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Introduction: Survival rates of pediatric acute myeloid leukemia (AML) in low- and middle-income countries (LMICs) seem extremely poor, and the available literature on the matter is scarce. Accordingly, there is a limited understanding of poor treatment outcomes seen in this population. Areas covered: We provide an overview of the available literature with respect to treatment outcomes of pediatric AML in LMICs yielding poor outcomes compared to high-income countries. Moreover, treatment outcomes vary markedly between LMICs. In addition, there is a wide variation among studies in how treatment outcomes are reported and analyzed. Expert opinion: The substantially inferior treatment outcomes of pediatric AML in LMICs emphasize the unprecedented importance of global initiatives and international collaborations to improve the survival of these patients. A coordinated approach is necessary to carry out country-specific situational analyses. These analyses will result in operational plans on how to structurally implement childhood cancer registries, align healthcare infrastructure, build on capacities, and provide universal health coverage in LMICs. In addition, we strongly recommend that, in the future, LMICs document, analyze, and publish pediatric AML treatment outcomes in a more structured and uniform manner.

Ferroelectric (FE) materials usually possess very high band gap (∼3–4 eV) and extremely poor electrical conductivity, which renders them unsuitable for photovoltaic applications. Here, we demonstra...

Inadequate feeding practices contribute to poor nutrition among Peruvian children. In response, Peru’s Lambayeque Regional Government funded an initiative in its four poorest districts to improve n...

Emerging economies are in an almost winless situation: they would benefit from improving the extremely poor economic situation, making them self-reliant and economically productive. However, the poor fight for daily survival and, therefore, cannot afford to improve themselves. This article describes the state of the &ldquo, Grande Hotel&rdquo, in the city of Beira, Mozambique, built-in Portuguese colonial times, a real vertical shanty building that is occupied by approximately 1000 inhabitants trapped in poverty. To carry out any constructive intervention in a building or an urban complex, it is necessary to carry out a rehabilitation project that is developed based on a diagnosis of the building understudy, its main deteriorations, the causes, mechanisms of action, evolution, and possible treatments to be used for its repair. Analysis methods are necessary for the conservation of buildings since trying to stop, or correct buildings&rsquo, deterioration without a diagnosis of their problems or a prognosis on their evolution is a risky procedure with a high percentage of failure chances. The use of an appropriate methodology for diagnosing the damage present in the &ldquo, and its prediction of evolution and development should directly impact a better quality of rehabilitation projects in the neighborhood where the building is located.

A series of breakwaters to protect a coastal wildlife refuge in southwestern Louisiana incorporated an innovative, lightweight design. Despite extremely poor soils and ongoing erosion that kept changing the shoreline throughout the project, the breakwaters are already showing dramatic results.

The main purpose of this article is to refer to the Author’s considerations presented in his doctoral monography entitled “Public law status of an extremely poor person”. First of all, the appropriateness of the research hypotheses and questions adopted by the Author will be analysed with particular emphasis attached to the validity of the conclusions drawn in the context of the current social and economic situation in Poland. The second part is dedicated to considerations of a „strictly content-related nature”: from the analysis of solutions to counteract poverty at the global level, through the regional (European) level, to the national (constitutional) level. At this stage, reference will also be made to the standard of protection of the rights of the extremely poor suggested by the Author. The next part will analyse the extent of the discrepancies between the ‘minimum standard’ of protection suggested by the Author and the factual and legal situation of the poor. Conclusions in this area will be particularly useful for law application practice.

Poverty has been a critical issue for a long time and continues to affect developing countries in the era of booming digitalization. This study investigates the contribution of digitalization to poverty alleviation, confirming that it can promote economic growth. However, utilizing a sample of 37 developing countries in 2014 and 2016, this study observes that the extremely poor are deprived of their share of the benefits that digitalization can offer. Therefore, while strategies to further promote digitalization are critical to economic development, support systems or policies meant to bring those in extreme poverty into mainstream development are badly needed.

Recently, there has been tremendous interest in deep and extreme poverty in the United States. We advance beyond prior research by using higher-quality data, improving measurement, and following leading standards in international income research. We estimate deep (less than 20% of medians) and extreme (less than 10% of medians) poverty in the United States from 1993 to 2016. Using the Current Population Survey, we match the income definition of the Luxembourg Income Study and adjust for underreporting using the Urban Institute’s TRIM3 model. In 2016, we estimate that 5.2 to 7.2 million Americans (1.6% to 2.2%) were deeply poor and 2.6 to 3.7 million (0.8% to 1.2%) were extremely poor. Although deep and extreme poverty fluctuated over time, including declines from 1993 to 1995 and 2007 to 2010, we find significant increases from lows in 1995 to peaks in 2016 in both deep (increases of 48% to 93%) and extreme poverty (increases of 54% to 111%). We even find significant increases with thresholds anchored at 1993 medians. With homelessness added, deep poverty would be 7% to 8% higher and extreme poverty 19% to 23% higher in 2016, which suggests that our estimates are probably lower bounds. The rise of deep/extreme poverty is concentrated among childless households. Among households with children, the expansion of SNAP benefits has led to declines in deep/extreme poverty. Ultimately, we demonstrate that estimates of deep/extreme poverty depend critically on the quality of income measurement.

Economic studies of consumer behavior focus almost exclusively on people in developed countries with relatively large household budgets as compared to others in the world. The very poor, those surviving on less than $2.50 per day, make up half the world's population and are not represented in academic studies of brand preference and choice. Those characterized as extremely poor, living on less than $1.25 per day, are estimated to comprise 1.3 billion people, with nearly half living in India and China 1 . In this paper we investigate demand for the very poor using economic models of choice that have been applied to studies of the American consumer in two product categories, toothpaste and laundry detergent. The data come from a unique panel of respondents in India where consumers purchase small and affordable single-use packages. Our analysis indicates that standard models of demand used to study wealthier consumers also apply to people in extreme poverty. https://www.dosomething.org/us/facts/11-facts-about-global-poverty

Highlights • Gallbladdercarcinosarcoma is a rare disease: The first case of a carcinosarcoma of the gallbladder (CSGB) was reported by Landsteiner in 1907. Up to now less than 100 Cases have been reported in the literature. • Non-specific signs: the clinical (abdominal pain, weight loss and jaundice, biological (including inflammatory sign, hepatic result), and radiological signs are nonspecific of gallbladder carcinosarcoma, The final diagnosis is anatomopathological of the specimen. • The diagnosis is delayed: Because of the nonspecific symptoms, a delayed diagnosis is generally associated with CSGB. Only 54 cases have undergone surgical resection as a treatment. • Surgical treatment remains the only cure for gallbladder carcinosarcoma: Chemotherapy and/or radiotherapy’s roles, they remain unclear because of the limited number of cases described in the literature, as chemotherapy has shown no a significant benefit in terms of morbidity or mortality. • Prognosis: The prognosis of this disease is normally poor. Most cases present with locally advanced disease and metastasis., Introduction Gallbladder Carcinosarcoma is a rare and fatal cancer characterized by the presence of a combination of a cancerous epithelial and mesenchymal components. Presentation of case We present the case of a 66 years old patient with a carcinoma gallbladder carcinoma who received a surgical treatment. The histological assessment revealed two histological components consisting of an adenocarcinoma and a spindle cell sarcoma compatible with the carcinosarcoma. Discussion This cancer is known to be extremely severe in that less than 100 cases have been documented in international medical review of literature. surgical treatment remains the only cure for gallbladder carcinosarcoma, The prognosis of this disease is extremely poor because it normally presents at advanced stages. Conclusion We present an extremely rare example of carcinosarcoma, and its attributes might be suggestive of a greater malignant potential. Consequently, the later the diagnosed worse is the prognosis.

The present paper shows that cross‐section demeaning with respect to time fixed effects is more useful than commonly appreciated, in that it enables consistent and asymptotically normal estimation of interactive effects models with heterogeneous slope coefficients when the number of time periods, T , is small and only the number of cross‐sectional units, N , is large. This is important when using OLS but also when using more sophisticated estimators of interactive effects models whose validity does not require demeaning, a point that to the best of our knowledge has not been made before in the literature. As an illustration, we consider the problem of estimating the average treatment effect in the presence of unobserved time‐varying heterogeneity. Gobillon and Magnac (2016) recently considered this problem. They employed a principal components‐based approach designed to deal with general unobserved heterogeneity, which does not require fixed effects demeaning. The approach does, however, require that T is large, which is typically not the case in practice, and the results reported here confirm that the performance can be extremely poor in small‐T samples. The exception is when the approach is applied to data that have been demeaned with respect to fixed effects. (Less)

В России, как и в большинстве других стран, основная нагрузка по уходу за пожилыми и инвалидами ложится на родственников. В статье на основе данных обследования «Комплексное наблюдение условий жизни населения» Росстата за 2018 г. проанализировано влияние родственного ухода на положение ухаживающих лиц. В частности, показано, что люди трудоспособного возраста, ухаживающие за родственниками, реже имеют работу; чаще работают неполный рабочий день или неполную рабочую неделю; чаще имеют хронические заболевания и более низкую самооценку здоровья. Интенсивный уход (более 20 часов в неделю) усиливает негативное влияние на занятость и самооценку здоровья. Среди лиц трудоспособного возраста, осуществляющих интенсивный родственный уход, выше доля бедных и крайне бедных и ниже доля лиц со среднедушевым доходом выше двукратной величины прожиточного минимума. Это свидетельствует о необходимости создания комплексной системы мер, направленных на поддержку родственников, осуществляющих уход, включая меры по сохранению занятости и развитию гибких форм занятости на рынке труда, расширению охвата лиц, имеющих родственников и нуждающихся в уходе, программами временного и дневного ухода, по оказанию консультационной поддержки родственников и организации очного и дистанционного обучения родственников навыкам ухода. Усиление поддержки родственников, осуществляющих уход, позволит людям пожилого возраста и инвалидам, нуждающимся в уходе, как можно дольше оставаться дома в привычных условиях и получать при этом качественный уход.

Asenapine maleate (AM) is an atypical antipsychotic agent, that has been widely prescribed for the management of schizoaffective disorders. However, the bioavailability of AM is extremely poor due to the extensive first-pass metabolism. With the advancement in pharmaceutical technologies, significant strides have been made to create novel formulations to address the bioavailability problem of AM.This review article provides an insight into all the formulation approaches undertaken by researchers to increase the bioavailability of AM encompassing the works utilizing ultrasound mediated transdermal delivery, nose to brain delivery, intestinal lymphatic system targeting,Numerous studies have been carried out on AM formulations over the recent years, many of these studies have shown significant improvement in bioavailability. We have also mentioned the unexplored domains which can be exploited for further enhancing the bioavailability of AM. Nonetheless, most of these studies are still limited to the research laboratory level and face multiple hurdles before making into the market. Attaining controllability and reproducibility for the production of novel formulations is needed to enable its transition from bench to bedside.

Pancreatic cancer (PC) is one of the most lethal malignancies with an extremely poor prognosis. In this study, we aim to construct a long noncoding RNA (lncRNA)-based panel biomarker to predict the overall survival of PC patients. The lncRNA expression profiles of PC samples were extracted from The Cancer Genome Atlas (TCGA-PAAD

Jamaican maximum-security correctional facilities are largely identified by their extremely poor, anachronistic, and inhuman conditions of custody. This overriding identity shelves the positive influence of reforms that have taken place or are currently underway. By drawing on interviews conducted with 55 inmates and nine correctional staff, secondary analyses, and the International Covenant on Civil and Political Rights (ICCPR, 1966), this article examines the degree to which recommendations from the “Improving Prison Conditions in the Caribbean” Conference have been implemented in the Jamaican context. The results suggest that since the Conference, noticeable steps have been taken by the Jamaican state to improve the quality of the rehabilitation experience against the backdrop of challenges of size and competing priorities. However, such improvements are not necessarily the direct result of the implementation of the Conference recommendations. Despite the improvements evidenced, it is argued that more meaningful reforms are required if more inmates are to be enabled to lead crime-free and productive lives upon release. This article provides contemporary insights into the improved conditions of imprisonment in Jamaica and makes recommendations on how serious offenders in the care of Jamaica’s correctional service can be better enabled to experience effective (not successful) reintegration.

Purpose Malignant high-grade gliomas are the most common and aggressive type of primary brain tumor, and the prognosis is generally extremely poor. In this retrospective study, we analyzed the outcome of systemic treatment in recurrent high-grade glioma patients and the impact of prognostic factors on survivals. Methods Data from 114 patients with recurrent high-grade glioma who received systemic treatment and followed in our clinic between 2012 and 2018 were retrospectively analyzed. Eastern Cooperative Oncology Group (ECOG) performance status, age, gender, histology, type of surgical resection, side effects after systemic treatment (deep vein thrombosis, hypertension, proteinuria), IDH1 and alpha thalassemia/mental retardation syndrome X-linked (ATRX) mutation status were investigated as prognostic factors for progression-free survival and overall survival. Results At the time of diagnosis, the median age was 48 (17–77) and 68% of the patients were male. Most common pathologic subtype was glioblastoma multiforme (68%). Median follow-up duration was 9.1 months (1–68 months). Median progression-free survival and overall survival were 6.2 months and 8 months, respectively. In multivariate analysis, ECOG PS, deep venous thrombosis and the presence of ATRX and IDH1 mutation were found to be independent prognostic factors for progression-free survival (p Conclusion Our study is real life data and the median progression-free survival and overall survival rates are similar to the literature. We have found ECOG PS, presence of ATRX and IDH1 mutation to be independent prognostic factors for both progression-free survival and overall survival.

We consider two types of weak-injectivity domains of a module. Small weak-injectivity domains gauge the extent of weak injectivity of modules; weak-injectivity domains are an alternative way to gauge their injectivity. We focus on notions which are opposite, respectively, to weakly injective or injective modules according to these two schemes. While we do consider both notions to some extent, our emphasis is on modules with smallest weak-injectivity domain; we name those modules extremely poor. The intersection of all (small) domains of weak injectivity is the natural focus of attention. The intersection of all (small) domains of weak injectivity contains the class of all (finitely generated) semisimple modules, but it is not always equal to it. The domain of weak injectivity of an extremely poor module thusly depends on the ring in question. We consider necessary and sufficient conditions for said intersections to consist solely of semisimple modules and look at examples of both circumstances, when this is the case and when it is not. When the intersection of weak-injectivity domains consists of semisimple modules, every extremely poor module is poor; we study further connections between these two notions. Comparisons are also drawn to paupers (poor modules with no proper poor direct summands); paupers are a type of poor module that is significant in understanding the intrinsic structure of poor modules. Extremely poor modules over PCI domains and extremely poor abelian groups are given particular attention.

Extremely poor people are the most difficult part of the poor in China, and they are also an important part of China's fight against poverty. The policy of assisting and supporting the extremely poor people has played an important role in ensuring the survival and living needs of the extremely poor people in urban and rural areas, and realizing the goal of sharing the development results for the whole people. Since 2015, the assistance and support system for the extremely poor has been disbursed separately, the financial expenditure has increased year by year, from 18.297 billion yuan to 25.930 billion yuan, and the annual financial account expenditure exceeds the budgeted expenditure every year. Therefore, it is urgent to make accurate and reasonable expectation on the financial expenditure of the relief of the extremely poor. Based on the analysis of financial support for the assistance and support of the poorest people from 2008 to 2018, this paper uses the Holt index forecast method to predict the social assistance expenditure for the next five years, and concludes that future financial needs will improve the support and assistance of the special hardship.

Protein deficiency is one of the causes of the poor nutritional status of the Indonesian population, is permanent, and long-term will have an impact on the lower quality of human resources. This study analyzes the impact of price and income changes on animal food consumption patterns and demand on five poverty level in Indonesia. The demand esimation uses Quadratic Almost Ideal Demand Systems, using the National Socio Economic Survey (SUSENAS) data (March 2016) compilation data of 291,414 households. The results showed that there were different interactions between beef and the other four animal protein food sources, namely the Poor, Almost Poor and Vulnerable Poor beef substitution was mainly chicken, followed by fresh fish and eggs. Hicksian's own-price elasticity decreases following the decrease in the level of household poverty. Cases of beef, household own-price elasticity "extremely poor" -11.70% and "not poor" -1.95%. The sensitivity of the decrease in beef consumption is due to an increase in own-prices for "extremely poor" households 5.5 times compared to "non-poor". Beef is a very luxurious and relatively inaccessible source of animal protein food, especially for extremely poor, poor, almost poor, and vulnerable poor households, and this constitutes 40% of Indonesia's population. To increase beef consumption, it is necessary to increase domestic beef production so that the price of beef is affordable not only for non-poor households but also for extremely poor, poor, almost poor and vulnerable poor households in Indonesia

Objective: Endometrial carcinoma (EC) was the fourth female malignancies in developed countries. Given that the prognosis of EC is extremely poor, it is vital to investigate its pathogenesi...

Prognosis for patients with acute basilar artery occlusion (BAO) remains poor. Successful revascularization is a main predictor of favorable clinical outcomes after mechanical thrombectomy for BAO. However, even if mechanical thrombectomy is successful, some patients have a poor clinical outcome, including vegetative state and mortality. This study investigated the factors that are predictive of extremely poor clinical outcomes despite successful revascularization after mechanical thrombectomy for BAO. We evaluated 35 consecutive patients who presented with acute ischemic stroke due to BAO and who were successfully treated with mechanical thrombectomy. A very poor outcome was defined as a modified Rankin Scale (mRS) score of 5 or 6 at 3 months after treatment. The associations between the clinical, imaging, procedural factors, and poor outcome were evaluated. Using univariate analyses, there were significant differences in the preoperative National Institute of Health Stroke Scale (NIHSS) score (22.0 ± 9.0 vs. 30.5 ± 4.3, p

Metastatic esophageal cancer to urinary bladder is extremely rare and presents as an extremely poor prognosis. Herein, we describe the case of a 68 year-old female with history of resected adenocarcinoma of gastroesophageal junction in remission, who presented with gross hematuria and a bladder lesion. The patient underwent resection of the mass with final pathology consistent with metastatic adenocarcinoma of gastroesophageal junction.

Leviticus chapter 5 is concerned with the trespass-offering. The difference between thetrespass offering and the sin-offering most likely lay not so much in the sacrifices themselves,and the management of them, as in the occasions of the offering of them. They were bothintended to make atonement for sin; but the former was more general, this applied to someparticular instances. Thus, concerning the trespass, if a man commits a sin: (i) In concealinghis knowledge, when he is adjured (v. 1). (ii) In touching an unclean thing (v. 2, 3). (iii) Inswearing (v. 4). (iv) In embezzling the holy things (v. 14-16). (v) In any sin of infirmity (v.17-19). Some other cases there are, in which these offerings were to be offered (chaps 6:2-4;14:12; 19:21; Num. 6:12). And concerning the trespass-offerings, (i) Of the flock (v. 5, 6).(ii) Of fowls (v. 7-10). (iii) Of flour (v. 11-13; but chiefly a ram without blemish (v. 15, etc.).This paper focuses on trespass offering of flour (v. 11-13). Provision is here made for thepoor of the people of God, and the pacifying of their consciences under the sense of guilt.Those that were not able to bring a lamb might bring for a sin-offering a pair of turtle-dovesor two young pigeons; however, if any were so extremely poor that they were not able toprocure these so often as they would have occasion, they might bring a an ephah of fine flourfor a sin offering, and this should be accepted. Therefore, it seems that the expense of the sinoffering was brought lower than that of any other offering, to teach the reader that no man'spoverty shall ever be a bar in the way of his/her forgiveness. The poorest of all may haveatonement made for them, if it be not their own fault. Furthermore, this paper seeks to findout whether the passage under consideration teaches that forgiveness can be obtained withoutthe shedding of blood or not.

Combining first-principles calculations with the solution to the Boltzmann transport equations, we examine the lattice thermal transport for the orthorhombic perovskite BaZrS3 through analyses of p...

Dedifferentiated liposarcoma (DDLPS) is a rare type of neoplasm which can originally rise in cardiac chamber. Owing to the recurrence and distant metastasis, the prognosis of the primary malignant cardiac tumor is extremely poor and remains a challenge for cardiac surgeons. Here, we report a patient with an intracavitary mass which was diagnosed as DDLPS by postoperative pathological examinations, experienced repeated in-situ recurrence of the malignant cardiac tumor.

Background: Until recently, advanced HCC patients with major vessel and cardiac involvement have had an extremely poor prognosis without satisfactory treatment. Case presentation: A 63-year-old Taiwanese male presented with metastatic HCC with RA and IVC thrombi, as well as pulmonary metastases that were successfully treated by multimodal management, encompassed by surgical thrombectomy, concurrent systemic sorafenib and locoregional therapies, and immunotherapy. The patient has achieved a complete response over the past 33 months. Conclusions: Through this case report, which shows a successful outcome via multimodal management, a more aggressive approach should be considered when a patient is expected to tolerate the risks and side effects of various treatments.

Lactic acidosis is an extremely rare paraneoplastic manifestation of hematological malignancies, and often carries an extremely poor prognosis. Mantle cell lymphoma is an aggressive and rare form of non-Hodgkin lymphoma. To the best of our knowledge, it is extremely rare to have severe lactic acidosis in patients with mantle cell lymphoma. In this article, we are reporting a rare case of mantle cell lymphoma diagnosed with typical cluster differentiation (CD markers) in bone marrow examination with persistent lactic acidosis refractory to intravenous hydration that responded well to chemotherapy. Malignant lactic acidosis is a medical emergency that needs rapid evaluation and identification that shows improved prognosis after the introduction of chemotherapy.

Primary squamous cell carcinoma of the liver is extremely rare, very difficult to diagnose, and carries an extremely poor prognosis. In this study, we discuss the imaging features of a patient with primary hepatic squamous cell carcinoma. The patient was admitted to hospital owing to discomfort in the right upper abdominal quadrant and a loss of appetite. He had no previous risk factors associated with hepatic squamous cell carcinoma and no history of systemic squamous cell carcinoma. We diagnosed primary hepatic squamous cell carcinoma by pathological analysis. Primary hepatic squamous cell carcinoma is rare, and its histological features are controversial, which makes the clinical and imaging diagnosis difficult. Therefore, it is urgent to improve the understanding of this disease in clinical practice to avoid misdiagnosis, and to identify the best treatment. This case provides a basis for the clinical diagnosis of primary hepatic squamous cell carcinoma.

Information on household poverty level in Wonosari Sub-district area is still very difficult to access by all parties. Therefore, this study aims to analyze poverty level and map of the spatial distribution of webGIS-based poor households in the site area. In determining the number of samples, descriptive statistical analysis techniques focused on assessing and describing the poverty level of each household. GIS analysis used GIS Application 2.18 to map the spatial distribution of poor households and regional poverty levels. GIS Application has been equipped with 2 web tools that are able to display webGIS-based maps. The results shows that the poverty level of households is in the poor category with a percentage of 72% of households, 14% of households are in the extremely poor category and 14% are in the fairly poor category. and 1 village is in a fairly poor category. This is a village that was built with a view that can be accessed by various PCs, laptops and android media so that the maps information from an analysis of household poverty levels and the spatial distribution of poor households can be accessed on the webGIS that has been built.

A lack of in-depth assessment of the nutritional status of homeless youth precludes interventions that achieve nutritional adequacy. We enrolled 118 unaccompanied homeless youth to obtain sociodemographic and health data along with dietary, anthropometric, biochemical, and clinical assessments. As a reference, homeless youth data were compared to a convenience sample of 145 college students. Obesity was prevalent among homeless youth than among college students (29% vs. 8% respectively (CI: 11.2, 29.9). Among homeless youth, 74% of females versus 41% of males were overweight/obese (CI: 14.9, 51.2). Homeless youth also had poor diet quality (44.37 (SD: 12.64)). Over 70% of homeless youth had inadequate intakes of vitamins A, C, D3 and E, as well as calcium and magnesium. Our findings show increased weight, adiposity, and suboptimal intakes of essential nutrients among unaccompanied homeless youth. Further studies are needed to inform evidence-based nutrition interventions that will aid in improving their nutritional health.

Traditional boring bars are generally made up of isotropic metallic materials and exhibit extremely poor chatter suppression ability. For enhancing the chatter stability, using anisotropic composite materials in the preparation of boring bars proves to be an effective method so as to enhance the boring bar’s natural frequency and damping. Additionally, the addition of constrained layer damping (CLD) technology on the composite boring bar can further improve the damping performance. This study aims to develop a theoretical analysis model for the prediction of the chatter stability of the CLD composite boring bar and explore the effectiveness and practicability of the CLD technology in suppressing the chatter of composite boring bar. Based on Euler–Bernoulli beam theory and the complex stiffness method of CLD, the structural dynamic model of the CLD composite boring bar was derived, and some structural parameters of the bar mainly including the ply angle of the composite material, the thicknesses of both damping layer, and constrained layer were also optimized. By combining the linear model of cutting force with a regenerative delay effect and the established dynamic model, the chatter analysis model of the CLD composite boring bar was constructed and the lobe diagram of the chatter stability of the cutting system was plotted by means of frequency domain method. The effects of the ply angle of the composite boring bar, the thicknesses of damping layer, and constrained layer on the chatter stability were examined. By performing time integral of the delay equation of motion, the time-domain response curves of the cutting system are obtained. The chatter stability prediction results based on the lobe diagram fit well with the prediction results on the basis of dynamic stiffness calculation and time-domain numerical integral results.

We herein report a very rare case of spontaneous regression of recurrent undifferentiated carcinoma of the endometrium. An 80-year-old woman had undergone total hysterectomy with bilateral adnexectomy for undifferentiated carcinoma of the endometrium. The cancer recurred locally 10 months after surgery and then metastasized to the lung and liver. After she and her family elected to receive supportive care without active treatment, the local recurrences dramatically decreased, and the metastases of the lung, liver, and peritoneum also disappeared. This case showed that spontaneous regression can occur even with malignant tumors showing an extremely poor prognosis, such as undifferentiated carcinoma of the endometrium.

Malignant mesothelioma (MM) is an aggressive malignancy arising from the mesothelial cells lining the pleura and other serosal membranes. It is associated with an extremely poor prognosis and has limited therapeutic options.Epidermal growth factor receptor (EGFR) is known to be highly overexpressed in mesothelioma with reported EGFR overexpression between 44 to 97%. Given this, several anti-EGFR agents have been trialed in mesothelioma. In this review, we provide an overview of the current available data on anti-EGFR therapies in MM and future directions of investigation with these targeted agents in MM.While many anti-EGFR therapies have failed to show significant efficacy in the management of MM, the pathway is biologically active and its abrogation preclinically points toward it being a valid target. Toward targeting the pathway, many novel EGFR-based therapies are still being investigated. Current ongoing research of interest in MM include EGFR-targeted nanotechnology approach for drug delivery, antibodies targeting the extracellular EGFR and potentially anti-EGFR antibody drug conjugates.

Aims: Overall survival (OS) of patients with recurrent or metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN) is extremely poor. New therapeutic options emerge but need to establi...

This analysis of Rural Haitian University (RHU, a pseudonym) highlights the complexities that have arisen as a social entrepreneur in an extremely poor rural region in a deeply impoverished developing nation has sought to employ higher education to encourage community development. We argue that RHU has languished as a result of its founder’s embrace of a grass roots-centered vision that nonetheless ironically tracked neoliberal assumptions and conditions concerning institutional sustainability. We contend that our case suggests that a strategy that assumes self-sustaining and autonomous higher education institutions is unlikely to succeed in very poor nations.

Hypomethylating agents (HMA) are the standard of care for treatment of myelodysplastic syndromes (MDS). HMA-failure MDS has extremely poor prognosis. This study was designed to explore the utility of eltrombopag in post-HMA failure MDS patients. Patients were treated in one of two arms: eltrombopag as monotherapy (Arm A), or with continuation of HMA (Arm B). The starting eltrombopag dose was 200 mg orally daily. Twenty-nine patients with a median age of 72 years (42-84) were enrolled. The median number of prior treatment was 1 (1-5). Seven (24%) patients were enrolled in cohort A and 22 (76%) in cohort B. One early death (30 days) occurred in cohort B due to infection/sepsis. Of 28 evaluable patients, 3 (11%) in cohort B experienced platelet improvement. Median overall survival was 12 months. This study demonstrated modest platelet improvement in some, without evidently increased toxicity or increased risk of leukemia progression.

Background: Gastric cancer (GC) is prone to metastasis that typically resulted in peritoneal carcinomatosis (PC). GC patients with PC have an extremely poor clinic prognosis. Although GC is sensitive to chemotherapy, PC causes chemotherapy failure. Recent studies showed the combination of intravenous and intraperitoneal chemotherapy can significantly improve the survival rates in GC patients with PC. Aim: To identify the clinical and adverse effects of intravenous chemotherapy combined with intraperitoneal perfusion chemotherapy in the treatment of abdominal peritoneal carcinomatosis arising from gastric cancer. Methods: Retrospective analysis was performed on 49 patients with abdominal peritoneal carcinomatosis from gastric cancer who were treated at the Fujian Medical University Union Hospital between September 2010 and September 2015. The patients were divided into 2 groups based on treatment method: patients subjected to intravenous chemotherapy (n = 27), referred to as the simple group and patients subjected to combined intravenous and intraperitoneal chemotherapy (n = 22), referred to as the combination group. The short-term effects and adverse effects were evaluated based on treatment method, in conjunction with a related review of the results. The long-term effect was evaluated based on the survival rate and median survival time of both groups of patients at 12, 18, 24, 30, 36, and 60 months, as determined through follow-up. Results: Gender, age, ECOG scores before treatment, clinical stages, and the pathologic data of advanced GC patients of the 2 groups were equally distributed. The objective efficacy evaluation results showed that the objective response rate (ORR) and disease control rate (DCR) of the simple group after treatment were significantly lower than in the combination group. The median survival time (MST) of the simple group was (6.57 ± 0.75) months, which was significantly shorter than in the combination group (15.03 ± 2.31) months ( P < 0.05). In addition, the 12-, 18-, 24-, 30-, 36-, and 60-month survival rates of the simple group were all significantly lower than those of the combination group. Furthermore, combined therapy improved the physical condition of the patients. The incidence of adverse reactions in the 2 groups was not statistically significant; neither of the treatments resulted in severe complications. Conclusion: Compared with intravenous chemotherapy alone, the combined intravenous and intraperitoneal perfusion chemotherapy was more effective in improving quality of life and extending survival in time patients with abdominal peritoneal carcinomatosis from gastric cancer. In addition, the treatment produced only mild adverse effects, showing that it is tolerable and therefore worth further clinical study.

Purpose: Several studies have reported controversial results about prognosis of gastric cancer in young age patients. The difference may partially result from variable definitions of young age. The aim of this study was to find out the relation between age and prognosis of gastric cancer patients, and to analyze the clinicopathological features and prognostic factors in young gastric cancer patients. Methods: Data queried for this analysis included GC patients from the Surveillance, Epidemiology, and End Results Program database from 1973 to 2014. Gastric cancer patients (N=79,505) diagnosed with an age≥18 were included. By combining patients with similar prognosis, we figured out 3 cutoff values of age, 35 years old, 65 years old and 75 years old. We divided patients into 4 groups: young age patients: 18-34 years; middle-age patients: 35-64 years; elderly patients: 65-74 years; extremely elderly patients: >74 years. GC patients from Sun Yat-sen University Cancer Center (SYSUCC) were used as external validation data. Results: The clinicopathological features of young age gastric cancer patients included: poor-differentiated, diffuse type of cancer, and advanced stage at diagnosis. The median survival of patients

Nigeria is endowed with vast human and material resources to engender development but it still continues to luxuriate within the confines of a top speed in reverse to oblivion. As its relics, neocolonialism has given birth to industrialization, urbanization and militarization of the political process which generally has created “sudden billionaires” on one end of the ladder (elected or appointed public officials) and extremely poor masses (unemployed graduates and depressed masses) at the other end of the ladder. This paper basically exposes the developmental retrogressive outlooks of the masses due to primitive capitalist accumulation by the few elites who have piloted the affairs of the nation.

Portal vein tumor thrombus (PVTT) is one of the most common complications of hepatocellular carcinoma (HCC), which refers to the advanced stage of HCC and indicates an extremely poor prognosis. Monotherapy cannot effectively prolong the survival benefit of patients with HCC-PVTT characterized by a high recurrence rate. With great progress in the area of immune and molecular targeted therapy, there comes a promising era of multidisciplinary management of HCC. Survival benefits can be achieved based on accurate diagnosis, staging, and multidisciplinary management. Additionally, in terms of the presence of controversy about the standard treatment algorithm and the absence of universal treatment guidelines, a multidisciplinary management program may afford the best hope for HCC-PVTT patients via appropriate implement of various treatment protocols.

Introduction: Glioblastoma is a highly aggressive brain tumor with an extremely poor prognosis. Genetic characterization of this tumor has identified alterations with prognostic and therapeutic impact, and many efforts are being made to improve molecular knowledge on glioblastoma. Invasive procedures, such as tumor biopsy or radical resection, are needed to characterize the tumor. Areas covered: The role of microRNA in cancer is an expanding field of research as many microRNAs have been shown to correlate with patient prognosis and treatment response. Novel methodologies like radiomics, radiogenomics, and radiomiRNomics are under evaluation to improve the amount of prognostic and predictive biomarkers available. Expert opinion: The role of radiomics, radiogenomics, and radiomiRNomic for the characterization of glioblastoma will further improve in the coming years.

As noted earlier, the ENRICH programme is being implemented in 202 unions across the country (locational map of these unions is shown in Annex 3 and the list of the POs implementing the ENRICH programme in all these unions is given in Annex 4. The total population of these unions is, as noted earlier, about 6 million, all of whom, regardless of their socio-economic status, are eligible, given the ENRICH programme design, to avail education and health services. The extremely poor, poor and low income households (accounting for about 5 million people) are eligible for multiple non-financial and financial services within the framework of a human-centred, multidimensional, integrated approach that the ENRICH programme is.

There are a small number of articles in the literature discussing palliative and end-of-life care in the SMI population. Most tackle the questions relating to competency to refuse care in end-stage anorexia or terminal medical conditions. This is a case review of a 55 year old patient with a complex psychiatric and medical history, who despite extensive treatment and long hospitalizations has failed to regain any ability to care for her basic needs. She has exhausted all available treatment options and her prognosis is extremely poor. The mental health community is resistant to discussing and/ or confronting the fact that such a patient faces with the need for end-of-life care directly related to chronic psychiatric illness.

In this paper the author argues that trans-identification and its associated medical treatment can constitute an attempt to evade experiences of psychological distress. This occurs on three levels. Firstly, the trans person themselves may seek to evade dysregulated affects associated with such experiences as attachment trauma, childhood abuse, and ego-alien sexual feelings. Secondly, therapists may attempt to evade feelings, such as fear and hatred, evoked by engaging with these dysregulated affects. Thirdly, we, as a society, may wish to evade acknowledging the reality of such trauma, abuse and sexual distress by hypothesizing that trans-identification is a biological issue, best treated medically. The author argues that the quality of evidence supporting the biomedical approach is extremely poor. This puts young trans people at risk of receiving potentially damaging medical treatment they may later seek to reverse or come to regret, while their underlying psychological issues remain unaddressed.Dans cet article l’auteur soutient que l’indentification trans et son traitement médical associé peuvent constituer une tentative pour échapper à des expériences de détresse psychologique. Ceci se produit à trois niveaux. Premièrement, la personne trans elle-même peut chercher à éviter les affects dérégulés associés aux expériences telles que le traumatisme de l’attachement, l’abus sexuel dans l’enfance, les ressentis sexuels qui semblent incompatibles avec l’égo. Deuxièmement, les thérapeutes peuvent tenter d’échapper à des émotions, telles que la peur et la haine, évoquées par l’implication avec ces affects dérégulés. Troisièmement, nous, en tant que société, pouvons être animés par le souhait d’échapper à la réalité de tels traumatismes, abus et détresse sexuels en nourrissant l’hypothèse que l’identification trans est une question biologique, qu’il vaut mieux soigner de manière médicale. L’auteur soutient que la qualité des preuves en faveur de l’approche biomédicale est extrêmement pauvre. Ceci expose les jeunes personnes trans au risque de recevoir des traitements médicaux qui les endommagent, traitements qu’elles peuvent plus tard chercher à inverser, ou qu’elles regrettent, pendant que les questions psychologiques fondamentales restent sans attention.In diesem Artikel legt der Autor dar, daß die Transidentifikation und die damit verbundene medizinische Behandlung einen Versuch darstellen können, Erfahrungen mit psychischer Belastung auszuweichen. Dies geschieht auf drei Ebenen. Erstens kann die Trans-Person selbst versuchen, dysregulierten Affekten auszuweichen, die mit Erfahrungen wie Bindungstrauma, Kindesmißbrauch und ichfremden sexuellen Gefühlen verbunden sind. Zweitens können Therapeuten versuchen, Gefühlen wie Angst und Haß auszuweichen, die durch die Auseinandersetzung mit diesen dysregulierten Affekten hervorgerufen werden. Drittens möchten wir uns als Gesellschaft möglicherweise der Anerkennung der Realität eines solchen Traumas, Mißbrauchs und sexuellen Leidens entziehen, indem wir die Hypothese aufstellen, daß die Transidentifikation ein biologisches Problem ist, das am besten medizinisch behandelt wird. Der Autor argumentiert, daß die Qualität der Beweise, die den biomedizinischen Ansatz unterstützen, äußerst mager ist. Dies birgt das Risiko, daß junge Transsexuelle möglicherweise schädliche medizinische Behandlungen erhalten, die sie möglicherweise später rückgängig machen oder bereuen könnten, während ihre zugrunde liegenden psychologischen Probleme weiterhin unberücksichtigt bleiben.In questio articolo l'Autore sostiene che l'identificazione trans ed il suo trattamento possono costituire un tentativo di eludere esperienze di disagio psichico. Ciò avviene su tre livelli. In primo luogo, il soggetto trans può cercare di eludere gli affetti disregolati associati a esperienze quali attaccamento e trauma, abusi infantili e vissuti sessuali alieni all’io. In secondo luogo, i terapeuti possono tentare di eludere i sentimenti, come la paura e l'odio, evocati dal coinvolgimento con questi affetti alterati. In terzo luogo, noi, come società, potremmo tentare di evitare di riconoscere la realtà di tale trauma, abuso e disagio sessuale ipotizzando che l’identificazione trans sia una questione biologica, che va trattata al meglio dal punto di vista medico. L'Autore sostiene che la qualità delle prove a sostegno dell'approccio biomedico sia estremamente scarsa. Ciò mette i giovani transessuali a rischio di ricevere cure mediche potenzialmente dannose, i cui effetti potrebbero in seguito cercare di anullare o comunque rimpiangere di averle fatte, mentre i loro problemi psicologici di fondo rimangono irrisolti.В статье автор обосновывает точку зрения, согласно которой идентификация с трансгендером и связанное с ней медицинское лечение могут представлять собой попытку избежать переживания психологического стресса. Это происходит на трех уровнях. Во-первых, сам транс-человек может стремиться избежать неуправляемых аффектов, связанных с такими переживаниями, как травма привязанности, насилие в детстве и чуждые эго сексуальные чувства. Во-вторых, терапевты могут пытаться избежать чувств, таких как страх и ненависть, вызванных воздействием неуправляемых аффектов. В-третьих, мы, как общество, можем стремиться к избеганию признания реальности травм, абьюза и сексуального дистресса, выдвигая гипотезу о том, что идентификация с трансгендером является биологической вопрос, к которому лучше всего подходить с медицинской точки зрения. Автор утверждает, что качество доказательств в поддержку биомедицинского подхода крайне низкое. Это подвергает молодых транс-людей риску получить потенциально опасную медицинскую помощь, о которой они впоследствии могут пожалеть, в то время как лежащие в их основе психологические проблемы остаются без внимания.En el presente trabajo, el autor argumenta que la identificación-trans y el tratamiento médico asociado puede constituir una intento de evadir experiencias de angustia psicológica. Esto sucede en tres niveles. Primero, la persona trans puede buscar evadir emociones desreguladas asociadas a experiencias como trauma de apego, abuso infantil, y sentimientos sexuales ego - no alineados. Segundo, los terapeutas pueden intentar evadir sentimientos, tales como miedo y odio, evocados al entrar en contacto con estos afectos desregulados. Tercero, nosotros, como sociedad, podemos desear evadir la realidad de semejante trauma, abuso y angustia sexual, al hipotetizar que la identificación-trans es un tema biológico, y mejor tratarlo medicalmente. El autor da cuenta que la evidencia que fundamenta el abordaje biomédico es extremadamente pobre. Esto supone, para las personas jóvenes trans, el riesgo de recibir tratamiento médico potencialmente dañino, que más tarde pueden buscar revertir, o del que arrepentirse mientras que los temas psicológicos subyacentes permanecen sin ser reconocidos.跨性别认同以及规避心理压力的尝试 文章认为, 跨性别认同以及与之关联的医学治疗是一种规避心理压力体验的尝试。这发生在三个层面。第一, 跨性别的个体会试图规避失调的情绪, 这些情绪关联着依恋创伤, 儿童期虐待, 自斥的性体验。第二, 治疗师会试图规避一些感受, 如害怕, 恨, 当他们跟随病人那些失调的感受时, 这些感受就会被唤起。第三, 我们, 作为社会, 试图回避承认这些现实存在的创伤、虐待和性压力, 规避的方式就是假定跨性别认同只是一种生理的问题, 最好通过医疗治愈。作者认为, 支持这些生理医学取向的证据十分薄弱。这把年轻的跨性别人群置于危险境地, 使他们接受了有潜在伤害的医疗干预, 而他们过些时间可能想要转变回来, 或是后悔进行了这些医疗处理, 而与此同时, 潜在的心理问题却没有得到处理。.

Here, we examined prognostic factors for extremely poor visual outcomes in patients with central retinal vein occlusion (CRVO) in actual practices. We included 150 consecutive eyes with treatment-naïve acute CRVO from four different facilities and observed them for over 24 months. Macular edema (ME) was treated with one or three monthly anti-vascular endothelial growth factor injections (1 or 3 + pro re nata). According to the final Snellen visual acuity (VA), we divided the patients into very poor VA (P

Pancreatic cancer with synchronous liver metastasis has an extremely poor prognosis, and surgery is not recommended for such patients by the current guidelines. However, an increasing body of studies have shown that concurrent resection of pancreatic cancer and liver metastasis is not only technically feasible but also beneficial to the survival in the selected patients. In this review, we aim to summarize the short- and long-term outcomes following synchronous liver metastasectomy for pancreatic cancer patients, and discuss the potential criteria in selecting appropriate surgical candidates, which might be helpful in clinical decision-making.

The coronavirus 2019 (COVID-19) pandemic has disrupted patient care across the NHS. Following the suspension of elective surgery, priority was placed in providing urgent and emergency surgery for patients with no alternative treatment. We aim to assess the outcomes of patients undergoing cardiac surgery who have COVID-19 infection diagnosed in the early postoperative period. We identified 9 patients who developed COVID-19 infection following cardiac surgery. These patients had a significant length of hospital stay and extremely poor outcomes with mortality of 44%. In conclusion, the outcome of cardiac surgical patients who contracted COVID-19 infection perioperatively is extremely poor. In order to offer cardiac surgery, units must implement rigorous protocols aimed at maintaining a COVID-19 protective environment to minimize additional life-threatening complications related to this virus infection.