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To determine the impact of initial vancomycin trough concentration (VTC) on mortality in adult patients in the intensive care unit (ICU) undergoing vancomycin therapy. During their first ICU stay, patients with initial VTC records after vancomycin treatment were recruited from the eICU Collaborative Research Database to this multicenter retrospective cohort study, and classified into four groups according to VTC: less than 10, 10–15, 15–20, and greater than 20 mg/L. Multivariable logistic regression and sensitivity analyses were performed to explore the association of VTC, as a continuous and categorical variable, with mortality. This study enrolled 7220 patients from 335 different ICUs at 208 hospitals. Multivariable logistic regression models indicated that VTC was positively correlated with ICU (odds ratio [OR], 1.028, 95% confidence interval [CI], 1.019–1.037) and hospital (OR 1.028, 95% CI, 1.020–1.036) mortalities. Moreover, compared with VTC less than 10 mg/L, VTCs of 10–15, 15–20, and greater than 20 mg/L were associated with a higher risk of ICU mortality (OR, 1.330, 95% CI, 1.070–1.653; OR, 1.596, 95% CI, 1.265–2.015; abd OR, 1.875, 95% CI, 1.491–2.357, respectively), and VTCs of 15–20 and greater than 20 mg/L were also correlated with increased hospital mortality (OR, 1.482, 95% CI, 1.225–1.793; and OR, 1.831, 95% CI, 1.517–2.210, respectively). Similar results persisted in patients with different Acute Physiology and Chronic Health Evaluation Ⅳ scores, creatinine clearance levels, ages, and body mass indexes. Our findings indicated a potential relationship of initial VTC with ICU and hospital mortalities in patients in the ICU. However, due to the retrospective nature of this study, future prospective studies or randomized controlled trials are needed to validate those results.

Background: Ovarian cancer is a fatal gynecologic malignancy that is found worldwide and exhibits an insidious onset and a lack of early warning symptoms. Despite ongoing studies, the mechanistic basis of the aggressive phenotypes of ovarian cancer remains unclear. Lysine acetyltransferase 6A (KAT6A) is a MYST-type histone acetyltransferase (HAT) enzyme identified as an oncogene in breast cancer, glioblastoma and leukemia. However, the specific functions of KAT6A in ovarian cancer remain unclear. Methods: Immunohistochemistry (IHC) staining and western blotting were performed to characterize KAT6A protein expression in ovarian cancer tissues and cell lines. The biological functions of KAT6A in ovarian cancer were evaluated by cell proliferation, wound healing and transwell invasion assays in vitro. Tumorigenesis and metastasis assays were performed in nude mice to detect the role of KAT6A in vivo. Mass spectrometry and immunoprecipitation assays were performed to detect the KAT6A-COP1 interaction. An in vivo ubiquitination assay was performed to determine the regulation of β-catenin by KAT6A. Results: In the present study, we revealed that KAT6A expression is upregulated in ovarian cancer and is associated with patient overall survival. Downregulation of KAT6A markedly inhibited the proliferation and migration abilities of ovarian cancer cells in vivo and in vitro. Additionally, the inhibition of KAT6A induced apoptosis and enhanced the sensitivity of ovarian cancer cells to cisplatin. Furthermore, KAT6A bound to and acetylated COP1 at K294. The acetylation of COP1 impaired COP1 function as an E3 ubiquitin ligase and led to the accumulation and enhanced activity of β-catenin. Conclusions: Our findings suggest that the KAT6A/COP1/β-catenin signaling axis plays a critical role in ovarian cancer progression and that targeting the KAT6A/COP1/β-catenin signaling axis could be a novel strategy for treating ovarian cancer.

ObjectiveThe aim of this study was to establish a nomogram model for predicting the risk of short-term recurrence in glioma patients.MethodsThe clinical data of recurrent glioma patients were summarized and analyzed in this study. Univariate and multivariate logistic regression analyses were performed to analyze the correlation between clinical data and the risk of short-term recurrence after operation. A nomogram was established based on the multivariate logistic regression model results.ResultsA total of 175 patients with recurrent glioma were enrolled, with 53 patients in the short-term recurrence (STR) group (recurrent time ≤6 months) and 122 patients in the long-term recurrence (LTR) group (recurrent time ≥36 months). Univariate analysis revealed that age at diagnosis, Karnofsky performance scores (KPSs), tumor location, glioma grade, glioma type, extent of resection (EOR), adjuvant chemotherapy (ad-CT), concurrent chemotherapy (co-CT), and isocitrate dehydrogenase (IDH) status were significantly associated with the short-term glioma recurrence. Multivariate analyses revealed that age at diagnosis, KPS, glioma grade, EOR, and IDH were independent risk factors for short-term glioma recurrence. A risk nomogram for the short-term recurrence of glioma was established, with the concordance index (C-index) of 0.971. The findings of calibration and receiver operating characteristic (ROC) curves showed that our nomogram model had good performance and discrimination to estimate short-term recurrence probability.ConclusionThis nomogram model provides reliable information about the risk of short-term glioma recurrence for oncologists and neurosurgeons. This model can predict the short-term recurrence probability and give assistance to decide the interval of follow-up or formulate individualized treatment strategies based on the predicted results. A free online prediction risk tool for this nomogram is provided: https://rj2021.shinyapps.io/Nomogram_ recurrence-risk/.

In large-scale imaging or measurement, a rotating photogrammetric system with a camera fixed on the surface of the turntable can be used to extend the field of view of the camera with the rotation of the turntable. The camera’s projection center needs to be located at the rotation axis of the turntable, so the images captured during the sequentially rotating share the same projection center. It is very convenient to merge the subimages into a panoramic image. Due to the complexity of the camera’s lens system, the position of the projection center is usually unknown, which makes it difficult to find the projection center and align it with the rotation axis of the turntable. We propose a method to find the distance and azimuth angle between the projection center and rotation axis to solve the alignment problem using the parameters of the camera. In theory, as long as the intrinsic and extrinsic parameters of the camera are known, the distance and angle can be obtained by rotating the turntable once. With the translation values calculated from the distance and angle, the camera can be moved in two directions perpendicular to each other, so its projection center passes through the rotation axis. The theoretical analysis of the alignment problem is given. Experiments verify the feasibility of the proposed method are conducted. The alignment uncertainty of the proposed method is

Background: 3D Pseudocontinuous Arterial Spin Labeling (3D-PCASL) MRI and optical coherence tomography angiography (OCTA) have been applied to detect ocular blood flow (BF). We aim to characterize the ocular BF in diabetic retinopathy (DR) using 3D-PCASL and OCTA, to discuss the relationship between ocular and cerebral BF, and to evaluate their potential utility to assess the severity of DR.Methods: A total of 66 participants (132 eyes) were included. Seventy-two eyes were classified in the proliferative diabetic retinopathy (PDR) group, and 60 were in the non-proliferative diabetic retinopathy NPDR group. Ocular and cerebral BF values were detected by 3D-PCASL using a 3.0T MRI scanner with two post-labeling delays (PLDs). Vessel density (VD)/perfusion density (PD) of the macular or peripapillary area were detected by OCTA. Parameters and clinical characteristics were compared between the PDR and NPDR eyes utilizing two-sample t-tests and chi-square tests. Spearman's rank correlation analysis, logistic regression analysis, and receiver operating characteristic curves (ROC) analyses were performed to evaluate the factors' role in DR severity.Results: The perfusions of the retinal/choroidal plexus (RCP), optic nerve head (ONH)/optic nerve (ON), and VD/PD of macular/peripapillary area in the PDR group were significantly lower compared to the NPDR group (p < 0.05). They were protective factors for PDR [ORs = 0.842 for RCP (1.5 s PLD), 0.910 for ONH (1.5 s PLD), 0.905 for ON (both 1.5 and 2.5 s PLD), 0.707 for macular VD, 0.652 for peripapillary VD, p < 0.05, respectively]. Ocular BF had a positive correlation with BF of the occipital lobe (OL) and temporal lobe (TL) in the cerebrum. The BF of RCP (lower than 7.825 mL/min/100 g at 1.5 s PLD) indicated PDR [areas under the curve (AUCs) = 0.682, 95% CI: 0.588–0.777, sensitivity: 70.7% specificity: 63.9%]. The AUC of RCP (PLD = 1.5 s) BF combined with peripapillary VD was 0.841 (95% CI: 0.588–0.777, sensitivity: 75.9% specificity: 82.9%).Conclusions: 3D-pcASL and OCTA may be effective non-invasive methods to measure ocular blood flow in DR patients and assess the severity of DR.

Purpose With strategy-as-practice theory the authors explore successful business-owning families hand-over of roles to the next generation. The authors argue for the usefulness of strategy-as-practice theory in exploring the complexity and plurality of best practices in intergenerational hand-over. The paper aims to discuss these issues. Design/methodology/approach A cross-cultural in-depth case study with best practice cases from China, Germany, Sweden, England, Tanzania, Israel and the USA, based on in-depth interviews of family members and non-family employees. Findings The authors identified three different succession patterns: a “monolithic practice,” a distributed leadership hand-over, and active ownership with a non-family managing director/CEO. Two other types of hand-over practices were categorized as incubator patterns that formed a part of, or replaced, what we traditionally see as a hand-over of roles. Families would switch between these practices. Research limitations/implications Surprisingly, a monolithic succession practice (a one-company-one-leadership role) was rarely used. Quantitative and qualitative research should consider, as should advisors to family owners and family businesses, the plurality of succession practices. Education should explore a variation of succession and how the dynamic of gender influences the process. Practical implications Giving practitioners, such as research and practitioner, an overview of strategic options so as to explore these in a client or research case. Social implications Adding the notions that the family is an incubator for new entrepreneurship makes it possible to show how not only sector or public policy generate new ventures. That family as source of entrepreneurship has been well established in the field but it mainstream policy thinking the family is not seen as such a source. Originality/value The paper offers an integrative model of the complexity of hand-over practices of ownership and leadership roles. It shows how these practices are fundamental for understanding how a family’s ownership and their leadership of businesses and new entrepreneurship develops.

Background: It remains unclear whether the mean vancomycin trough concentration (VTC) derived from the entire course of therapy is of potential benefit for critically ill patients. This study was conducted to explore the association between mean serum VTC and mortality in intensive care units (ICUs).Methods: 3,603 adult patients with two or more VTC records after receiving vancomycin treatment in the eICU Collaborative Research Database were included in this multicenter retrospective cohort study. Mean VTC was estimated using all measured VTCs and investigated as a continuous and categorical variable. Patients were categorised into four groups according to mean VTC: 20 mg/L. Multivariable logistic regression and subgroup analyses were performed to investigate the relationship of mean VTC with mortality.Results: After adjusting for a series of covariates, logistic regression analyses indicated that mean VTC, as a continuous variable, was positively correlated with ICU (odds ratio, 1.038, 95% confidence interval, [1.014–1.063]) and hospital (1.025 [1.005–1.046]) mortalities. As a categorical variable, mean VTC of 10–15 mg/L was not associated with reduced ICU (1.705 [0.975–2.981]) and hospital (1.235 [0.829–1.841]) mortalities. Mean VTC of 15–20 mg/L was not correlated with a lower risk of hospital mortality (1.370 [0.924–2.029]). Moreover, mean VTCs of 15–20 and >20 mg/L were significantly associated with higher ICU mortality (1.924 [1.111–3.332]; 2.428 [1.385–4.258]), and mean VTC of >20 mg/L with higher hospital mortality (1.585 [1.053–2.387]) than mean VTC of Conclusion: Mean VTC was not associated with reduced ICU/hospital related mortality. Our results suggested that VTC monitoring might not guarantee vancomycin efficacy for ICU patients.

The alignment problem of a rotating optical measurement system composed of a charge-coupled device (CCD) camera and a turntable is discussed. The motion trajectory model of the optical center (or projection center in the computer vision) of a camera rotating with the rotating device is established. A method based on camera calibration with a two-dimensional target is proposed to calculate the positions of the optical center when the camera is rotated by the turntable. An auxiliary coordinate system is introduced to adjust the external parameter matrix of the camera to map the optical centers on a special fictitious plane. The center of the turntable and the distance between the optical center and the rotation center can be accurately calculated by the least square planar circle fitting method. Lastly, the coordinates of the rotation center and the optical centers are used to provide guidance for the installation of a camera in a rotation measurement system. Simulations and experiments verify the feasibility of the proposed method.

To assess the association between serum ammonia level upon admission during the initial intensive care unit (ICU) stay and mortality.This retrospective cohort study included 2703 adult patients in eICU Collaborative Research Database. The ICU mortality within ammonia deciles were assessed. Logistic regression analyses were performed to analyze the relationship between ammonia and mortality.We defined three ammonia categories:47, 47-111, and ≥111 μg/dL, corresponding to low, intermediate, and high ICU mortality. Increased ammonia was significantly associated with increased ICU mortality (per 10 μg/dL increase: odds ratio, 1.070 [95% confidence intervals, 1.05-1.09]; intermediate vs. low: 1.90 [1.41-2.56]; high vs. low: 4.38 [2.99-6.41]) and in-hospital mortality (1.06 [1.04-1.08]; 1.45 [1.13-1.87]; 3.41 [2.43-4.79]). Adding ammonia to the Acute Physiology and Chronic Health Evaluation (APACHE) IV score improved the area under the curve from 0.826 to 0.839 (P 0.001) and from 0.806 to 0.813 (P = 0.001) for ICU and in-hospital mortality, respectively. Interaction and subgroup analyses demonstrated consistent results in patients with different APACHE IV scores, with or without hepatic diseases.Elevated serum ammonia level in critically ill patients upon admission was an early risk factor for higher ICU and in-hospital mortality.

Toxic epidermal necrolysis (TEN) is a rare, severe, life-threatening skin disease and it requires urgent critical care, including admission to the intensive care unit (ICU). It is characterized by fatal sequelae and high mortality. Currently, insufficient evidence exists to support the use of any systemic adjuvant therapy, such as cyclophosphamide, intravenous immunoglobulin (IVIg), or corticosteroids. However, plasmapheresis has been increasingly valued by clinicians due to its significant efficacy and little adverse side effects. To assess the efficacy of such treatment, 28 patients who were diagnosed with TEN or SJS/TEN overlap were continuously recruited in the ICU from February 2009 to August 2016. These patients including both children and adults were randomly divided into two groups based on whether or not plasmapheresis therapy was performed after admission, which resulted in a plasmapheresis group (n=13) and a non-plasmapheresis group (n=15). Severity of the disease and the efficacy of treatments were evaluated by the severity-of-illness score for TEN. The results indicated that plasmapheresis may be superior to conventional therapies, such as IVIg or corticosteroids. Furthermore, plasmapheresis combined with other treatments might not be advantageous compared to the effect of plasmapheresis alone.

The calibration of multi-projector display with extra-large field of view (FOV) and quantitative registration analysis for realizing perfect visual splicing is crucial and difficult. In this paper, we present a novel calibration method to realize the seamless splicing for a multi-projector display system with extra-large FOV. The display consists of 24 projectors, covering the range of 360 degrees in the longitude direction and 210 degrees in the latitude direction. A wide-angle camera fixed on a rotating optical system is used to scan the entire display scene and establish point-to-point correspondence between projector pixels and spatial points using the longitude and latitude information. Local longitude table and latitude table are established on the target of the wide-angle camera. A deterministic method is proposed to locate the North Pole of the display. The local tables corresponding to different camera views can be unified based on the image of the North Pole to form global longitude and latitude tables of arbitrary free-form surface. The mapping between the projector pixels and the camera pixels is established by inverse projection technique, and then each pixel of each projector can be appointed a pair of unique longitude and latitude values. A quantitative registration accuracy analysis method is proposed for multi-projector display system, in which, three-frequency temporal unwrapping method based on coded longitude and latitude values is applied to calculate the registration accuracy. Experiments prove that the registration error of the multi-projector system is less than 0.4 pixels.

// Qiang Su 1 , Zhigang Sun 2 , Chenguang Zhang 3 , Yanli Hou 4 and Bangwei Cao 1 1 Department of Oncology, Beijing Friendship Hospital, Capital Medical University, Beijing, China 2 Department of Thoracic Surgery, Jinan Center Hospital Affiliated to Shandong University, Shandong University, Jinan, China 3 Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Capital Medical University, Beijing, China 4 Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China Correspondence to: Yanli Hou, email: // Bangwei Cao, email: // Keywords : NSCLC, PD-1 antibody, PD-L1 antibody, docetaxel, meta analysis Received : March 06, 2017 Accepted : July 12, 2017 Published : July 27, 2017 Abstract Meta-analysis was conducted to systematically assess the effectiveness and safety of programmed cell death protein-1 or ligand-1 (PD-1 or PD-L1) antibodies versus docetaxel alone in advanced non small cell lung cancer (NSCLC). In addition, the prognostic significance of PD-L1 expression in advanced NSCLC was also investigated. 5 eligible studies including 3579 patients were identified through comprehensive search of multiple databases. The results showed that pooled hazard ratios (HR) for overall survival (OS) and progression free survival (PFS) were 0.69 (95% CI: 0.63-0.75; p < 0.001) and 0.87 (95% CI: 0.80-0.94; p < 0.001), between PD-1/PD-L1 antibodies and docetaxel treatment arms, respectively. The pooled relative risk (RR) value for objective response rate (ORR) was 1.53, (95% CI: 1.16-2.01, p = 0.003). Further, subgroup analysis based on PD-L1 expression indicated that pooled HR for OS was significant with 0.66(95% CI: 0.59-0.74, p < 0.001) for PD-L1≥1%. However, PD-L1 < 1% had HR value of 0.79 (95% CI: 0.67-0.93, p = 0.006). Our study concluded that advanced NSCLC patients benefited more with PD-1/PD-L1 antibodies than docetaxel in the second line treatment. PD-L1≥10% in tumor tissues is sufficient to show significant improvement in patient’s outcome with PD-1/PD-L1 antibodies compared to docetaxel. Moreover, PD-1/PD-L1 antibodies treatment showed significant decrease in conventional chemotherapy adverse events, but increased immune-associated adverse effects.

Purpose The purpose of this paper is to explore and analyse in-depth how family owners develop autonomy through ownership for family members within the family, the family within the business and the business within its context. Design/methodology/approach A cross-cultural in-depth case study with best practice cases from China, Germany, Sweden, England, Tanzania, Israel and the USA. It was based on in-depth interviews of family members and non-family employees. Findings A business-owning family has to balance paradoxical choices such as safety or loss of attachments; a stable notion of self or grasping new opportunity; own drive or dependency on others. These constituted the micro-dynamics of autonomy. The macro-outcome of negotiating autonomy was strategy formations such as succession, cluster ownership, stewardship, new business models. Research limitations/implications The research findings enable a more differentiated analysis in case studies and qualitative research and with this theory development on family owner motivation. Practical implications It will give insight for practitioners, advisors and family owners, on the complexity of maintaining family health, family member commitment and emotional issues when developing ownership strategies. Social implications The paper offers a model over the complexity of autonomy, a main drive for entrepreneurship within our economy. It shows the complexity of gender and life stage choices. Originality/value The paper offers a model over the complexity of autonomy, regarded as the main drive for entrepreneurship and family ownership. It shows how this process is fundamental for understanding how the family develops its ownership.

In this paper, a fast rotary mechanical projector (RMP) is designed and manufactured for high-speed 3D shape measurement. Compared with the common high-speed projectors, RMP has a good performance in high-speed projection, which can obtain high quality projected fringes with shorter camera exposure time by using the error diffusion binary coding method and chrome plating technology. The magnitude, acceptability of systemic projection error is analyzed and quantified in detail. For the quantified error, the probability distribution function (PDF) algorithm is introduced to correct the error. Corrected projection error is reduced to more than one third of the original error. Subsequently, a monocular measurement system composed of the RMP and a single camera is constructed. The combination of the RMP device and PDF algorithm ensure the accuracy of a corresponding 3D shape measurement system. Experiments have demonstrated that the proposed solution has a good performance for the 3D measurement of high-speed scenes.

Considering that the market demand is stochastic and dependent on effort, this essay shows that the benchmark revenue-sharing contract could not coordinate a three-level supply chain consisting of one manufacturer, one distributor, and one retailer. By assuming that the retailer himself bears the effort cost, coordination is achieved by implementing revenue-sharing contract based on rebate and penalty policy in one transaction or two transactions of three-level supply chain, and the former is a special case of the latter. When the disruptions induce the changes of the market demand, the revenue-sharing contract could not coordinate the supply chain. To deal with the problem, this essay introduces two forms of improved revenue-sharing contracts which have antidisruption ability. The model of improved revenue-sharing contract is optimized when the market demand is in the additive form with effort dependent demand. Formulas are given to calculate the optimal contract parameters. Finally, this essay demonstrates the accuracy of the model of improved revenue-sharing contract with the help of numerical examples.

A 49-year-old man was diagnosed with small cell lung cancer in May 2005. Chemotherapy was started with 60 mg/day cisplatin iv drip (from days one to three), 2 mg topotecan (TP) hydrochloride iv drip (from days one to four), and traditional Chinese medicine (TCM) AiDi injection for anti-tumor. After four cycles, he underwent conformal radiotherapy with 56Gy/28 fractions in October 2005. In April 2006, a mass on the right supraclavicular area was found. Therefore, he underwent another course of radiotherapy. The fields included the right supraclavicular area and the radiation dose was 50Gy/25 fractions. After completion of chemoradiotherapy, the patient achieved complete remission. Subsequently, the patient received prophylactic cranial irradiation (PCI). Until April of 2012, he had been followed up regularly. Since the SCLC diagnosis, he had received TCM for seven years. In April 2012, the patient complained of coughing again. Subsequently, the patient was given five cycles of an etoposide carboplatin regimen. A computed tomography (CT) scan was performed for review, which showed no obvious change. The patient underwent a second-line chemotherapy irinotecan cisplatin three times. However, the symptoms and CT of this patient showed no significant improvement. We changed the chemotherapy regimen to TP (topotecan 1.2 mg iv drip, days one to five; carboplatin 100 mg iv drip, days one to five). After two TP regimens, the patient died in his sleep on 3 March 2013. In this case, the standardized sequential chemotherapy and radiotherapy treatment, PCI, TCM, and good compliance may have contributed to the patient's longer survival.

The appearance of retinal blood vessels is an important diagnostic indicator of serious disease, such as hypertension, diabetes, cardiovascular disease, and stroke. Automatic segmentation of the retinal vasculature is a primary step towards automatic assessment of the retinal blood vessel features. This paper presents an automated method for the enhancement and segmentation of blood vessels in fundus images. To decrease the influence of the optic disk, and emphasize the vessels for each retinal image, a multidirectional morphological top-hat transform with rotating structuring elements is first applied to the background homogenized retinal image. Then, an improved multiscale line detector is presented to produce a vessel response image, and yield the retinal blood vessel tree for each retinal image. Since different line detectors at varying scales have different line responses in the multiscale detector, the line detectors with longer length produce more vessel responses than the ones with shorter length; the improved multiscale detector combines all the responses at different scales by setting different weights for each scale. The methodology is evaluated on two publicly available databases, DRIVE and STARE. Experimental results demonstrate an excellent performance that approximates the average accuracy of a human observer. Moreover, the method is simple, fast, and robust to noise, so it is suitable for being integrated into a computer-assisted diagnostic system for ophthalmic disorders.

Recently, the main therapy of medullary thyroid cancer (MTC) is surgical, but by which way there is a poor prognosis with a mean survival of only 5 years. In some cases, some researchers found that it is the medullary thyroid cancer stem cells (MTCSCs) that cause metastasis and recurrence. This study aimed to eradicate MTCSCs through administration of all-trans-retinoic acid (ATRA). Here we demonstrate that MTCSCs possess stem- like properties in serum-free medium. The ABCG2, OCT4 and sodium iodide symporter (NIS) were changed by ATRA. Additionally, we found that ATRA can increase the expression of NIS in vivo. All the data suggested that ATRA could increase the iodine uptake of MTCSCs through NIS.

Modern direction finding (DF) methods usually use antenna arrays to receive information from an unknown radiation source, and further process the information in order to locate the transmission source. Small aperture array is easy to carry, install, deploy and operate because of small volume, light weight, and it is preferred to large aperture array, and is frequently used in many aspects such as the navigation of ships and aircrafts, locating interfering or illegal transmitters. But at the same time, small aperture array has poor performance in precision. This work demonstrates the signals received by small aperture array are processed coupled, and the differences between signals in amplitude and phase are amplified greatly, which makes it possible that small aperture array is able to have good performance.

Mast cell (MC) leukemia (MCL) is a subtype of systemic mastocytosis (SM) defined by the World Health Organization as ⩾ 20% of MCs in the bone marrow (BM) aspirate, with (leukemic variant) or without (aleukemic variant) ⩾ 10% of MCs in peripheral blood (PB). The European/American Consensus Group on Mastocytosis has recently proposed a new subclassification of MCL that distinguishes acute vs chronic MCL based on the presence vs absence of organ damage, respectively.

Colorectal cancer (CRC) is 1 of the 3 most commonly diagnosed malignant tumours worldwide. Its incidence in China has shown an increasing trend in recent years, especially in Shanghai. Epidemiological statistics in 20121 showed that the number of new cases increased from the sixth most numerous to the second most numerous since the 1970s. The morbidity of CRC increased from 12 per 100 000 to 56 per 100 000, and the average annual growth rate was greater than 4%. More than half of the patients had locally advanced CRC at the time of diagnosis. Currently, the American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) TNM staging system is considered the most robust tool for predicting prognosis. The lymph nodes (LN) classification of metastasis (pN) is established on the basis of the number of LNs involved (Box 1). A population-based large-scale study revealed that node-negative patients with rectal cancer in whom 7 or fewer LNs were examined had a lower recurrence-free interval than patients in whom at least 8 LNs were examined (17.0% v. 10.7%, p = 0.016).2 The National Cancer Institute guidelines recommended a minimum of 12 LNs to stage LN-negative CRC. The greater number of LNs retrieved, the greater the chance that metastatic LNs can be found. This results in more accurate disease staging, which would allow more appropriate adjuvant treatment planning and better calculation of a patient’s long-term prognosis. Box 1 Lymph nodes (LN) classification of metastasis (pN) Classification Description pN1a Metastases in 1 regional LN pN1b Metastases in 2–3 regional LNs pN1c Tumour deposits in the subserosa, mesentery, or nonperitonealized pericolic or perirectal tissues without regional nodal metastasis pN2a Metastases in 4–6 regional LNs pN2b Metastases in 7 or more regional LNs View it in a separate window Berger and colleagues3 were the first to analyze the LN ratios (LNRs) of patients enrolled in a large adjuvant chemotherapy trial following complete colon cancer (stages II and III) resection using LNR groups based on quartiles. Outcomes included overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS). Survival decreased significantly as LNR increased for all 3 outcomes. When a subgroup analysis was performed of the number of positive LNs, this variable was significant only in predicting survival in those who had fewer than 10 LNs in their pathological sample; for those with an LN count of 10–15 or greater than 15, the LNR was once again the most significant predictor of survival. The LNR has also been shown to be an independent prognosticator in patients with rectal cancer.4–8 Peng and colleagues8 were the first to demonstrate the association between LNR and survival rate in patients with rectal cancer. The mean LNR was 0.34, and they reported that LNR was an independent risk factor for local recurrence, DFS and OS. In these studies,4–8 the LNR cutoff values were 0.01–0.61. Some studies used LNR quartiles, while others used median LNR. This may be related to cancer stage, patient race, sample size and other factors. It is well known that the survival rate for locally advanced rectal cancer, especially stage III, varies widely.9 According to the seventh edition of the TNM classification, patients with stage III cancer are classified based on the number of positive nodes. Intuitively, it seems safe to believe that the prognostic significance of 5 positive nodes out of a total of 5 will be completely different from 5 positive nodes out of a total of 30. The LNR has been shown to be an important prognostic factor in gastric, breast, pancreatic and CRC.10,11 In this study, we sought to evaluate the prognostic impact of the LNR in patients with locally advanced rectal cancer.

Nonlinear state estimation and fusion tracking are always hot research topics for information processing. Compared to linear fusion tracking, nonlinear fusion tracking takes many new problems and challenges. Especially, the performances of fusion tracking, based on different nonlinear filters, are obviously different. The conventional nonlinear filters include extended Kalman filter (EKF), unscented Kalman filter (UKF), particle filter (PF) and cubature Kalman filter (CKF), and the recent square-root cubature Kalman filter (SCKF) has been paid more and more attention by researchers because of its advantages of computation complexity and estimation accuracy over other nonlinear filters. However, the SCKF is mainly designed for single sensor system, and for present nonlinear multi-sensor system, it is not applicable. Based on the current results of fusion tracking algorithms, this paper provides a novel multi-sensor fusion tracking algorithm based on the SCKF. Firstly, a brief introduction of basic SCKF algorithm is given. Then, the centralized fusion tracking frame with augmented measurements and the sequential fusion tracking frame are presented respectively. Finally, two computer simulation examples are demonstrated. Simulations results show that the centralized SCKF can obtain better performances of accuracy, stability and convergence.

The aim of this study was to analyze the risk factors and prognosis for patients with esophageal perforation occurring during or after radiotherapy for esophageal carcinoma. We retrospectively analyzed 322 patients with esophageal carcinoma. These patients received radiotherapy for unresectable esophageal tumors, residual tumors after operation, or local recurrence. Of these, 12 had radiotherapy to the esophagus before being admitted, 68 patients had concurrent chemoradiotherapy (CRT), and 18 patients had esophageal perforation after RT (5.8%). Covered self-expandable metallic stents were placed in 11 patients. Two patients continued RT after stenting and control of infection; one of these suffered a new perforation, and the other had a massive hemorrhage. The median overall survival was 2 months (0–3 months) compared with 17 months in the non-perforation group. In univariate analysis, the Karnofsky performance status (KPS) being ≤70, age younger than 60, T4 stage, a second course of radiotherapy to the esophagus, extracapsular lymph nodes (LN) involving the esophagus, a total dose >100 Gy (biologically effective dose−10), and CRT were risk factors for perforation. In multivariate analysis, age younger than 60, extracapsular LN involving the esophagus, T4 stage, and a second course of radiotherapy to the esophagus were risk factors. In conclusion, patients with T4 stage, extracapsular LN involving the esophagus, and those receiving a second course of RT should be given particular care to avoid perforation. The prognosis after perforation was poor.

According to the requirements of modernization and informatization for the new generation of medium and heavy truck, we raise a corresponding design and solution and complete the work of hardware and software designing and realization independently. Firstly, I analyze the background and status of the proposed scheme; on this basis, we discuss the necessity of the hardware, software, and the related technology. Then, I describe the details of the structure and principles for the hardware. Meanwhile, the information processing process is described, and I explain the specific implementation of software via detailed description of CAN message received and classified threads. Finally, we get the corresponding conclusions through the functional verification and performance diagnosis.

The purpose of this investigation was to analyze the correlation between CT size and gross pathologic size for subjects with primary hepatocellular carcinoma (HCC). This analysis included 174 patients with HCC who underwent surgery. Enhanced computed tomography (CT) was performed up to 30 days before surgery. After resection, the size of the tumor on gross pathologic examination was recorded. The maximal measurement in one dimension on axial imaging and pathologic examination was extracted for statistical analysis. The clinical and pathologic sizes were compared using a percent size difference (%Δsize) as an end point. A regression analysis was applied to study the association between pathologic and radiographic size. The median radiographic and pathologic size were 70.58 ± 38.9 mm and 68.59 ± 40.56 mm, respectively. The radiographic size was larger than or equal to the pathologic size in 110/174 tumors (63.2%), and smaller in 64/174 (36.8%) tumors. Overall, the radiographic and pathologic sizes were positively correlated (r = 0.983, P = 0.000). CT seemed to overestimate the tumor size by 2.16 mm compared to final pathology (P = 0.024). The median %Δsize was 3.3%. Pathologic tumor size was significantly underestimated in patients with a tumor size 3–5 cm (P = 0.011), Grade I HCC (P = 0.023), with clear boundary (P = 0.013). We concluded that CT size and pathologic size were positively correlated, but differences did exist. Utilizing the radiographic tumor when planning radiation would have covered 63.2% of gross tumors. For a radiographic tumor size < 50 mm, utilizing a 3-mm margin around the radiographic tumor would have covered 90% of gross lesions, while a margin of 5 mm would have covered 95%, and a margin of 15 mm would have covered 100%.

Purpose To compare the quality of computed tomography (CT) and magnetic resonance imaging (MRI) in target delineation of hepatocellular carcinoma. Patients and methods Thirty-one patients with hepatocellular carcinoma received CT and MRI (including diffusion-weighted imaging [DWI]) before surgery. The maximal measurement on axial imaging and pathologic examination were extracted for statistical analysis. Results CT, MRI, DWI-based tumour size correlated well with pathologic sizes, r = 0.974, 0.969, 0.964 respectively. But Wilcoxon signed-ranked test showed that differences did exist. CT overestimated the tumour size by 2.9 mm compared to pathology (95% CI: - 13.2 to 7.4 mm). The agreement of MRI-pathology seemed to be worse than CT, with a mean difference of 3.6 mm (95% CI: - 14.7 to 7.7 mm). The worst agreement was in DWI-pathology, with a mean difference of 5 mm (95% CI: - 17.9 to 7.9 mm). But significant difference was found neither between CT and MRI (P = 0.477) nor between MRI and DWI (P = 0.079). Conclusions CT and MRI-based tumour size correlated well with pathologic size, but differences did exist. Most of the lesions were overestimated by CT and MRI. CT and MRI were similar in the guidance of target delineation, and DWI had added little value to MRI. A margin of 10 mm around the gross tumour volume to become the clinical target volume is likely not sufficient.

Textures in many images or video scenes are difficult to code because of the large amount of visible detail. This paper proposes an image coding approach to solve this problem, in which we incorporate image decomposition and texture synthesis technology into the image coding framework. The key idea of our approach is to first decompose the original image into cartoon component u and texture component v with different basic characteristics, and then to synthesize the selected texture regions in texture component v. The cartoon component u and the non-synthetic regions in texture component v are compressed by JPEG. Experimental results show bit-rate savings of over 30% compared with JPEG at similar visual quality levels.

The shaping of the buyer's market and the increasingly throat-cutting competition both serve as the key reasons for the account sale being the essential selling means for enterprises, therefore, it matters a great deal for businesses to exactly assess the returns of the account sale and balance the returns and risks of credit. In this paper, the profit evaluation of the account sale would be regarded as a discrete-time continuous-state Markov process, and the probability of contract-violated enterprises relevant to the tally company along with information acquisition costs would also be fully taken into consideration. Under information entropy and dynamic planning theory, model of profit evaluation under imperfect information has been established to promote its preciseness, scientific credibility and to lay a better decision-making foundation for tally enterprises.

This paper introduces a SOPC high-speed interconnection platform based on FPGA convenient for integrate processing system with Ethernet. Embedded processor PowerPC405e, corporated with logic array, implement seamless connection with processing system, as well as gigabit Ethernet. It shows flexiblity and efficiency through data storage and playback with NAS storage system.

UWB(Ultra Wideband) system takes up extremely wide bandwidth, so it interferes with narrowband communication systems each other easily, that influences the system performance. The main approach to the problem is designing pulse waveform for UWB system to make it have notches in narrowband interferences. The paper designed UWB pulse with APSWF (approximate prolate spheroidal wave functions) that is finite in time domain and frequency domain, made generated pulse satisfy the demand of spectrum hole. The experimental results showed that, the designed pulse could avoid the central frequencies of narrowband systems, and suppressed the narrowband interferences, so solved the coexistence of UWB system and narrowband communication systems successfully.

A PC-based-air-ABS-HIL-simulation test bench with low cost and high efficiency is presented in this paper which can be used to developed air-ABS for commercial vehicle. It has been developed in Matlab/Simulink environment with the real-time rapid prototyping tool: xPC target. The architecture, hardware, and software of this test bench are described in details. Utilizing the test bench, the real-time HIL-simulation tests for air-ABS have been completed. The results illustrate the effectiveness and applicability of the developed test bench.

An exact and minute analysis of characteristics and scattering pattern of finite dipole array is presented in this paper. These features include the compensating for the mutual coupling effect between the array element, and the frequency characteristics as well as the scattering patterns of the dipole array. Furthermore the scattering property with different incident angle and array size is also discussed, and it also analyzed how the incident angle and array size affect the patterns. Scattering patterns shows a good performance of restraint of side lobe level and a good direction of main beams. The moment method is employed to obtain the characteristics.

Efficient diagnosis of faults in digital circuits requires high quality diagnostic test sets that are generated by effective algorithm. In this work, novel optimization algorithms for diagnostic test generation are proposed that require significantly less time than previous methods. The diagnostic test generation is performed using particle swarm optimization (PSO) or improved PSO, and fault simulator. Experimental results illustrate the effectiveness of the approach. STPG based on improved PSO is generally superior to both GA-based STPG and PSO-based STPG in terms of achieved fault coverage and required CPU time.

A texture image segmentation algorithm based on wavelet transform and kd-tree clustering is studied in this paper. Firstly, texture features of an image are extracted using wavelet transform. Secondly, an improved algorithm based on quarter partition is given to smooth the texture feature image. Thirdly, the clustering algorithm using the kd-tree data structure is applied to the texture segmentation, and then a fast texture feature clustering effect is achieved. At last, simulations are performed on the presented algorithm, and the simulation result shows that the presented algorithm has lower segmentation error rate, high accuracy and good in-time performance.

PURPOSE:To analyze the effectiveness and toxicities in the re-irradiation of locally recurrent nasopharyngeal carcinoma (NPC) using intensity-modulated radiotherapy (IMRT). METHODS:This is a retrospective analysis of 54 NPC patients with local recurrence re-irradiated with IMRT. The re-staging for rT1, rT2, rT3, rT4 were 3 (5.6%), 8 (14.8%), 9 (16.7%), 34 (63%) respectively. The average dose to GTV was 69.95 Gy (49.8-76.58 Gy), the average BED(3Gy) was 116.8 Gy (83.5-127.9 Gy). V₉₅ was 96%, and D₉₅ was 65.75 Gy. 33.3% of them received concurrent chemoradiotherapy. RESULTS:Median overall survival (OS) was 21 months (1-93 mon). The 1-, 2-year local progression free survival (LPFS) rate was 84.5%, 64% and OS rate was 71.7%, 44.3%. Severe late adverse events (SLAE) occurred in 48.1% of patients, including 31.5% with ulcer or necrosis of the nasopharyngeal mucosa, 20.4% with difficulty in feeding, 18.5% with temporal lobe necrosis, 11.1% with massive hemorrhage. 15.4% died of local regional progression, 5.8% died of distant metastasis, 25% died of SLAE, 9.6% died of both local regional progression and SLAE that could not be differentiated, 5.8% died of other medical complications. Concurrent chemoradiotherapy was the independent negative prognostic factors for LPFS; PTV>100 ml was a predictive factor of poor OS; patients with invasion of post-styloid space were at higher risk of SLAE. CONCLUSIONS:The present study demonstrated that IMRT with 70Gy was efficient for local tumor control. However, we observed a high frequency of serious late complications. More optimized combination treatment and patient selection are required to achieve excellent local control without significant late morbidities in locally recurrent NPC.