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The Growing Area regarding Neoadjuvant Treatment inside Locally-advanced Anus Cancer malignancy: Proof along with Prospects.
Background Esophageal cancer (EC) is one of the most common cancers, causing many people to die every year worldwide. Accurate estimations of the spatial distribution of EC are essential for effective cancer prevention. Methods EC mortality surveillance data covering 964 surveyed counties in China in 2014 and three classes of auxiliary data, including physical condition, living habits and living environment data, were collected. Genetic programming (GP), a hierarchical Bayesian model and sandwich estimation were used to estimate the spatial distribution of female EC mortality. Finally, we evaluated the accuracy of the three mapping methods. Results The results show that compared with the root square mean error (RMSE) of the hierarchical Bayesian model at 6.546 and the sandwich estimation at 7.611, the RMSE of GP is the lowest at 5.894. According to the distribution estimated by GP, the mortality of female EC was low in some regions of Northeast China, Northwest China and southern China; in some regions downstream of the Yellow River Basin, north of the Yangtze River in the Yangtze River Basin and in Southwest China, the mortality rate was relatively high. Conclusions This paper provides an accurate map of female EC mortality in China. A series of targeted preventive measures can be proposed based on the spatial disparities displayed on the map.Background and aims Herbaceous plants can survive periods of prolonged freezing as belowground structures or seed, which can be insulated from cold air by soil, litter or snow. Belowground perennial structures vary in both form and their exposure to soil frost, and this structural variation thus may be important in determining the responses of plant communities to frost stress. Methods We conducted a suite of snow removal experiments in a northern temperate old field over three years to examine the relative freezing responses of different plant functional groups based on belowground perennation traits. A litter removal treatment was added in the third year. Species-level percent cover data were recorded in May, June, and September then pooled by functional group. Key results Snow removal decreased total plant cover, and this response was particularly strong and consistent among years for tap-rooted and rhizomatous species. The snow removal responses of cover for plants with root buds and new recruits from seed varied from positive to negative responses among years. The cover of rootstock plants consistently increased in response to snow removal. Rhizomatous species were generally the most vulnerable to litter removal. Conclusions This study is the first to explore the effects of variation in frost severity on the responses of different plant perennation trait functional groups. The responses of herbaceous species to frost may become increasingly important in northern temperate regions in the coming decades as a result of declining snow cover and increasing temperature variability. Our results reveal substantial variation in responses among perennation trait functional groups, which could drive changes in species abundance in response to variation in soil frost.Background and aims Floral colour is a primary signal in plant-pollinator interactions. The association between red flowers and bird pollination is well known, explained by the "bee avoidance" and "bird attraction" hypotheses. Nevertheless, the relative importance of these two hypotheses has rarely been investigated on a large scale, even in terms of colour perception per se. Methods We collected reflectance spectra for 130 red flower species from different continents and ascertained their pollination systems. The spectra were analysed using colour vision models for bees and (three types of) birds, to estimate the colour perception by these pollinators. The differences in colour conspicuousness (chromatic and achromatic contrast, purity) and in spectral properties between pollination systems and across continents were analysed. Key results Compared with other floral colours, red flowers are very conspicuous to birds and much less conspicuous to bees. The red flowers pollinated by bees and by birds are more conspicuous to their respective pollinators. Compared with the bird flowers in the Old World (OW), the New World (NW) ones are less conspicuous to bees and maybe more conspicuous not only to VS-birds (violet-sensitive) but also to UVS-birds (ultraviolet-sensitive). These differences can be explained by the different properties of the secondary reflectance peak (SP). SP intensity is higher in red flowers pollinated by bees than those pollinated by birds (especially the NW bird flowers). A transition from high-SP to low-SP in red flowers can induce chromatic contrast changes, with a greater effect on reducing attraction to bees than enhancing attraction to birds. Conclusions Shades of red flowers differ between pollination systems. Moreover, red bird flowers are more specialized in the NW than in the OW. The fine evolution towards colour specialization is more likely to result in higher efficiency of bee avoidance than bird attraction.Background Stigma affects access and treatment outcomes in men who have sex with men. We assessed the effect of novel community health worker-led antiretroviral therapy delivery (CLAD). Methods A retrospective cohort study of routinely collected data was conducted. We used the t-test to compare the mean adherence to scheduled drug refill appointments before and after implementing CLAD. Results The mean adherence to drug refill was 1.4 (±0.7 SD) of monthly scheduled refills before CLAD and 4.7 (±1.2 SD) of monthly refills in CLAD (P less then 0.001). Conclusion The CLAD model was more effective for drug refill appointments than a regular HIV clinic.Background While trends in caesarean birth by maternal request in low- and middle-income countries are unclear, age, education, multiple gestation and hypertensive disease appear associated with the indication when compared with caesarean birth performed for medical indications. Methods We performed a secondary analysis of a prospectively collected population-based study of home and facility births using descriptive statistics, bivariate comparisons and multilevel mixed-effects logistic regression. Results Of 28 751 patients who underwent caesarean birth and had a documented primary indication for the surgery, 655 (2%) were attributed to caesarean birth by maternal request. The remaining 98% were attributed to maternal and foetal indications and prior caesarean birth. In a multilevel mixed effects logistic regression adjusted for site and cluster of birth, when compared with caesareans performed for medical indications, caesarean birth performed for maternal request had a higher odds of being performed among women ≥35 y of age, with a university or higher level of education, with multiple gestations and with pregnancies complicated by hypertension (P less then 0.01). Caesarean birth by maternal request was associated with a two-times increased odds of breastfeeding within 1 h of delivery, but no adverse outcomes (when compared with women who underwent caesarean birth for medical indications; P less then 0.01). Conclusion Caesarean performed by maternal request is more common in older and more educated women and those with multifoetal gestation or hypertensive disease. It is also associated with higher rates of breastfeeding within 1 h of delivery.Conifers have evolved different chemical and anatomical defenses against a wide range of antagonists. Resin ducts produce, store and translocate oleoresin, a complex terpenoid mixture that acts as both a physical and a chemical defense. Although resin duct characteristics (e.g., number, density, area) have been positively related to biotic resistance in several conifer species, the literature reporting this association remains inconclusive. Axial resin ducts recorded in annual growth rings are an archive of annual defensive investment in trees. This whole-life record of defense investment can be analyzed using standard dendrochronogical procedures, which allow us to assess interannual variability and the effect of understudied drivers of phenotypic variation on resin-based defenses. Understanding the sources of phenotypic variation in defenses, such as genetic differentiation and environmental plasticity, is essential for assessing the adaptive potential of forest tree populations to resist pests under climate change. Here, we reviewed the evidence supporting the importance of resin ducts in conifer resistance, and summarized current knowledge about the sources of variation in resin duct production. We propose a standardized methodology to measure resin duct production by means of dendrochronogical procedures. This approach will illuminate the roles of resin ducts in tree defense across species, while helping to fill pivotal knowledge gaps in plant defense theory, and leading to a robust understanding of the patterns of variation in resin-based defenses throughout the tree's lifespan.Effects of climate warming on tree growth and physiology may be driven by direct thermal effects and/or by changes in soil moisture. Dioecious tree species usually show sexual spatial segregation along abiotic gradients, however, few studies have assessed sex-specific responses to warming in dioecious trees. We investigated the sex-specific responses in growth, photosynthesis, nonstructural carbohydrate (NSC), water use efficiency and whole-plant hydraulic conductance (KP) of the dioecious tree species Populus cathayana under +4°C elevated temperature with and without supplemental water. For both sexes, high temperature treatments significantly decreased growth (height and biomass), photosynthetic rate (A), the ratio of A to dark respiration rate, stomatal conductance (gs), transpiration rate, NSC, leaf water potential and KP, but increased water use efficiency (estimated from carbon isotope composition). Under warming with supplemental water, most traits of females did not change relative to ambient conditions, but traits of males decreased, resulting in greater sexual differences. Females showed a lower KP, and their gs and A responded more steeply with water-related traits than males. These results show that the effect of summer warming on growth and photosynthesis was driven mainly by soil moisture in female P. cathayana, while male performance was mainly related to temperature. Females may experience less thermal stress than males due to flexible water balance strategy via stomata regulation and water use.Background To observe prevalence, characteristics and outcomes associated with operative vaginal birth (OVB). Methods We compared spontaneous vaginal birth with OVB. Results Of 993 women, 759 (76.4%) experienced vaginal birth; 716 were spontaneous (94.3%), 14 (1.8%) underwent forceps-assisted birth and 29 (3.8%) had vacuum assistance. SB939 concentration In a multivariable model of OVB (forceps and vacuum), compared with a midwife, general practitioners (OR 5.6, p = 0.04) and integrated emergency surgical officers (OR 42.8, p = 0.001) were more likely to attend. Women experiencing OVB were more likely to receive local anesthesia (OR 3.0, p = 0.009). Conclusion OVB is used sparingly but safely at Mizan-Tepi University Teaching Hospital.
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