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Publication oncologic outcome throughout pancreaticoduodenectomy: Perform regionalization efforts be the better choice?
The risk of kidney stone presentations increases after hot days, likely due to greater insensible water losses resulting in more concentrated urine and altered urinary flow. It is thus expected that higher temperatures from climate change will increase the global prevalence of kidney stones if no adaptation measures are put in place. This study aims to quantify the impact of heat on kidney stone presentations through 2089, using South Carolina as a model state. We used a time series analysis of historical kidney stone presentations (1997-2014) and distributed lag non-linear models to estimate the temperature dependence of kidney stone presentations, and then quantified the projected impact of climate change on future heat-related kidney stone presentations using daily projections of wet-bulb temperatures to 2089, assuming no adaptation or demographic changes. Two climate change models were considered-one assuming aggressive reduction in greenhouse gas emissions (RCP 4.5) and one representing uninibited greenhouse gas emissions (RCP 8.5). The estimated total statewide kidney stone presentations attributable to heat are projected to increase by 2.2% in RCP 4.5 and 3.9% in RCP 8.5 by 2085-89 (vs. 2010-2014), with an associated total excess cost of ~ $57 million and ~ $99 million, respectively.A two-way 224-Gbit/s four-level pulse amplitude modulation (PAM4)-based fibre-free-space optical (FSO) converged system through a 25-km single-mode fibre (SMF) transport with 500-m free-space transmission is successfully constructed, which adopts injection-locked vertical-cavity surface-emitting lasers with polarisation-multiplexing mechanism for a demonstration. Compared with one-way transmission, two-way transmission is an attractive architecture for fibre-FSO converged system. Two-way transmission over SMF transport with free-space transmission not only reduces the required number of fibres and the setups of free-space transmission, but also provides the advantage of capacity doubling. Incorporating dual-wavelength four-level pulse amplitude modulation (PAM4) modulation with polarisation-multiplexing mechanism, the transmission capacity of fibre-FSO converged system is significantly enhanced to 224 Gbit/s (56 Gbit/s PAM4/wavelength × 2-wavelength × 2-polarisation) for downlink/uplink transmission. Bit error rate and PAM4 eye diagrams (downstream/upstream) perform well over 25-km SMF transport with 500-m free-space transmission. This proposed two-way fibre-FSO converged system is a prominent one not only because of its development in the integration of fibre backbone with optical wireless extension, but also because of its advantage in two-way transmission for affording high downlink/uplink data rate with good transmission performance.We aimed to assess some of the potential genetic pathways for cancer development from non-malignant intraductal papillary mucinous neoplasm (IPMN) by evaluating genetic mutations and methylation. In total, 46 dissected regions in 33 IPMN cases were analyzed and compared between malignant-potential and benign cases, or between malignant-potential and benign tissue dissected regions including low-grade IPMN dissected regions accompanied by malignant-potential regions. Several gene mutations, gene methylations, and proteins were assessed by pyrosequencing and immunohistochemical analysis. RASSF1A methylation was more frequent in malignant-potential dissected regions (p = 0.0329). LINE-1 methylation was inversely correlated with GNAS mutation (r =  - 0.3739, p = 0.0105). In cases with malignant-potential dissected regions, GNAS mutation was associated with less frequent perivascular invasion (p = 0.0128), perineural invasion (p = 0.0377), and lymph node metastasis (p = 0.0377) but significantly longer overall survival, compared to malignant-potential cases without GNAS mutation (p = 0.0419). The presence of concordant KRAS and GNAS mutations in the malignant-potential and benign dissected regions were more frequent among branch-duct IPMN cases than among the other types (p = 0.0319). Methylation of RASSF1A, CDKN2A, and LINE-1 and GNAS mutation may be relevant to cancer development, IPMN subtypes, and cancer prognosis.Jarman-Bell (1974) hypothesized that in the dry savanna of Africa, small-bodied herbivores tend to browse more on forage with high protein and low fibre content. This implies browsing on high nutritive forage by meso-herbivores, and grazing and mixed feeding on coarse forage by mega-herbivores. We tested this hypothesis in the riverine alluvial grasslands of the Kaziranga National Park (KNP), where seasonal flood and fire play an important role in shaping the vegetation structure. We analyzed the feeding habits and quality of major forage species consumed by three mega-herbivores, viz. greater one-horned rhino, Asian elephant, and Asiatic wild buffalo, and three meso-herbivores, viz. swamp deer, hog deer, and sambar. We found that both mega and meso-herbivores were grazers and mixed feeders. Overall, 25 forage plants constituted more than 70% of their diet. Among monocots, family Poaceae with Saccharum spp. (contributing > 9% of the diet), and, among dicots, family Rhamnaceae with Ziziphus jujuba (contributinvailability, predation risk, and management practices such as controlled burning of the grasslands. The ongoing succession and invasion processes, anthropogenic pressures, and lack of grassland conservation policy are expected to affect the availability of the principal forage and suitable habitat of large herbivores in the Brahmaputra floodplains, which necessitates wet grassland-based management interventions for the continued co-existence of large herbivores in such habitats.Agricultural fields in drylands are challenged globally by limited freshwater resources for irrigation and also by elevated soil salinity and sodicity. It is well known that pedogenic carbonate is less soluble than evaporate salts and commonly forms in natural drylands. However, few studies have evaluated how irrigation loads dissolved calcium and bicarbonate to agricultural fields, accelerating formation rates of secondary calcite and simultaneously releasing abiotic CO2 to the atmosphere. This study reports one of the first geochemical and isotopic studies of such "anthropogenic" pedogenic carbonates and CO2 from irrigated drylands of southwestern United States. A pecan orchard and an alfalfa field, where flood-irrigation using the Rio Grande river is a common practice, were compared to a nearby natural dryland site. Strontium and carbon isotope ratios show that bulk pedogenic carbonates in irrigated soils at the pecan orchard primarily formed due to flood-irrigation, and that approximately 20-50% of soil Cluxes at local, regional and global scales.The difference in the shear strength and other characteristics of the cohesive soil containing calcareous nodules (CSCN) between samples with large size and corresponding scaling size, which is called scaling effect, is significantly affected by its calcareous nodule content (CNC) of the gradation composition. However, current researches rarely reveal the influence of the CNC on the scaling effect in shear strength of samples. In this study, how and why the CNC affects the scaling effect in shear strength were explored. Then a method to reduce the scaling effect based on the reason for influence was proposed. Results show that the correlation between the scaling effect in shear strength and the CNC presents a step curve. This is attributed to that it is easier to form a skeleton effect in samples with scaling size for the same CNC. Considering the skeleton effect, a calculation model for the shear strength parameters of CSCN samples with large size is proposed to reduce the scaling effect. This paper demonstrates that the proposed calculation model provides an access to obtain calculated shear strength parameters of CSCN samples with large size by using measured results of samples with corresponding scaling size.Having infected by Helicobacter pylori, the infection often leads to gastritis, gastric ulcer, or even gastric cancer. The disease is typically treated with antibiotics as they used to effectively inhibit or kill H. pylori, thus reducing the incidence of gastric adenoma and cancer to significant extent. H. pylori, however, has developed drug resistance to many clinically used antibiotics over the years, highlighting the crisis of antibiotic failure during the H. pylori treatment. We report here that the fucoidan from Sargassum hemiphyllum can significantly reduce the infection of H. pylori without developing to drug resistance. Fucoidan appears to be a strong anti-inflammation agent as manifested by the RAW264.7 cell model examination. Fucoidan can prohibit H. pylori adhesion to host cells, thereby reducing the infection rate by 60%, especially in post treatment in the AGS cell model assay. Mechanistically, fucoidan intervenes the adhesion of BabA and AlpA of H. pylori significantly lowering the total count of H. pylori and the level of IL-6 and TNF-α in vivo. These results all converge on the same fact that fucoidan is an effective agent in a position to protect the stomach from the H. pylori infection by reducing both the total count and induced inflammation.The immune response after SARS-CoV-2 vaccine administration appears to be characterized by high inter-individual variation, even in SARS-CoV-2 positive subjects, who could have experienced different post-infection, unresolved conditions. We monitored anti-SARS-CoV-2 IgG levels and kinetics along with circulating biomarkers in a cohort of 175 healthcare workers during early immunization with COVID-19 mRNA-LNP BNT162b2 vaccine, to identify the associated factors. IGF-1R inhibitor Subjects with a previous SARS-CoV-2 infection were characterized by higher BMI and CRP levels and lower neutrophil count with respect to naïve subjects. Baseline IgG levels resulted associated with CRP independently on BMI and inflammatory diseases. Among 137 subjects undergoing vaccination and monitored after the first and the second dose, three kinetic patterns were identified. The pattern showing a rapid growth was characterized by higher IgG levels at baseline and higher CRP and MCHC levels than negative subjects. Subjects previously exposed to SARS-CoV-2 showed higher levels of CRP, suggesting persistence of unresolved inflammation. These levels are the main determinant of IgG levels at baseline and characterized subjects belonging to the best performing, post-vaccine antibody kinetic pattern.The tumor burden (TB) is significantly related to the severity of cytokine release syndrome (CRS) caused by CAR-T cells, but its correlation with therapeutic efficacy has not been systematically studied. This study focused on the effects of the TB level on both the safety and efficacy of ssCART-19 as a treatment for r/r B-ALL. Taking the 5% tumor burden as the boundary, the study participants were divided into 2 groups, high and low tumor burden groups. Under this grouping strategy, the impacts of differential r/r B-ALL TBs on the clinical therapeutic efficacy (CR rate and long-term survival) and safety profiles after ssCART-19 cell treatment were analysed. 78 patients were reported in this study. The differential B-ALL TBs significantly affected the complete remission (CR) rates of patients treated with ssCART-19, with rates of 93.94% and 75.56% in the low and high TB groups, respectively (P = 0.0358). The effects of TBs on long-term therapeutic efficacy were further studied based on event-free survival (EFS) and overall survival (OS) profiles; both the OS and EFS of the low TB group were better than those of the high TB group, but the differences were not statistically significant.
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