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Abstract Background Gastrectomy remains the curative option in gastric cancer. However, the growing concern that preoperative waiting jeopardizes survival has not been fully addressed. The present population‐based cohort study aimed to clarify the impact of preoperative waiting time (PreWT). Methods We included patients with clinical Stage II–III gastric cancer who received curative surgery from 2008 to 2017 of Taiwan Cancer Registry. PreWT was defined as the time from endoscopic diagnosis to surgery. The prognostic impact on overall survival (OS) was evaluated with Cox and restricted cubic spline regressions. Results A total of 3059 patients with a median age of 68 years were evaluated. The median PreWT was 16 days (interquartile range, 11–24 days), and patients with a shorter PreWT were younger, had a more advanced disease and received adjuvant therapies. Despite a shorter OS occurring with prolonged PreWT (median OS by PreWT [days]: 7–13, 2.7 years; 14–20, 3.1 years; 21–27, 3.0 years; 28–34, 4.7 years; 35–31, 3.7 years; 42–48, 3.4 years; 49–118, 2.8 years; p = 0.029), the differences were not significant after adjustment. The Cox and restricted cubic spline regressions showed that prolonged PreWT was not a significant prognostic factor for OS (p = 0.719). Conclusions The population‐based study suggests that a PreWT of 49–118 days does not independently correlate with a poor prognosis in Stage II–III gastric cancer. The study provides rationale for a window period for preoperative therapies and patient optimization.

Background/Purpose: Previous studies have seldom investigated the psychological factors that are associated with dissatisfaction with healthcare services. We therefore examined the associations of depression and anxiety with service dissatisfaction among older adults. Methods: A community-based health survey was conducted from 2012 to 2016. Residents aged ≥65 years were randomly recruited from Yilan City, Taiwan. Besides overall dissatisfaction, we assessed dissatisfaction with physicians' ability, physicians’ attitude, and waiting time. The Hospital Anxiety and Depression Scale was used to detect depressive and anxiety symptoms with optimal cut-off points of 3 for the anxiety subscale and 6 for the depression subscales. Results: Of the 3480 residents included in this study, the overall dissatisfaction rate was 7.9%. After controlling for covariates, depressive and anxiety symptoms were consistently correlated with the various dimensions of dissatisfaction. More specifically, depressive symptoms were associated with overall dissatisfaction and dissatisfaction with physicians’ ability and attitude. Conversely, anxiety was uniquely associated with dissatisfaction with waiting time. Conclusion: Psychological symptoms were consistent correlates of dissatisfaction with healthcare services among older adults, although the specific symptoms had different associations with the various dimensions of dissatisfaction.

Abstract Chemotherapy is generally considered as the main treatment for metastatic gastric adenocarcinoma. The role of gastrectomy for metastatic gastric cancer without obvious symptoms is controversial. The objective of this study is to investigate survival outcomes of treatment modalities using a real-world data setting. A retrospective cohort study was designed using the Taiwan Cancer Registry database. We identified the treatment modalities and used Kaplan–Meier estimates and Cox regressions to compare patient survival outcomes. From 2008 to 2015, 5599 gastric adenocarcinoma patients were diagnosed with metastatic disease (M1). The median overall survival (OS) of patients with surgery plus chemotherapy had the longest survival of 14.2 months. The median OS of the patients who received chemotherapy alone or surgery alone was 7.0 and 3.9, respectively. Age at diagnosis, year of diagnosis, tumor grade, and treatment modalities are prognostic factors for survival. The hazard ratios for patients who received surgery plus chemotherapy, surgery alone, and supportive care were 0.47 (95% CI 0.44–0.51), 1.22 (95% CI 1.1–1.36), and 3.23 (95% CI 3.01–3.46), respectively, by multivariable Cox regression analysis when using chemotherapy alone as a referent. Chemotherapy plus surgery may have a survival benefit for some selected gastric adenocarcinoma patients with metastatic disease.

Obstacle avoidance is essential for the effective operation of autonomous mobile robots, enabling them to detect and navigate around obstacles in their environment. While deep learning provides significant benefits for autonomous navigation, it typically requires large, accurately labeled datasets, making the data's preparation and processing time-consuming and labor-intensive. To address this challenge, this study introduces a transfer learning (TL)-based automatic labeling segmentation (ALS) framework. This framework utilizes a pretrained attention-based network, DifferNet, to efficiently perform semantic segmentation tasks on new, unlabeled datasets. DifferNet leverages prior knowledge from the Cityscapes dataset to identify high-entropy areas as road obstacles by analyzing differences between the input and resynthesized images. The resulting road anomaly map was refined using depth information to produce a robust drivable area and map of road anomalies. Several off-the-shelf RGB-D semantic segmentation neural networks were trained using pseudo-labels generated by the ALS framework, with validation conducted on the GMRPD dataset. Experimental results demonstrated that the proposed ALS framework achieved mean precision, mean recall, and mean intersection over union (IoU) rates of 80.31%, 84.42%, and 71.99%, respectively. The ALS framework, through the use of transfer learning and the DifferNet network, offers an efficient solution for semantic segmentation of new, unlabeled datasets, underscoring its potential for improving obstacle avoidance in autonomous mobile robots. [ABSTRACT FROM AUTHOR]

In this work, through utilizing the mixed-ligand synthesis method, two coordination polymers (CPs) based on Co(II), namely, {[Co(μ-ppda)(μ-pbmeix)]·H2O}n (2) and [Co(μ-opda)(μ-pbmeix)0.5]n (1), have been triumphantly formed from 1,4-bis(2-methylimidazol-1-ylmethyl)benzene (pbmeix), a semi-rigid ligand with Co(II) nitrate salts and distinct carboxylic acid co-ligands (o/ppda = 1,2-/1,4-phenylenediacetate). For treatment of pancreatic cancer, the as-generated compounds’ inhibitory activity against the viability of cancer cell was determined by the Cell Counting Kit-8 (CCK-8) assay. The above compounds’ suppression effect against the cells invasion and migration ability was investigated by the trans-well detection. The real time reverse transcription-polymerase chain reaction (RT-PCR) subsequently was employed to test the VEGF signaling pathway activation. Eventually, the cancer cells apoptosis levels after treating with above compound were assessed via detecting the BCL-2 protein expression level. Furthermore, results from molecular docking simulation indicate that complex 1 not only exhibits relatively lower affinity energy, but also forms more binding interactions in comparison to complex 2 when binding to a given target protein. Complex 1 was much superior to complex 2 on treating pancreatic cancer via suppressing the cancer cell invasion, migration and viability ability.