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ObjectiveRadical hysterectomy has long been considered as the standard surgical treatment for early-stage cervical cancer (IA2 to IB1 stages), according to the 2009 International Federation of Obstetrics and Gynecology. This study aims to conduct an in-depth evaluation of the effectiveness and safety of non-radical surgery as an alternative treatment for patients with early-stage cervical cancer.MethodsA systematic search of online databases including PubMed, Embase, and the Cochrane Library was conducted to identify relevant literature on surgical treatment options for early-stage cervical cancer. Keywords such as “cervical cancer,” “conservative surgery,” “early-stage,” “less radical surgery,” and “simple hysterectomy” were used. Meta-analysis was performed using Stata 15.0 software, which included randomized controlled trials (RCTs) and cohort studies.ResultsThis meta-analysis included 8 eligible articles covering 9 studies, with 3,950 patients in the simple hysterectomy (SH) surgery group and 6,271 patients in the radical hysterectomy (RH) surgery group. The results indicate that there was no significant difference between the two groups in terms of the Overall Survival (OS) (HR = 1.04, 95% CI: 0.86–1.27, p = 0.671; Heterogeneity: I2 = 33.8%, p = 0.170), Disease Free Survival (DFS) (HR = 1.39, 95% CI: 0.59–3.29, p = 0.456; Heterogeneity: I2 = 0.0%, p = 0.374), Cervical Cancer Specific Survival (CCSS) (HR = 1.11, 95% CI: 0.80–1.54, p = 0.519; Heterogeneity: I2 = 11.9%, p = 0.287) and recurrence rate (RR = 1.16, 95% CI: 0.69–1.97, p = 0.583; Heterogeneity: I = 0.0%, p = 0.488). However, the mortality rate (RR = 1.35, 95% CI: 1.10–1.67, p = 0.006; Heterogeneity: I2 = 35.4%, p = 0.158) and the rate of postoperative adjuvant therapy (RR = 1.59, 95% CI: 1.16–2.19, p = 0.004; Heterogeneity: I2 = 92.7%, p

Abstract This paper presents comprehensive research of the advantages and applicability of various concrete carbonation detection methods. Employing a combination of Phenolphthalein indicator (PI), Thermogravimetric analysis (TGA), X-ray phase analysis (XRD), Fourier transform infrared spectroscopy (FTIR), and Quantitative calcium carbonate analysis (CA), a detailed comparison to determine the carbonation depth in the partial carbonation zone of concrete specimens is conducted. Among the quantitative analysis methods, CA measures CaCO3 content based on chemical reactions, while TGA obtains the concentration distribution of Ca(OH)2 and CaCO3. Among qualitative analysis methods, XRD tested the intensity distribution of Ca(OH)2 and CaCO3, while FTIR traced the characteristic peaks of C-O functional groups in a specific spectral range to determine the depth of carbonation of concrete. Results indicate that the depth of carbonation values measured by CA, TGA, XRDA, and FTIR are 2–3 times higher than those measured by PI. This research may provide valuable insights for the design of carbonation detection in concrete.

Crack location and type identification of reinforced concrete columns in service is of great interest to researchers, since it influences the decision-making of maintenance and retrofit. Due to the existing of load and corrosion, the complex stress state leads to complicated crack development which has been a challenge for researchers to determine the crack type. Acoustic emission (AE) method gives a promising solution to non-destructively locate and identify the crack position and type. In this work, corroded reinforced concrete columns were subjected to compression test with different eccentric degree. AE signals during the loading process were recorded. The traditional RA-AF method and a newly proposed Gaussian mixture model (GMM) method were applied to process the data for crack type identification. It was found that due to the large data set, RA-AF cannot identify the crack type in between the shear crack and the tensile crack types. The probability density distribution of GMM result gives an attractive offer to determine the crack type. A simple 4-step method based on GMM plot is proposed to identify the crack type which can calculate the ratio of shear crack and tensile crack in collected signals.

Objective: To explore the efficacy and safety of PD-1/PD-L1 inhibitors in treating recurrent/refractory ovarian cancer (OC).Methods: The online databases, including PubMed, Embase and Cochrane Library, were searched for relevant literatures on exploring the efficacy and safety of PD-1/PD-L1 inhibitors in the treatment of recurrent/refractory OC. The keywords are as follows: Ovarian neoplasms, programmed death receptor, PD-1, PD-L1, immunotherapy, and immune checkpoint inhibitor. Furthermore, qualified studies were screened for further meta-analysis.Results: In this study, 11 studies (990 patients) were analyzed to evaluate the efficacy of PD-1/PD-L1 inhibitors in the treatment of recurrent/refractory OC. The combined results proved that the objective response rate (ORR) was 6.7%, 95% CI (4.6%,9.2%), disease control rate (DCR) was 37.9%, 95% CI (33.0%, 42.8%), median overall survival (OS) was 10.70 months, 95% CI (9.23, 12.17), and median progression free survival (PFS) was 2.24 months, 95% CI (2.05, 2.43). In addition, in terms of the safety of patients suffering from recurrent/refractory OC and receiving PD-1/PD-L1 inhibitors, the combined treatment related adverse events (TRAEs) were 70.9% (61.7%–80.2%), and the combined immune related adverse events (iAEs) were 29%, 95% CI (14.7%, 43.3%).Conclusion: In patients with recurrent/refractory OC, PD-1/PD-L1 inhibitors were used alone and there was no obvious evidence of improved efficacy and survival. As for safety, the incidences of TRAEs and iAEs are high, so PD1/PD-L1 inhibitors should be applied according to individual conditions.Clinical Trial Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=367525, identifier CRD42022367525.

ObjectiveThe selection of minimally invasive surgery (MIS) or open laparotomy for ovarian cancer (OC) after neoadjuvant chemotherapy still remains controversial. This study aimed to assess the efficacy and safety of MIS versus open laparotomy following neoadjuvant chemotherapy for advanced OC, so as to provide another option to select optimal surgical procedures for patients with OC.MethodsRelevant literature studies about the risks of progression or mortality between women receiving MIS and open laparotomy for interval debulking surgery (IDS) were searched in the online databases, including PubMed, Embase, and the Cochrane Library with the following keywords: “ovarian neoplasms”, “minimally invasive surgical procedures”, “laparotomy”, and “neoadjuvant therapy”. Eligible studies were screened out for further meta-analysis.ResultsSix eligible literature studies, with 643 patients in the MIS group and 2,885 patients in the open laparotomy group, were included in this meta-analysis. No significant differences were detected in the overall survival (OS) of patients with OC who were treated with MIS or open laparotomy [hazard ratio (HR) = 0.85; 95% confidence interval (CI) = 0.59–1.23; heterogeneity: P = 0.051, I2 = 57.6%]. However, the progression-free survival (PFS) was significantly higher in patients with OC treated with MIS than those treated with laparotomy (HR = 0.73; 95% CI = 0.57 to 0.92; heterogeneity: P = 0.276, I2 = 22.4%). The completeness of debulking removal (R0 rate) in the open laparotomy group was not statistically higher compared with the control group (RR = 1.07; 95% CI = 0.93 to 1.23; heterogeneity: P = 0.098, I2 = 52.3%), and no significant differences in residual disease of ≤1 cm (R1) (RR = 1.08; 95% CI = 0.91 to 1.28; heterogeneity: P = 0.330, I2 = 12.6%) and postoperative complications were found between the two groups (RR = 0.72; 95% CI = 0.34 to 1.54; heterogeneity: P = 0.055, I2 = 60.6%). Furthermore, the length of stays in hospital was significantly shorter in patients with OC treated with MIS than those treated with open laparotomy (Standard Mean Difference (SMD) = −1.21; 95% CI = −1.78 to −0.64; heterogeneity: P < 0.001, I2 = 92.7%].ConclusionsFor IDS after NACT in patients with advanced OC, complete cytoreductive surgery with MIS is another feasible and effective choiceSystematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022298519, identifier CRD42022298519

Abstract Background Ovarian cancer (OC) is a gynecological malignancy with the highest mortality rate. Cisplatin (DDP) based chemotherapy is a standard strategy for ovarian cancer. Despite good response rates for initial chemotherapy, almost 80% of the patients treated with DDP based chemotherapy will experience recurrence due to drug-resistant, which will ultimately result in fatality. The aim of the present study was to examine the pathogenesis and potential molecular markers of cisplatin-resistant OC by studying the differential expression of mRNAs and miRNAs between cisplatin resistant OC cell lines and normal cell lines. Methods Two mRNA datasets (GSE58470 and GSE45553) and two miRNA sequence datasets (GSE58469 and GSE148251) were downloaded from the Gene expression omnibus (GEO) database. Differentially expressed genes (DEGs) and differentially expressed miRNAs (DEMs) were screened by the NetworkAnalyst. Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were conducted to analyze the biological functions of DEGs. The protein-protein interaction network was constructed using STRING and Cytoscape software to identify the molecular mechanisms of key signaling pathways and cellular activities. FunRich and MiRNATip databases were used to identify the target genes of the DEMs. Results A total of 380 DEGs, and 5 DEMs were identified. Protein–protein interaction (PPI) network of DEGs containing 379 nodes and 1049 edges was constructed, and 4 key modules and 24 hub genes related to cisplatin-resistant OC were screened. Two hundred ninety-nine target genes of the 5 DEMs were found out. Subsequently, one of these 299 target genes (UBB) belonging to the hub genes of GSE58470 and GSE45553 was identified by MCODE and CytoHubba,which was regulated by one miRNA (mir-454). Conclusions One miRNA–mRNA regulatory pairs (mir-454-UBB) was established. Taken together, our study provided evidence concerning the alteration genes involved in cisplatin-resistant OC, which will help to unravel the mechanisms underlying drug resistant.

A long-term elevated temperature environment is typically found in the metallurgy industry, which has adverse effects on the properties and microstructure of concrete structures. A few studies investigated the effect of short-time high temperature on the properties and microstructure of concrete, but the effect of long-term elevated temperature is seldom analysed. In this study, the deterioration mechanism of concrete under long-term elevated temperature was investigated by determining the thermal stresses on basis of finite element model (FEM) and analyzing the changes in its chemical composition and microstructure through X-ray diffraction (XRD), pore structure analysis (PSA) and scanning electron microscope (SEM). The results indicated that the maximum temperature stress of surface concrete could exceed 4 MPa, which was close to the ultimate tensile strength of normal concrete. The results also showed that calcium hydroxide (CH) could decompose at less than 200 ℃ because of the crystallization of tiny CH crystals, doping with other ions, extended heating time, and xonotlite (α-C2SH), which was formed on the internal surface of the concrete and decomposed on its external surface. Owing to these reasons, cracks and holes were generated, resulting in severe deterioration of the concrete structure.

The study on the influence of early age damage of concrete on its long-term strength development is of great importance. In this work, 102 concrete cubes with and without supplementary cementitious materials (SCMs) were prepared. The pre-loading with loading degrees of 20%, 50%, and 80% of the corresponding compressive strength at 3-, 7-, 14-, and 28 d age was applied to the concrete samples. Then, concrete samples were further cured to 270 d, and the compressive strength was tested by the uniaxial compression test. The acoustic emission signals during the compressive strength test were collected. It is found that the pozzolanic reaction healed the damage caused by the early age damage, and the compressive strength of concrete with the incorporation of SCMs at 270 d age after pre-loading was higher than that of ordinary concrete without SCMs. The peak frequency of the uniaxial compression acoustic emission of concrete can be divided into four frequency intervals to correspond to different damage mechanisms of concrete, namely: interval I (12 ± 5 kHz), interval II (38 ± 5 kHz), interval III (171 ± 5 kHz), interval IV (259 ± 5 kHz).

The effects of reinforcement corrosion and sustained axial load on mechanical performance of reinforced concrete (RC) columns were investigated in the present study. Three different degrees of reinforcement corrosion were achieved by controlling the durations of accelerated corrosion test (i.e., 16 days, 31 days, and 63 days). Three levels of sustained axial load (i.e., 0%, 30%, and 60% of the ultimate bearing capacity) were concentrically applied on column specimens. The impressing current and the sustained load were applied on column specimens simultaneously, mimicking the degradation of RC columns in real structures. Results indicated that transverse stirrups yielded higher corrosion degree than that of the longitudinal rebar under identical duration of accelerated corrosion test. The application of sustained axial load improved the performance of corroded RC columns in terms of the reinforcement corrosion, the ultimate axial load, as well as the stiffness. Additionally, more longitudinal cracks along the main rebar were exhibited for column specimens subjected to sustained axial load. For both loaded and unloaded column specimens, corrosion of reinforcing steels exacerbated the mechanical deterioration of RC columns, lowering the ultimate load carrying capacity and the axial deformation compared to the uncorroded columns.

In this paper, the damage of a reinforced concrete (RC) column with various levels of reinforcement corrosion under axial loads is characterized using the acoustic emission (AE) technique. Based on the AE rate process theory, a modified damage evolution equation of RC associated with the axial load and different corrosion rates is proposed. The experimental results show that the measured AE signal parameters during the loading process are closely related to the damage evolution of the RC column as well as the reinforcement corrosion level. The proposed modified damage evolution equation enables dynamic analysis for the damage of corrosion on a RC column under axial loading for a further real-time quantitative evaluation of corrosion damage on reinforced concrete.

Based on the fractal geometry, a quantitative index describing the development degree of the internal corrosion expansion of reinforced concrete was proposed. This approach could describe the similarity and complexity of the development of corrosion-induced cracks in concrete simultaneously. Based on this approach, the influence of cracking pattern and coarse aggregate distribution on crack distribution was investigated. This study obtained the crack distribution of reinforced concrete by using the half-soaking galvanic accelerated corrosion method. The results showed that the cracking pattern was the main factor affecting the complexity of crack distribution. For cracks with the simplest cracking pattern, the presence of coarse aggregate and its surface irregularity greatly affected their development trend.

For cementitious materials, electrical resistivity is often used in the study of the cement hydration process at early age, as one of the few indicators that can be continuously and non-destructively monitored. Variation characteristics of resistivity are widely reported to interact with the early-age performance of cement paste, such as hydration kinetics parameters and setting time. However, there is no reasonable mathematical model to predict the resistivity at early ages, especially within the first 24 h, due to significant changes in the porosity and degree of saturation. In this work, a mathematical model was developed by considering the partially saturated state and density change of C-S-H (calcium silicate hydrate). To verify the model, two experimental methods were chosen, including the non-contact electrical resistivity test and isothermal calorimetry test. The hydration heat and resistivity of cement paste with a water–cement ratio of 0.35 and 0.45 were continuously monitored for 3 days. In the resistivity test, embedded temperature sensors were used to monitor the internal temperature and temperature correction was treated carefully in order to obtain accurate data. The test results prove that the mathematical model can accurately predict electrical resistivity and describe the saturation state of early-age cement pastes under sealed curing.

In this work, the failure process of non-corroded and corroded reinforced concrete (RC) columns under eccentric compressive loading is studied using the acoustic emission (AE) technique. The results show that reinforcement corrosion considerably affects the mechanical failure process of RC columns. The corrosion of reinforcement in RC columns leads to highly active AE signals at the initial stage of loading, in comparison to the non-corroded counterparts. Also, a continuous AE hit pattern with a higher number of cumulative hits is observed for corroded RC columns. The spatial distribution and evolution of AE events indicate that the reinforcement corrosion noticeably accelerates the initiation and propagation of cracking in the RC columns during compressive loading. The AE characteristics of corroded RC columns are in agreement with the macroscopic failure behaviors observed during the damage and failure process. A damage evolution model of corroded RC columns based on the AE parameters is proposed.

The chloride ions diffusion in concrete is an important problem inducing the corrosion of reinforcement under marine environment. Based on a parallel transmission model, the diffusion coefficient of chloride ions in ITZ was determined. Thereafter, the measured parameters of ITZ were integrated into a numerical model to simulate the chloride ions diffusion and the reliability of the model was verified by comparing the numerical simulation with the surface scanning results collected from the electron microprobe. The test results show that if the concrete is taken as a threephase composites, the numerical model can reflect the real transmission process of chloride ion more accurately.

Concrete is a multiphase composite material, in which the mortar, aggregate and interfacial transition zone (ITZ) have important influence on the chloride ions transport. In this research, the thickness ITZ was measured and the concentration distribution of chloride ions in concrete was obtained through electron microprobe analysis. The experiment results that the thickness of ITZ follows a normal distribution and the size of aggregate shows no clear influence on the thickness of ITZ.

An anisotropic elastic-damage coupled constitutive model for plain concrete is developed, which describes the concrete performance degradation. The damage variable, related to the surface density of micro-cracks and micro-voids, and represented by a second order tensor, is governed by the principal tension strain components. For adequately describing the partial crack opening/closure effect under tension and compression for concrete, a new suitable thermodynamic potential is proposed to express the state equations for modeling the mechanical behaviors. Within the frame-work of thermodynamic potential, concrete strain mechanisms are identified in the proposed anisotropic damage model while each state variable is physically explained and justified. The strain equivalence hypothesis is used for deriving the constitutive equations, which leads to the development of a decoupled algorithm for effective stress computation and damage evolution. Additionally, a detailed numerical algorithm is described and the simulations are shown for uni-axial compression, tension and multi-axial loadings. For verifying the numerical results, a series of experiments on concrete were carried out. Reasonably good agreement between experimental results and the predicted values was observed. The proposed constitutive model can be used to accurately model the concrete behaviors under uni-axial compression, tension and multi-axial loadings. Additionally, the presented work is expected to be very useful in the nonlinear finite element analysis of large-scale concrete structures.

Objective: To explore the efficacy and safety of PD-1/PD-L1 inhibitors in treating recurrent/refractory ovarian cancer (OC). Methods: The online databases, including PubMed, Embase and Cochrane Library, were searched for relevant literatures on exploring the efficacy and safety of PD-1/ PD-L1 inhibitors in the treatment of recurrent/refractory OC. The keywords are as follows: Ovarian neoplasms, programmed death receptor, PD-1, PD-L1, immunotherapy, and immune checkpoint inhibitor. Furthermore, qualified studies were screened for further meta-analysis. Results: In this study, 11 studies (990 patients) were analyzed to evaluate the efficacy of PD-1/PD-L1 inhibitors in the treatment of recurrent/refractory OC. The combined results proved that the objective response rate (ORR) was 6.7%, 95% CI (4.6%,9.2%), disease control rate (DCR) was 37.9%, 95% CI (33.0%, 42.8%), median overall survival (OS) was 10.70 months, 95% CI (9.23, 12.17), and median progression free survival (PFS) was 2.24 months, 95% CI (2.05, 2.43). In addition, in terms of the safety of patients suffering from recurrent/refractory OC and receiving PD-1/PD-L1 inhibitors, the combined treatment related adverse events (TRAEs) were 70.9% (61.7%–80.2%), and the combined immune related adverse events (iAEs) were 29%, 95% CI (14.7%, 43.3%). Conclusion: In patients with recurrent/refractory OC, PD-1/PD-L1 inhibitors were used alone and there was no obvious evidence of improved efficacy and survival. As for safety, the incidences of TRAEs and iAEs are high, so PD1/PD-L1 inhibitors should be applied according to individual conditions. [ABSTRACT FROM AUTHOR]