Search

Objective To explore the efficacy and safety of bronchoscopic ablation combined with local injection of endostatin in patients with intratracheal metastasis of advanced non-small cell lung cancer(NSCLC). Methods A retrospective study was conducted on 58 patients with airway stenosis caused by NSCLC admitted to the Department of Respiratory in Ankang People's Hospital from December 2021 to December 2022. Thirty cases treated with bronchoscopic ablation alone were served as the control group, and 28 cases treated with bronchoscopic ablation combined with local injection of endostatin were served as the treatment group. Dyspnea index, Karnofsky performance scale (KPS)score, curative effect and the number of intraoperative and postoperative complications of all patients were recorded before and after 1 week of treatment. After 1 month, a bronchoscopic reexamination was performed to evaluate airway stenosis, complications and efficacy. Results Before treatment,there was no significant difference in dyspnea index and KPS score between two groups (P＞0.05). After treatment, the dyspnea indexes decreased and the KPS scores increased in the two groups (P＜0.01), and dyspnea index in the treatment group was lower (1.22±0.72 vs 1.70±0.57, t=3.334, P＜0.05), and the KPS score was higher (85.55±7.04 vs 80.50±5.10, t=3.808, P＜0.05) compared to the control group. Bronchoscopy re-examination 1 month after treatment, the total effective rate of the treatment group was slightly higher than that of the control group, but the difference was not statistically significant (64.29% vs 43.33%, χ2=2.555, P＞0.05). There were 19 cases and 21 cases of hemoptysis of different degrees in the treatment group and the control group, respectively, which improved after local treatment with hemocoagulase and epinephrine, without perforation and dyspnea. Conclusion Bronchoscopic ablation combined with local injection of endostatin is more effective than endoscopic ablation in improving dyspnea and quality of life in patients with advanced NSCLC, without increasing the risk of complications, and whether it can improve the total effective rate remains to be further discussed.

Objective: In Spring 2020 when COVID-19 hit, community colleges moved almost all classes online. This disruption impacts recent math reforms, including contextualization, raising concerns about sustained faculty and institutional leadership commitment. This study investigated how community college faculty teaching contextualized math courses adapted their instruction in response to COVID-19-related disruptions and how community college and instructional leadership addressed math contextualization efforts in response to COVID-19. Methods: Using multiple case studies, we conducted interviews with faculty and institutional leaders from two large community colleges in a Midwestern state. We also integrated field notes, observations, lesson plans, project documentation, and other contextual information as complementary data. Results: Three themes revealed how faculty and institutional leaders navigated the process of adapting contextualization efforts throughout the pandemic: reaching out to create community remotely, reimagining contextualization or pushing the pause button, and skilling up to persist through and toward change. Contribution: This study provides insight into the unique challenges and innovations due to sudden yet enduring disruptions that impact instruction, faculty development, and institutional support around instructional reform in the community college. This research informs faculty and institutional leaders navigating sustained efforts around math reform to identify actions to help institutions and their faculty continue advancing high-impact approaches and initiatives to math instruction in any environment.

To investigate the effects of two different water sources, domestic sewage and nutrient solution, on residue decomposition and the transformation of chromium chemical forms in Cr (Ⅵ) contaminated constructed wetlands, a micro Coix lacryma-jobi constructed wetland was constructed to treat chromium containing wastewater［using domestic sewage (DWS) and 1/2 Hoagland nutrient solution (HNS) as simulated solutions containing 0, 20, 40 mg·L-1 Cr (Ⅵ), respectively］. By using the buried root decomposition method, the decomposition dynamics of residual roots and the transformation pattern of chromium chemical forms were studied. The results were as follows: (1) Under 20 and 40 mg·L-1Cr (Ⅵ) stress, the growth of C. lacryma-jobi was inhibited. The plant height and stem diameter of HNS treatment were greater than those of DWS treatment, but the plant height and stem diameter of HNS treatment were more inhibited by Cr (Ⅵ) than those of DWS treatment. (2) The decomposition rate of C. lacryma-jobi residual roots decreased with the increase of Cr (Ⅵ) concentration, and the decomposition rate of HNS treatment was higher than that of DWS treatment. After 60 d of decomposition, under DWS treatment, the residual root chromium content of 20 and 40 mg·L-1 Cr (Ⅵ) treatment decreased by 11.70% and 8.09% respectively compared with that at the initial stage of root burial, while under HNS treatment, the residual root chromium content decreased by 15.80% and 18.42% respectively. The percentage of residual chromium in C. lacryma-jobi root residues at 20 and 40 mg·L-1 treatments decreased with the extension of root burial time, while the percentage of ethanol-extracted chromium and deionized water extracted chromium increased, and the percentage of acetic acid bound chromium increased significantly. (3) In the early stage of residue decomposition, the COD, TN, NH4-N, and total chromium content in the effluents treated with HNS and DWS increased, and then decreased. The trend of change was consistent with the residue decomposition process. HNS treated constructed wetlands were more efficient in removing chromium from wastewater. The research results indicate that after harvesting plants in constructed wetlands, root decomposition can quickly increase the chromium content in the effluent, and appropriately improve the nutritional status in wastewater, which can promote residue decomposition and removal of chromium by wetlands.

In this article, we discuss both prospective and retrospective causal inferences, building on Neyman’s potential outcome framework. For prospective causal inference, we review criteria for confounders and surrogates to avoid the Yule–Simpson paradox and the surrogate paradox, respectively. For retrospective causal inference, we introduce the concepts of posterior causal effects given observed evidence to quantify the causes of effects. The posterior causal effects provide a unified framework for deducing both effects of causes in prospective causal inference and causes of effects in retrospective causal inference. We compare the medical diagnostic approaches based on Bayesian posterior probabilities and posterior causal effects for classification and attribution.

This chapter illustrates the potential promise and complexities of free college initiatives from the perspective of administrators, faculty, staff, and students who are involved in a scholarship program at a small Midwestern community college. Based on two waves of interviews conducted in 2019 and 2021 respectively, we found that, while largely supportive of the free college movement, the program participants shared clear reservations due to potential unintended burdens on the part of institutions, and compounding barriers for students that free tuition alone cannot solve. This chapter closes by presenting a series of implications to inform the implementation of "free college" to realize its full promise.