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PD-1 blockade has been recommended as first-line therapy for nonresectable or metastatic mismatch repair-deficient/microsatellite instability-high (dMMR/MSI-H) colorectal cancer (CRC). However, the safety and efficacy of neoadjuvant PD-1 blockade immunotherapy for locally advanced dMMR/MSI-H CRC remain unclear.From June 2020 to June 2022, 11 locally advanced dMMR/MSI-H CRC patients treated at the Sixth Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) were enrolled. All patients received 6 sintilimab (Innovent, LTD) injections (200 mg/injection, every 3 weeks) before radical laparoscopic resection. The patient clinical and pathological data were analyzed retrospectively.dMMR was confirmed by immunohistochemistry for all patients. However, polymerase chain reaction (PCR) or next-generation sequencing confirmed MSI-H for only 90.9% (10/11) of the patients, while 1 patient had microsatellite stable (MSS) disease. After 6 injections of neoadjuvant anti-PD-1 therapy, 90.9% (10/11) of the patients (those confirmed to have dMMR and MSI-H disease) achieved pathological complete response (pCR). The other patient, who achieved major pathological response with residual tumor1%, had dMMR but MSS disease. No grade 3 or above immunotherapy-related adverse events occurred [Common Terminology Criteria for Adverse Events ; version 5.0]. Overall, 72.7% (8/11) of the patients had grade 1-2 immunotherapy-related adverse events . No operational mortality or complications occurred within 30 days after surgery.Single-agent neoadjuvant PD-1 antibody immunotherapy was safe and effective in locally advanced dMMR/MSI-H CRC. Dual confirmation of MMR and MSI status by immunohistochemistry and next-generation sequencing or PCR is necessary for dMMR/MSI-H CRC patients before immunotherapy. The immunotherapy regimen used in this study deserves further validation in phase II and III clinical studies.

Complex soil pore geometry and heterogeneity determines the ability of a soil to retain moisture and conduction. These soil properties are widely recognized as key factors of essential ecological functions and services. However, until recently, the existing pore identification methods have the problems of low identification accuracy and operating efficiency, which has restricted the development of soil science. The objective of this study was to propose a neighborhood median weighted fuzzy c-means method based on grayscale-gradient feature (NMFCM-G) to identify soil pore structure automatically and accurately. By combining three-dimensional (3D) printing technology with X-ray computed tomography technology, a 3D simulation model with known aperture (10-cm inner diameter) was adopted to evaluate the pore identification error rate of the NMFCM-G method quantitatively. Compared to the methods commonly applied in previous studies, the NMFCM-G method had the smallest average area relative error (2.98%), which was only 1/6 of that of the Image J method with the largest area relative error (18.46%). The NMFCM-G method also had the smallest average perimeter (5.46%), about 3/5 of that of the Image-Pro Plus method with the largest perimeter relative error (8.35%). Meanwhile, the NMFCM-G method was successfully tested on undisturbed cylindrical soil samples, providing encouraging results in terms of identifying irregular pore structure from the complex hierarchical organization of soil. The results show that the NMFCM-G method had the smallest distribution entropy (0.81), the smallest inter-class correlation (0.164 0), and the largest distribution coefficient (0.11), which proves that the NMFCM-G method performed the best in identifying different soil pore structures. Overall, the NMFCM-G method provides new insights into identifying pore structures and thus could provide an automatic and high-efficiency technique for studying the effects of tillage and freeze-thaw cycles on pore structure and soil quality in the future.

Background Disaster experiences have long-term health effects. However, less is known about the pathways of the association between disaster experiences and people’s long-term health. We aimed to examine the long-term (10-year) effect of housing damage in the 2008 Wenchuan earthquake on survivors’ health and to explore the pathways of the long-term effect. Methods We used data from a survey conducted in 2018 in rural areas affected by the 2008 Wenchuan earthquake. The survey collected information on housing damage caused by the earthquake from survivors aged 18 years old or above. Our primary outcome was dichotomous self-rated health in 2018. We considered decreased living standards and debt burden as mediators. To examine the long-term effect of housing damage on health, we performed multivariable binary logistic regression models. We also performed mediation analyses using the “KHB-method”. Results Compared with no/slight damage, serious damage (odds ratio (OR): 1.50, 95% confidence interval (CI): 1.11,2.04) and collapse (OR: 1.57, 95% CI: 1.13,2.18) were associated with a higher risk of poor health. Decreased living standards and debt burden mediated 8.49% and 4.79%, respectively, of the association between serious damage and poor health and 10.64% and 6.10%, respectively, of the association between collapse and poor health. Conclusion Housing damage in a natural disaster is a long-term risk for survivors’ health. Long-term policies and interventions are necessary to protect and promote the health of survivors who experience housing damage. In addition to house reconstruction assistance, policies and interventions can be designed to promote living standards and financial situations to protect survivors’ health.

Pre-disaster mitigation and preparedness activities are necessary to reduce vulnerability in a society and to protect people whenever disasters occur. Although disaster preparedness and protective behaviors have attracted scholars worldwide, there has been little investigation into the differences between the preparedness of rural and urban households. This study examines the associations of various influencing factors with household disaster preparedness in urban and rural China, where urban-rural differences remain substantial in spite of rapid economic growth. Data from a large area affected by the 2008 Wenchuan earthquake were used. Results from linear regression models showed that the urban-rural differences in disaster preparedness were mainly explained by the socioeconomic factors, such as education, income, and social status (being a CCP member). Community activities intended to reduce the risk of disaster can also encourage an individual to carry out preparedness activities. Interventions may be needed to focus on low socioeconomic status households to improve their disaster preparedness. Community activities may serve as an important approach to design interventions.

Objective To evaluate the surgical and oncologic outcomes of robotic sleeve lobectomy in comparison with video-assisted thoracoscopic surgery (VATS) and open surgery. Methods Surgical outcomes in patients with non–small cell lung cancer who underwent sleeve lobectomy via robotic, VATS, and thoracotomy were assessed using the χ2 test, Fisher exact test, and the Kruskal–Wallis rank sum test. Log-rank test and Cox proportional hazards model were used in survival analyses. Propensity score–weighted matching was used to achieve the balance of baseline among the 3 groups. Results Between 2012 and 2017, 188 patients were included and divided into robotic (n = 49), VATS (n = 73), and open (n = 66) groups. After weighted matching that retained all patients, no statistical difference in 90-day mortality or morbidity among the 3 groups was shown. Patients in the robotic group had less bleeding loss (P .050). Conclusions Robotic sleeve lobectomy is a safe, feasible, and effective procedure. Compared with VATS and open techniques, robotic sleeve lobectomy has a similar oncologic prognosis for patients with centrally located non–small cell lung cancer. Further studies with a larger sample size and long-term follow-up are needed.

For monitoring soil water dynamics in cold regions, the major concerns are not only liquid soil water content (LSWC) and total soil water content (TSWC), but soil ice content (SIC) as well. The field determination of SIC is more challenging than that of LSWC or TSWC and no practical method has been found. This study presents a method that combined a neutron moisture meter (NMM) with a dielectric tube sensor (DTS) lowered in a common access PVC-tube, in which NMM was for determining TSWC and DTS was for LSWC. Consequently, the absolute difference was of SIC. The proposed method was tested in an agricultural field over the winter of 2011–2012. Field calibration and a cross-check showed that DTS and NMM measurements in the common access PVC-tube were very similar (R2 = 0.9503, RMSE = 0.0197 cm3 cm−3) to the volumetric soil water contents (VSWCs) ranging from 0.05 to 0.40 cm3 cm−3. More importantly, the results of overall experimental period confirmed that both sensors had the same responses in the unfrozen layers but different responses in the frozen layers. Based on this, we transformed the measurements of both sensors into SIC. Furthermore, for characterizing the SIC dynamics during the overall experimental period, we presented the curve-based results and the map-based results, respectively. These results verified that the proposed method is feasible to determine the SIC profiles in situ with a major advantage that allows both probes lowering multiple access PVC-tubes at the field scale.

Wilting is a common symptom in plants responding to drought stress. Early wilting detection is of high importance for crop precision management. However, it is challenging to develop a reliable measurement technology. This study presents a sensing method based on three-dimensional (3D) images that are generated by a laser scanner. A leaf wilting index (LWI"2"D"F"T) is defined from the spectrum of a two-dimensional (2D) Fourier transform (FT), in which a leaf is equivalent to a mathematical surface in 3D space, and thus a wilting process refers to a series of the curved surfaces. To verify the effectiveness of the index LWI"2"D"F"T, we applied our method to zucchini plants (Cucurbita pepo L.) 17days after they emerged from the soil. The laboratory experiments included two periods of 10days each. From six leaves of three plants tested in the first period, it was observed that this index was capable of sensing the stress response of the zucchini from slight wilting to severe stress levels. The regression results between LWI"2"D"F"T and ambient temperature (T"a"i"r) fitted a linear equation with 0.814=

We describe a novel technique of thoracoscopic circumferential tracheal resection and end-to-end anastomosis. A 60-year-old woman presented with wheezing and progressive dyspnea. Computed tomography scan revealed a mass at the lower trachea, and a nitinol mesh stent was implanted by bronchoscopy. After 2 weeks, a complete thoracoscopic tracheal resection and reconstruction was performed. The postoperative course was uneventful. The final pathologic examination confirmed the diagnosis of primary adenoid cystic carcinoma of the trachea.