodemographic characteristics, epidemic-related factors, psychological status (PHQ-9, GAD-7, and PHQ-15), psychological assistance needs, perceived stress and support, PTSD symptoms (PCL-C) and suicidal and self-injurious ideation (SSI). Participants were hospital workers in all positions from 46 hospitals. Chi-square tests to compare the scales and logistic regression analysis were used to identify risk factors for PTSD and SSI. RESULTS: Among the 33,706 participants, the prevalences of depression, anxiety, somatic symptoms, PTSD symptoms, and SSI were 35.8%, 24.4%, 49.7%, 5.0%, and 1.3%, respectively. Logistic regression analysis showed that work in a general ward, attention to the epidemic, high education, work in non-first-line departments, insufficient social support, and anxiety and somatization symptoms were influencing factors of PTSD (P

Background: Primary tracheal adenoid cystic carcinoma is a rare, slow-growing pulmonary malignancy. Due to the low incidence, clinicians are poor in the diagnosis and treatment of such disease, which is prone to cause misdiagnosis or missed diagnosis, consequently leading to delayed treatment. Case Presentation: Here, we reported a case of a 72-year-old woman who was diagnosed as primary bronchial adenoid cystic carcinoma after three years. At the time of final diagnosis, lesion involvement was seen in the entire bronchus and radical treatment was not available. Conclusions: Endoscopic bronchoscopy and palliative radiotherapy can relieve the symptoms of the patient and make the patient survive with the tumor for a long time.

BackgroundDrug-susceptible pulmonary tuberculosis patients notified and treated under national tuberculosis program, ChinaMethodsWe conducted a cross-sectional study in six provinces in 2017 to assess the burden and distribution of health expenditure costs among tuberculosis-affected households and analyze related risk factors. The data was collected through face-to-face questionnaire survey. Intensity of financial burden was the median positive overshoot beyond a threshold that defined as annual total (direct and indirect) costs exceeding 20% of the pre-TB annual household income.ResultsOf 1147 patients, median (interquartile range) total costs due to tuberculosis care were US$965.5(461.8, 2059.3). Costs due to pre-treatment care accounted for 46.3% and direct costs accounted for 82.5% for total costs. Median (interquartile range) intensity of catastrophic costs was 32%(11%, 88%). Living below poverty line, household size less than four, employment in informal sector, receiving treatment from tuberculosis dispensary and hospitalization were independent predictors of associated with higher financial burden.ConclusionDespite free tuberculosis care services, the health expenditure due to tuberculosis were high among tuberculosis-affected households.Trial registrationThe Ethics Committee of Chinese Center of Disease Control and Prevention approved the study (No.201625, dated 22 November 2016).

Energy Internet is a major innovation to deal with the environmental crisis and efficient energy management and use in the current society. The important condition to achieve this goal is to summarize, integrate, process and apply the data of various industries in the energy field, and then support the relevant management and decision-making. In this process, how to ensure the authenticity and credibility of data is one of the keys in the construction of energy Internet. Therefore, this paper will study the application scenarios of blockchain technology in data traceability. With the help of the natural characteristics of blockchain, such as decentralized, distributed storage, tamper proof, open and transparent, combined with relevant national standards and international theoretical models, based on the needs of energy Internet data integration and management, this paper will develop a data traceability method suitable for the energy industry, and build a covering energy Data life cycle model of Internet. Through the research of this paper, we can help all localities to establish data traceability mechanism in the energy Internet, to help users to accurately grasp where the data is created, what systems have been transferred, which users have carried out query and modification, and so on, so as to realize the monitoring and control of the whole process of data flow, which helps to improve the credibility of data, and also helps to ensure the safety and quality of data and promote the construction of energy Internet huge data application.

Highlights • Depression, anxiety, and somatic symptoms in hospital workers were 30.2%, 20.7%, and 46.2% • 6.5% hospital workers reported suicidal or self-harm ideation. • Female, single, and low-level educational background were risk factors of psychological impact. • Epidemic-related attitudes and behaviors are associated with stress, support, and SSI. • County hospital workers suffered more psychological effects, stress, and SSI., Background There was an outbreak of COVID-19 towards the end of 2019 in China, which spread all over the world rapidly. The Chinese healthcare system is facing a big challenge where hospital workers are experiencing enormous psychological pressure. This study aimed to (1) investigate the psychological status of hospital workers and (2) provide references for psychological crisis intervention in the future. Method An online survey was conducted to collect sociodemographic features, epidemic-related factors, results of PHQ-9, GAD-7, PHQ-15, suicidal and self-harm ideation (SSI), and the score of stress and support scales. Chi-square test, t-test, non-parametric, and logistic regression analysis were used to detect the risk factors to psychological effect and SSI. Results 8817 hospital workers participated in this online survey. The prevalence of depression, anxiety, somatic symptoms, and SSI were 30.2%, 20.7%, 46.2%, and 6.5%, respectively. Logistic regression analysis showed that female, single, Tujia minority, educational background of junior or below, designated or county hospital, need for psychological assistance before or during the epidemic, unconfident about defeating COVID-19, ignorance about the epidemic, willingness of attending parties, and poor self-rated health condition were independent factors associated with high-level depression, somatic symptom, and SSI among hospital workers (P

Aim Delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) is a serious complication of carbon monoxide poisoning. This study aimed to explore the predictive values of serum biochemical markers and apparent diffusion coefficient (ADC) on DEACMP. Material and methods Seventy-nine patients were divided into two groups based on the onset of DEACMP 60 days after with acute carbon monoxide poisoning. The baseline data of ACMP patients were collected. Serum levels of cardiac troponin I (cTNI), lactic acid (Lac), carboxyhemoglobin (COHb), creatine kinase (CK), creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), C-reactive protein (CRP), and neuron-specific enolase (NSE) were measured within 24 hours of ACMP onset. The ADC of globus pallidum, centrum semiovale, and periventricular white matter were recorded by diffusion-weighted magnetic resonance imaging (DW-MRI) within 48 hours of admission. Logistic regression analysis was performed to determine the risk factors for DEACMP. Results The incidence of coma and duration of poisoning in the DEACMP group were significantly higher than those in the non-DEACMP group. The levels of Lac, CK, CK-MB, LDH, CRP and NSE in the DEACMP group were higher than those in the non-DEACMP group. The ADC value of globus pallidus in the DEACMP group was significantly higher than that in non-DEACMP group. The duration of poisoning, coma degree, CK, LDH, NES, and CRP were closely associated with the occurrence of DEACMP. Conclusion The duration of poisoning, coma degree, and serum levels of CK, LDH, CRP, and NSE were independent risk factors for DEACMP.

In this paper, the Internet and the power industry are deeply integrated to create a new development model, so as to realize the economic transformation from non clean energy driven to clean energy driven. Based on the theoretical framework of innovative business model, this paper adjusts the organizational structure, pays more attention to the cooperation with external institutions, so as to seek the market entrance of energy Internet, and studies the behavior of energy suppliers under the traditional business model and innovative business model from different angles.

Background: Knee osteoarthritis (KOA) is a chronic disease, which is also recognized as a common disease affecting the elderly. However, the application of Western medicine is limited in clinical because of its obvious adverse reactions. Warm needle acupuncture (WNA) has a long history in the treatment of KOA and is widely used in Chinese. Here we will submit a protocol to evaluate the efficacy and safety of WNA in the treatment of KOA. Methods: We will search 5 English databases (PubMed, MEDLINE, Embase, Cochrane Library, Web of Science), 4 Chinese databases [China National Knowledge Infrastructure (CNKI), China Biology Medicine, Chinese Science and Technology Journal Database (VIP), and Wanfang database] and grey literature for randomized controlled trials of WNA in the treatment of KOA. The primary outcome measure is Western Ontario and McMaster Universities Arthritis Index (WOMAC), and the secondary outcome will include degree of knee flexion and adverse events caused by WNA, such as dizziness, nausea, abdominal pain, arrhythmia, etc. The selection of the literatures will be conducted by endnote X7 software, and we will use Review Manger V.5.3 software to conduct the meta-analysis. Results: This study will provide reliable evidence for WNA in the treatment of KAO. Conclusion: The conclusion of this study will testify the efficacy and safety of WNA in the treatment of KAO. Registration: OSF Preregistration. 2020, October 11; osf.io/bu5qw

To investigate the effect of Qiguiyin Decoction (芪归银方, QGYD) on multidrug-resistant Pseudomonas aeruginosa infection in Sprague-Dawley (SD) rats. A pseudomonal infection model in SD rats was established by injecting multidrug-resistant P. aeruginosa intraperitoneally. Infected rats were randomized into four groups treated with Pure water, QGYD, ceftazidime, or combined QGYD and ceftazidime. Blood samples were obtained from the abdominal aorta. Serum was then collected and analyzed by peptide array for immune responsiveness to multidrug-resistant beta-lactamase proteins, including Verona integronen-coded metallo-beta-lactamase 1 (VIM-1), Sao Paulo metallo-beta-lactamase 1 (SPM-1), and Temoniera (TEMs). Blood levels of interleukin-1β (IL-1β), interleukin-4 (IL-4), and interferon-γ (IFN-γ) were assessed by enzyme-linked immunosorbent assay. QGYD enhanced antibody reactivity against VIM-1 [epitopes 7–11 and 36–40] and TEM-1 [epitopes 26–27, 52–55, and 66–70]. QGYD treatment restored the compromised antibody reactivity against VIM-1 [epitopes 53–54 and 56–58] and SPM-1 [epitopes 16–19 and 82–85] following pseudomonal infection. Serum levels of IL-1β and Th1/Th2 in the rats were significantly elevated following pseudomonal infection (P 0.05). QGYD improves the immune response to pseudomonal infection in rats by stimulating the production of protective antibodies against drug-resistant proteins VIM-1, SPM-1, and TEM-1. In addition, it protects the immune system and maintains immune responsiveness by restoring IL-1β and Th1/Th2 levels.

To investigate the cost-effectiveness of a comprehensive programme for drug-resistant tuberculosis launched in four sites in China in 2011.In 2011-2012, we reviewed the records of 172 patients with drug-resistant tuberculosis who enrolled in the comprehensive programme and we collected relevant administrative data from hospitals and China's public health agency. For comparison, we examined a cohort of 81 patients who were treated for drug-resistant tuberculosis in 2006-2009. We performed a cost-effectiveness analysis, from a societal perspective, that included probabilistic uncertainty. We measured early treatment outcomes based on three-month culture results and modelled longer-term outcomes to facilitate estimation of the comprehensive programme's cost per disability-adjusted life-year (DALY) averted.The comprehensive programme cost 8837 United States dollars (US$) per patient treated. Low enrolment rates meant that some fixed costs were higher, per patient, than expected. Although the comprehensive programme appeared 30 times more costly than the previous one, it resulted in greater health benefits. The comprehensive programme, which cost US$ 639 (95% credible interval: 112 to 1322) per DALY averted, satisfied the World Health Organization's criterion for a very cost-effective intervention.The comprehensive programme, which included rapid screening, standardized care and financial protection, improved individual outcomes for MDR tuberculosis in a cost-effective manner. To support post-2015 global heath targets, the comprehensive programme should be expanded to non-residents and other areas of China.Étudier le rapport coût-efficacité d'un programme global de lutte contre la tuberculose pharmacorésistante lancé en 2011 dans quatre régions chinoises.En 2011-2012, nous avons analysé les dossiers de 172 patients atteints de tuberculose pharmacorésistante qui s'étaient inscrits à ce programme global et nous avons collecté des données administratives pertinentes auprès de différents hôpitaux et de l'agence de santé publique chinoise. À titre de comparaison, nous avons examiné une cohorte de 81 patients soignés pour une tuberculose pharmacorésistante entre 2006 et 2009. Nous avons réalisé une analyse coût-efficacité, sur le plan sociétal, qui incluait une incertitude probabiliste. Nous avons mesuré les résultats du traitement précoce en fonction de résultats de culture sur trois mois et modélisé les résultats à long terme pour faciliter l'estimation du coût du programme global par année de vie corrigée du facteur incapacité (AVCI) évitée.Le programme global coûte 8837 dollars des États-Unis (US$) par patient soigné. Le faible taux d'inscription signifiait que certains coûts fixes par patient étaient plus importants que prévu. Bien que ce programme global se soit révélé 30 fois plus cher que le précédent, il a débouché sur des avantages accrus en matière de santé. Le programme global, qui coûte 639 US$ (intervalle de crédibilité à 95 %: 112 à 1322) par AVCI évitée, satisfait au critère de l'Organisation mondiale de la Santé définissant une intervention très rentable.Le programme global, qui incluait un dépistage rapide, des soins standardisés et une protection financière, a amélioré les résultats des patients atteints de tuberculose multirésistante en limitant les dépenses. Afin de soutenir les objectifs mondiaux pour l'après-2015 en matière de santé, le programme global devrait être élargi aux non-résidents et à d'autres régions de Chine.Investigar la costoeficacia de un programa integral para la tuberculosis farmacorresistente lanzado en cuatro localizaciones de China en 2011.En 2011–2012, se revisaron los informes de 172 pacientes con tuberculosis farmacorresistente que se habían inscrito en el programa integral y se recogieron datos administrativos relevantes de hospitales y la agencia de salud pública de China. Como término de comparación, se examinó un cohorte de 81 pacientes que habían sido tratados para la tuberculosis farmacorresistente en 2006−2009. Se llevó a cabo un análisis de costoeficacia desde una perspectiva societaria que incluía la incertidumbre probabilística. Se midieron los resultados de los tratamientos tempranos basados en los resultados de un cultivo de tres meses y se modelaron resultados a largo plazo para facilitar la estimación del coste del programa integral de años de vida en función de la discapacidad (AVAD) evitada.El programa integral costó 8.837 dólares estadounidenses (USD) por paciente tratado. Las bajas tasas de inscripción significaban que algunos de los costes fijos eran mayores por paciente que lo esperado. A pesar de que el programa integral parecía 30 veces más costoso que el anterior, tuvo como resultado unos mejores beneficios para la salud. El programa integral, que costó 639 USD (intervalo de credibilidad del 95%: de 112 a 1.322) por AVAD evitado, satisfizo el criterio de la Organización Mundial de la Salud en cuanto a intervenciones muy costoefectivas.El programa integral, que incluía un examen rápido, cuidados estándar y protección financiera, mejoró los resultados individuales de la tuberculosis multirresistente (MR) de una manera costoefectiva. Para apoyar los objetivos de salud globales posteriores a 2015, el programa integral debería expandirse a no residentes y otras áreas de China.استقصاء مدى فعالية تكلفة البرنامج الشامل للتصدي لمرض السل المقاوم للأدوية الذي بدأ العمل به في أربعة مواقع في الصين في عام 2011.راجعنا سجلات 172 مريضًا يعانون من السل المقاوم للأدوية ممن تم تسجيلهم في البرنامج الشامل، وجمعنا البيانات الإدارية ذات الصلة من المستشفيات ووكالة الصحة العامة بالصين، وذلك في الفترة من 2011 إلى 2012. وفحصنا مجموعة تتكون من 81 مريضًا ممن تلقوا العلاج من السل المقاوم للأدوية في الفترة بين 2006 و2009 بغرض المقارنة. وأجرينا تحليلًا لمدى فعالية التكلفة من الناحية المجتمعية، حيث انطوى التحليل على احتمالات عدم التيقن من النتائج. وأجرينا قياسًا للنتائج الأولية للعلاج اعتمادًا على نتائج عملية المستنبتات التي استمرت لمدة 3 أشهر، واستخدمنا النتائج التي ظهرت على مدى أطول كنموذج لتيسير تقدير تكلفة البرنامج الشامل باستخدام سنوات العمر المصححة باحتساب مدد العجز (DALY) التي تم تفاديها.بلغت تكلفة البرنامج الشامل 8837 دولارًا أمريكيًا للمريض الواحد الذي تلقى العلاج. وكانت المعدلات المنخفضة للتسجيل بالبرنامج تعني ارتفاعًا في بعض التكاليف الثابتة لكل مريض عن الحد المتوقع. وبالرغم من أن تكلفة البرنامج الشامل بدت أكثر ارتفاعًا بثلاثين ضعفًا مقارنةً بما سبق، فإنه أثمر عن نتائج أكثر جدوى من الناحية الصحية. إن البرنامج الشامل الذي تكلف 639 دولارًا أمريكيًا (بنسبة ثقة مقدارها 95%‏‏: من 112 إلى 1322 حالة) باستخدام سنوات العمر المصححة باحتساب مدد العجز التي تم تفاديها، قد اتفق مع معايير منظمة الصحة العالمية باعتباره تدخلاً فعالًا من حيث التكلفة إلى حد كبير.إن البرنامج الشامل، الذي اشتمل على الفحص السريع، والرعاية الصحية المتوافقة مع المعايير، والحماية المالية قد حسَّن من مستوى نتائج علاج السل المقاوم للأدوية المتعددة على المستوى الفردي بأسلوب فعال من حيث التكلفة. ويجب توسيع نطاق البرنامج الشامل ليضم غير المقيمين بالدولة ومناطق أخرى في الصين، وذلك لدعم الأهداف العالمية المنشودة لما بعد 2015 في مجال الصحة.旨在调查 2011 年在中国四个地点实施的耐药结核病综合方案的成本效益。.在 2011 至 2012 年，我们查阅了 172 位接受该综合方案的耐药结核病患者的记录，并且从各家医院和中国的公共卫生机构收集了相关管理性数据。为了进行对比，我们调查了一组曾在 2006 年至 2009 年接受过耐药结核病治疗的 81 位患者。我们从社会视角对成本效益进行分析，其中包括概率不定性。我们在为期三个月的培养结果的基础上评估了早期治疗结果，并且以更长期的结果建模，以便于估计该综合方案每个伤残调整生命年 (DALY) 挽救生命的成本。.接受该综合方案的每位患者的治疗花费为 8837 美元 (US$) 。低接受率意味着每位患者的一些固定费用比预期的更高。尽管该综合方案的费用比之前的高 30 倍，但是它有更高的健康效益。该综合方案的每个伤残调整生命年挽救生命花费 639 美元（95% 置信区间：112 至 1322），符合世界卫生组织规定的一项极具成本效益的干预措施的标准。.这套包含了快速筛查、标准化护理和财务保障的综合方案以具有成本效益的方式，改善了多药耐药结核病患者的个人治疗成果。为了实现 2015 年后的全球健康目标，该综合方案的普及范围应扩大至非本地居民和中国的其他地区。.Изучить экономическую эффективность комплексной программы по борьбе с лекарственно-устойчивым туберкулезом, запущенной в четырех китайских городах в 2011 г.В 2011–2012 гг. мы изучили медицинские карточки 172 пациентов, страдавших лекарственно-устойчивой формой туберкулеза и принявших участие в комплексной программе, и собрали соответствующие административные данные из больниц и агентства общественного здравоохранения Китая. Для сравнения рассматривалась когорта из 81 пациента, прошедшего лечение от лекарственно-устойчивой формы туберкулеза в период 2006–2009 гг. Нами был проделан анализ экономической эффективности с точки зрения социологии, который включал вероятностную неопределенность. Нами были измерены ранние результаты лечения (по данным культур, высеянных после трех месяцев лечения) и смоделированы исходы в более длительной перспективе, что позволило оценить выраженные в расчете на год жизни затраты на комплексную программу по утраченному времени в результате инвалидности (DALY), потерю которого удалось предотвратить.Стоимость комплексной программы составила 8837 долларов США из расчета на одного пациента. Малое число участников программы означало, что некоторые фиксированные затраты из расчета на пациента были выше, чем ожидалось. Хотя данная комплексная программа оказалась в 30 раз дороже, чем предыдущая, ее результаты с точки зрения пользы для здоровья пациентов оказались лучше. Комплексная программа стоимостью 639 долларов США (95% доверительный интервал, диапазон от 112 до 1322 долларов США) из расчета на предотвращенный DALY удовлетворяет критериям Всемирной организации здравоохранения для экономически эффективного вмешательства.Комплексная программа, включавшая быстрое скрининговое обследование, стандартизированное лечение и финансовую защиту, улучшила результат лечения у больных с МЛУ-формой туберкулеза и показала высокую экономическую эффективность. Чтобы достичь глобальных целей в сфере здравоохранения на период после 2015 года, данную комплексную программу следует распространить на нерезидентов страны и на другие регионы Китая.

This paper proposes a novel parking spaces detection algorithm which is based on image segmentation and local binary pattern. The vehicles are usually contains a lot of compositions, while the vacant parking spaces' composition is relatively small. According to this characteristic, we segment the parking image. To judge whether each parking area has a large number of small split or not, can achieve the detection of the parking stalls. In this paper, we improve the Mean Shift algorithm and achieve the accurate segmentation result. This proposed method was tested on indoor and outdoor parking lots. The result confirmed the efficiency of the proposed method, with the detection rate being over 97%. But, this method fails to detect non-vehicle objects and when the Vehicle color and ground color is very similar. So we the introduce the texture features, use LBP (local binary pattern) to extract the parking texture feature. Using the complementary between features and ultimately to achieve accurate detection.

Reliable pedestrian detection is an important problem in visual surveillance. This paper presents a combined method for pedestrian detection, which significantly improves the detection accuracy without degradation of the detection speed. Firstly, we create a table to mark foreground pixels by means of background difference for eliminating background interference areas. Secondly, Weighted Linear Regression Model embedded into cascade GAB is used for training weak classifier with parts model based on head-shoulder. Finally, two classifiers based on Haar-Like features and Shapelet features respectively fuse to detect pedestrian. The experimental results show that our method can boost the detection rate and reduce the false alarm with non-degradation of detection speed. Particularly, our detection mechanism performs well in the lower resolution and relative complex background situation.

Traffic information collection technology is the basis to constructing the ITS common information platform, in which the most critical and complex part is the automatic detection technology to vehicles. In this paper, we focus on the mathematics morphology technology's application in vehicles images processing. Through reading a large number of documents, we can conclude that the image's geometric features usually can't be affected by external environment and learn that mathematical morphology in processing vehicles images under complex environment has obvious advantages. Through studying Vehicle identification based on morphology, the main contents are as follow: Noise filtering, adhesion target segmentation, image reconstruction, image matching, and other key technologies. In this paper, the image morphology in vehicle detection of specific applications was reviewed.

The stereo-garage for electric vehicle recharging has been studied and developed. The charging fees management system of the garage adopts IC inductive card, intelligent charging system, safety charging socket and charging state monitoring technology. The intelligent and automatic parking and charging have been achieved, which provides effective protection for the development of electric vehicles.

Analyze method of Material selection, splicing and surface treatment and so on in the process of the development of product model. The difficulty of data conversion from the 3-dimensional modeling data to the CNC data has been solved; the split principle of the shape of a model has been established, and a complete set of products based on the CNC model making has been developed.

To identify issues relevant to nationwide implementation, a project was conducted during 1999-2001 to support and evaluate the development of a case-based measles surveillance system (MSS) in Shandong and Henan provinces, China. The performance of MSS surveillance and the descriptive characteristics of reported measles cases and outbreaks were analyzed. Of the 5782 suspected cases in 2001, 85% were investigated and 66% had serologic results. In all, 39% of cases were confirmed, 36% were compatible, and 25% were discarded; 81% of outbreaks identified involved

This post hoc analysis of a phase 3 trial explored the effect of pixantrone in patients (50 pixantrone, 47 comparator) with relapsed or refractory aggressive B-cell non-Hodgkin lymphoma (NHL) confirmed by centralized histological review. Patients received 28-d cycles of 85 mg/m(2) pixantrone dimaleate (equivalent to 50 mg/m(2) in the approved formulation) on days 1, 8 and 15, or comparator. The population was subdivided according to previous rituximab use and whether they received the study treatment as 3rd or 4th line. Median number of cycles was 4 (range, 2-6) with pixantrone and 3 (2-6) with comparator. In 3rd or 4th line, pixantrone was associated with higher complete response (CR) (23·1% vs. 5·1% comparator, P = 0·047) and overall response rate (ORR, 43·6% vs. 12·8%, P = 0·005). In 3rd or 4th line with previous rituximab (20 pixantrone, 18 comparator), pixantrone produced better ORR (45·0% vs. 11·1%, P = 0·033), CR (30·0% vs. 5·6%, P = 0·093) and progression-free survival (median 5·4 vs. 2·8 months, hazard ratio 0·52, 95% confidence interval 0·26-1·04) than the comparator. Similar results were found in patients without previous rituximab. There were no unexpected safety issues. Pixantrone monotherapy is more effective than comparator in relapsed or refractory aggressive B-cell NHL in the 3rd or 4th line setting, independently of previous rituximab.