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BACKGROUND Urachal carcinoma is a rare nonurothelial malignant tumor with high rates of local recurrence and systemic metastasis. Although radical resection is widely considered the standard treatment, there is still a debate regarding the benefits of lymphadenectomy. Nocodazole datasheet To explore these factors, we investigated the recurrence pattern of urachal cancer and the impact of lymphadenectomy on long-term survival. METHODS The data of 62 patients pathologically diagnosed with urachal carcinoma at Sun Yat-sen University Cancer Center from 2002 to 2019 were retrospectively reviewed. Lymphadenectomy was defined as lymph nodes retrieved from the obturator, internal iliac, and external iliac lymph node stations. The Kaplan-Meier method and Cox regression model were used to identify prognostic factors. OS and DFS were the primary endpoints. RESULTS Of the 47 males and 15 females included, 54 patients underwent partial cystectomy, and 27 patients underwent lymphadenectomy. The number of patients with Sheldon stage IIIA, IIIB, IIIC, IVA, and IVB were 43 (69.4%), 4 (6.5%) 3 (4.8%), 6 (9.7%), and 6 (9.7%), respectively. The median DFS was 32.7 months, and the mean OS was 114.6 months. Sheldon stage (P less then .001) and tumor size (P = .001) were identified as independent prognostic factors for DFS, whereas Sheldon stage (P = .003), peritoneal metastasis (P = .006), distant metastasis (P = .024), and recurrence in pelvic lymph nodes (P = .015) were independent prognostic factors for OS. CONCLUSIONS Urachal carcinoma has a high recurrence rate, but only peritoneal metastasis, distant metastasis, and recurrence in pelvic lymph nodes were found to be associated with OS. Lymphadenectomy was recommended because of its role in accurately staging the disease, and further research is needed to focus on lymphadenectomy and standardized the procedure. © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.Developing highly-active and non-precious electrocatalysts for efficient oxygen evolution reaction is important for designing renewable energy production and storage devices. In this work, high dense / ultra-thin Co-Ni boride nanoflakes supported on 3-dimensional (3D) CoNi skeleton are in-situ fabricated by a simple one-step high-temperature solid state boronizing process. Benefiting from the induced high electro-active surface area and low charge transfer resistance, CoNiB-700 exhibits high catalytic activity at overpotential of 262 (η 10 ) and 284 mV (η 20 ) to deliver current density of 10 and 20 mA cm -2 respectively, with Tafel slope of 58 mV dec -1 in alkaline medium towards the OER. The density functional theory (DFT) calculations also reveal that the Ni regulated Co-B compound has lower rate-determining energy barrier of *OOH intermediate than mono-Co-B compound, facilitating to produce more active catalyzing sites for accelerated surface charge-transfer process for the OER. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.INTRODUCTION The recent DAWN trial created a paradigm shift in acute stroke treatment from 'time-based' criteria (within 6 hours) to 'tissue-based' criteria dependent on advanced neuroimaging such as CT perfusion (CTP). This has expanded the thrombectomy window from 6 to 24 hours and has major implications for healthcare providers involved in acute stroke management. Our aim is to characterise changes in the utilisation, diagnostic yield and accuracy of CTP in the diagnosis of acute stroke in the year following the DAWN trial. METHODS Four hundred and forty-three patients underwent CTP for investigation of suspected stroke between 1 January 2017 and 31 December 2018. Studies in 2017 were considered 'pre-DAWN' while studies in 2018 were considered 'post-DAWN trial'. Electronic medical records were reviewed to extract patient characteristics. Each patient was categorised as early presenter (within 6 hours) or late presenter (over 6 hours). Chi-squared tests were performed to assess for differences in proportions between the 2 years. RESULTS There was a 50% increase in CTP performed from 177 in 2017 to 266 in 2018. The proportion of all CT that were CTP increased by 40% while CTP in late presenters increased by 70% in 2018. The sensitivity, specificity and proportions of CTP with a final diagnosis of acute stroke, TIA or nonstroke did not demonstrate statistically significant differences between the 2 years. CONCLUSIONS The CTP utilisation, particularly in late presenters, has substantially increased since the DAWN trial. This contributes to increasing burden on healthcare services related to the diagnosis and management of stroke. © 2020 The Royal Australian and New Zealand College of Radiologists.The search of alternative approaches to epithelial cell adhesion molecule (EpCAM), for the isolation of circulating tumor cells (CTC), is on the rise. This work attempts at evaluating the feasibility of using a new glycosaminoglycan, SCH45, as a probe to isolate CTCs from the peripheral blood of 65 advanced/metastatic cholangiocarcinoma (CCA) patients. The positive enrichment of CTCs from 1 mL of blood using SCH45-bound magnetic beads and subsequent staining on an integrated microfluidic platform is demonstrated. Results detailing CTC concentrations averaging ≥1 CTCs mL-1 of blood are shown, and a conventional protein biomarker, EpCAM, has been used to corroborate the finding that 100% of the patients possess CTCs in their blood. Studies detailing the use of CTCs in the prognostic monitoring and treatment effectiveness of advanced/metastatic CCA are scarce, and the isolation of CTCs from all CCA patients tested has not been reported yet. A strong correlation between CTC counts and disease progression at the time of and/or in advance of radiographic imaging in patients receiving chemotherapy is also reported. This study is one of its kind with the new probe and reduced sample volume and has potential for use in CCA diagnosis and prognosis in the near future. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.The global pandemic of coronavirus disease 2019 (COVID-19) is associated with the development of acute respiratory distress syndrome (ARDS), which requires ventilation in critically ill patients. The pathophysiology of ARDS results from acute inflammation within the alveolar space and prevention of normal gas exchange. The increase in proinflammatory cytokines within the lung leads to recruitment of leukocytes, further propagating the local inflammatory response. A consistent finding in ARDS is the deposition of fibrin in the air spaces and lung parenchyma. COVID-19 patients show elevated D-Dimers and fibrinogen. Fibrin deposits are found in the lungs of patients due to the dysregulation of the coagulation and fibrinolytic systems. Tissue factor (TF) is exposed on damaged alveolar endothelial cells and on the surface of leukocytes promoting fibrin deposition, while significantly elevated levels of plasminogen activator inhibitor 1 (PAI-1) from lung epithelium and endothelial cells create a hypofibrinolytic state.
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