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The effect of statins in preventing hepatocellular carcinoma (HCC) recurrence after curative liver resection has been controversial. Some retrospective studies identified perioperative use of statins was associated with significantly lower risk of HCC recurrence and improve recurrence-free survival (RFS) after liver resection, among patients with or without chronic hepatitis viral infection in multivariate survival analysis. However, a recent single-center study enrolled 430 cases in Taiwan revealed that the protective effect of statins was only significant in univariate analysis but not significant in multivariate analyses. To evaluate the effect of statins on the risk of HCC recurrence after curative liver resections, we performed a systematic review and meta-analysis on this topic. A systematic search of Medline, Embase, and Web of Science was conducted through December 2019. Studies were included if they evaluated perioperative exposure to statins, reported the recurrence of HCC after curative resection, and reported hazard ratios (HR) of multivariable analysis by Cox proportional hazards model. Summary HR estimates with 95% confidence intervals (CI) were calculated using the random-effects model. The analysis included 5 studies reporting the recurrence of HCC among 8,586 patients after liver resection, in which 411 of them received perioperative statins treatments. A meta-analysis of the studies showed a significant (39%) reduction in the risk of HCC recurrence among patients who took statins (adjusted HR, 0.61; 95% CI, 0.49-0.76), with no or little heterogeneity among studies (χ2=5.58, df=4, I2=28%). In conclusion, perioperative statins use may improve recurrence-free survival and decrease the risk of HCC recurrence after curative liver resection. Further prospective studies and larger randomized controlled trials (RCTs) are warranted to validate the conclusion. Statin usersNon-statin usersAdjusted Hazard RatioStudyTotalTotalWeightIV, Random, 95%CIYear of publicationWu 2012175439437.6%0.68 (0.53-0.87)2012Lee 2016132207831.2%0.66 (0.49-0.90)2016Kawaguchi 2017317037.0%0.34 (0.12-0.75)2017Nishio 20184360014.5%0.42 (0.25-0.71)2018Young 2019304009.8%0.79 (0.41-1.52)2019Total (95% CI)4118175100.0%0.61 (0.49-0.76)Heterogeneity: Tau2=0.02; Chi2=5.58, df=4 (p=0.23); I2=28%Test for overall effect: Z=4.43 (p Citation Format: Chun Philip Yeung, Siu Tim Cheung, Kwok Chai Kelvin Ng, Bo San Paul Lai, Ching Ning Charing Chong. Statin use associated with reduced risk of hepatocellular carcinoma recurrence following liver resection: A systematic review and meta-analysis [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 2345.

Minimally invasive approach has been increasingly applied in liver resection. However, laparoscopic major hepatectomy is technically demanding and is practiced only in expert centers around the world. Conversely, use of robot may help to overcome the difficulty and facilitate major hepatectomy.Between September 2010 and March 2019, 151 patients received robotic hepatectomy for various indications in our center. 36 patients received robotic hemihepatectomy: 26 left hepatectomy and 10 right hepatectomy. During the same period, 737 patients received open hepatectomy and out of these, 173 patients received open hemihepatectomy. A propensity score-matched analysis was performed in a 1:1 ratio.After matching, there were 36 patients each in the robotic and open group. The two groups were comparable in demographic data, type of hemihepatectomy, underlying pathology, size of tumor, and background cirrhosis. Conversion was needed in 3 patients (8.3%) in the robotic group. There was no operative mortality. The operative blood loss and resection margin were similar. Though not significantly different, there was a higher rate of complications in the robotic group (36.1% vs. 22.2%) and this difference was mostly driven by higher intra-abdominal collection (16.7% vs. 5.6%) and bile leak (5.6% vs. 2.8%). Operative time was significantly longer (400.8 ± 136.1 min vs 255.4 ± 74.4 min, P 0.001) but the postoperative hospital stay was significantly shorter (median 5 days vs 6.5 days, P = 0.040) in the robotic group. When right and left hepatectomy were analyzed separately, the advantage of shorter hospital stay remained in left but not right hepatectomy. For patients with hepatocellular carcinoma, there was no difference between the two groups in 5-year overall and disease-free survival.Compared with the open approach, robotic hemihepatectomy has longer operation time but shorter hospital stay. Thus, use of robot is feasible and effective in hemihepatectomy with the benefit of shorter hospital stay.

Sumiko read in the Chronicle that Poston was the only Nikkei relocation center administered by the Office of Indian Affairs. Maybe that was why security seemed rather lax here. Supposedly, the other relocation centers were run by the War Relocation Authority. The camps for Issei like Jiichan and Uncle were run by the Department of Justice and were more like prisons.-Cynthia Kadohata, WeedflowerIn her 2006 children's novel Weedflower, Cynthia Kadohata depicts an unlikely friendship between Sumiko, a Japanese-American girl, and Frank, a Mohave boy, in a time of war. The novel's portrayal of this friendship mobilizes a critique of militarism by suggesting the potential of cross-racial encounters to transform the logic of state power in settler colonialism. Kadohata explores militarism's reach into the social and familial fabric of Americans' lives outside the traditional battlefield. By considering how military rule shapes friendships and the encounters of everyday life, Kadohata imagines how individuals living in these spaces can both sustain and challenge military efforts. This broader perspective on war echoes feminist scholar Cynthia Enloe's (1983) longstanding work on querying the battlefield as just one locus of militarism and as a specific expression of patriarchy more generally. Looking at militarism through everyday encounters instead of exclusively through the battlefield thus allows a consideration of not just war itself but also other structures of power and domination that underlie war and extend from it. Instead of detailing the exceptionalism of World War II and therefore of the internment of Japanese Americans, Kadohata connects both to a longer social and political history that has shaped relations between racial groups within the United States. Though Kadohata foregrounds war as the enabling condition for unlikely friendships, those very friendships also challenge the logic of defining people outside one's own community as enemies or simply outsiders, undermining the militarized vision of war as a clash between different groups of people. In an imaginative fictional account, then, Kadohata enacts the transformative potential of alternative contact between Asians and Natives in the United States.Motivated by her father's internment at the Colorado River Relocation Center, Kadohata sets her novel in this very camp, which was nicknamed "Poston" after Charles Debrille Poston, the first Superintendent for Indian Affairs in Arizona. Poston was the only war relocation center administered by a separate federal agency, the Bureau of Indian Affairs (BIA); even the Gila River Relocation Center, the other camp located on Indian reser vation land in Arizona, remained under the administration of the War Relocation Authority (WRA).1 This setting allows for the possibility of contact between a Japanese-American internee girl, Sumiko, and a Mohave boy from outside the camp, Frank; more importantly, it connects the war camps to the context of Native removal and dispossession. Focusing on the encounter between Sumiko and Frank, Kadohata shifts attention away from the uniqueness of war internment for Japanese Americans to the longstanding histories of incarceration that have characterized the US government's treatment of nonwhite peoples.In this essay, I argue that the militarized friendship narratives at the heart of the novel enable a critique of settler-colonial militarism. While focusing on Kadohata's novel, I also turn to a range of cultural and critical conversations in political theory, literary criticism, historical research, and documentary film to explore how this militarized friendship narrative resonates with broader discourses on alternative contact. I consider how Kadohata's fictional narrative offers an open-ended consideration of war that both engages radical critiques of the US nation-state and reveals the possible co-option of difference into liberalism's narratives of freedom and equality. …

P Lai: In spring 2009, I offered a junior-level English seminar on Literatures of American Imprisonment, a course that surveyed writing that emerges from or reflects on various historical moments and forms of captivity. Rather than considering such imprisonment as anomalous to the United States of America, the course forwarded an argument about the constitutive quality of such captivity for American national character. We read captivity narratives from colonial America in the contact between European and Native Americans; African American slave narratives; Indian boarding school memoirs; Japanese American internment poetry; contemporary prison writing and neo-abolitionist discourse; and poetry from the Guantanamo Bay prison detainees. While the readings covered a span of over three hundred years, we read them out of chronological order to avoid creating a progressive narrative of increasing freedom or decreasing restrictions on the individual body. Instead, we considered how imprisonment has functioned variously to delimit who belongs to the national body and where boundaries can be drawn for the nation-state. The class began with a focused consideration of prison abolition by way of Angela Y. Davis’s succinct, provocative Are Prisons Obsolete? and selections from Joy James’s Brown, Michelle. The Culture of Punishment: Prison, Society, and Spectacle. New York University Press, 2009.

Purpose: Colorectal cancer is an important cause of cancer deaths. Here, we focused our investigation on the β-catenin gene which is implicated in colorectal carcinogenesis and tested whether β-catenin mRNA is detectable in the plasma of colorectal carcinoma and adenoma patients using quantitative reverse transcriptase-PCR. Experimental Design: Plasma β-catenin mRNA was measured from 58 colorectal carcinoma patients, 49 colorectal adenoma patients, and 43 apparently normal subjects using intron-spanning primers and Taqman probes. Five clinicopathological parameters were studied and correlated with plasma β-catenin mRNA concentration. Additionally, 19 colorectal carcinoma patients after tumor removal were also recruited for plasma β-catenin mRNA measurement to further demonstrate the clinical usefulness of this test. Results: β-catenin mRNA was detected with median concentrations of 8737 (range: 1480–933,100), 1218 (range: 541–2,254) and 291 (range: 0–1,366) copies/ml plasma in colorectal carcinoma, colorectal adenoma, and apparently normal subjects, respectively. Statistical analysis demonstrated that plasma β-catenin mRNA concentration was correlated to tumor stage but not sex, age, lymph node status, and degree in differentiation. Moreover, plasma β-catenin mRNA concentration decreased significantly after tumor removal in 16 of 19 (84%) colorectal carcinoma patients. Conclusions: We conclude that plasma β-catenin mRNA may potentially serve as a marker for colorectal cancer.

Partial response (PR) signaling with maximum likelihood (ML) detection is now a well-entrenched technology in magnetic disk drive systems. Indeed, read channel products using Extended Partial Response (EPR) systems are ubiquitous in commercially available disk drive products. Efforts are now underway to implement even more advanced detection methods that combine EPR systems with trellis coding techniques to provide higher recording densities or to operate with a lower SNR for a given bit error rate (EPR). This paper describes one such method, which is referred to as TC-E/sup 2/PRML. TC-E/sup 2/PRML is based on the idea of jointly designing the coding and the equalization functions to achieve improved utilization of the available SNR and bandwidth of the head/media combination. Its SNR performance is superior to that of the previous generation PRML or EPRML channels over the linear densities of current and future interest (PW50/T>3.0).

A read channel IC achieves >1.5 dB SNR improvement over a 32/34 rate EPRML read channel at 2.8 user bit density. The 0.18 /spl mu/m BiCMOS chip operates up to 700 Mb/s with 1.8 W read mode power using 3.3 V analog and 1.8 V digital power supplies. The die area is 9.64 mm/sup 2/.

Objectives & Background Circulating leucine-rich α-2-glycoprotein-1 (LRG1) protein has been found in the plasma and urine of patients with acute appendicitis (AA) and may be useful for diagnosis. The present study aimed to investigate whether circulating LRGI mRNA levels also improve the early diagnosis of AA. Methods A prospective study was conducted between December 2011 and October 2012 on patients presenting to the ED with acute abdominal pain ( Results Eighty-four consecutive patients (40 (47.6%) with AA and 44 (52.4%) without AA; mean age 35 years; 41.6% males) were recruited. Median whole blood LRG1 mRNA levels were higher in AA patients than in non-AA patients (2.2 (95% CI 1.3–2.6) vs 1.3 (95% CI 0.8–1.8)×10 5 copies/ml, p =0.0122). Of 40 AA patients, 13 (32.5%) were diagnosed as complicated AA, and had median LRG mRNA level higher than in patients with simple AA (3.2 (95% CI 2.2–4.1) vs 1.6 (95% CI 1.1–2.5)×10 5 copies/ml, p =0.0479). At a LRG1 mRNA cutoff of 1.9×10 5 copies/ml, the optimal sensitivity and specificity were 57.5% and 72.7% respectively. At this cutoff, the odds ratio for AA was 3.6 (95% CI 1.5–9.0; p =0.0047). Conclusion Whole blood LRG1 mRNA levels may be useful to diagnose simple and complicated AA from other causes of abdominal pain. Acknowledgement This research study was supported by a Direct Grant for Research from the Chinese University of Hong Kong (reference no.: 2041642) (HK$18000).

Hypothesis Since the early 1990s, the laparoscopic technique has been increasingly used for the treatment of perforated peptic ulcer. It is important to validate a risk scoring system that can stratify patients into various risk groups before comparing the treatment outcome of laparoscopic repair against that of conventional open surgery. The scoring system should be able to predict the likelihood of mortality and morbidity. Boey score and APACHE II (Acute Physiology and Chronic Health Evaluation II) score may be of use in patient stratification. Design Retrospective review of relevant case notes by one reviewer. Setting A teaching hospital treating 0.5 million to 1 million patients during the study period. Patients Patients operated on for perforated peptic ulcer between January 1989 and December 1998. Patients treated conservatively were excluded. Main Outcome Measures Mortality and postoperative complications (morbidity). Results A total of 436 patients (365 male and 71 female) with a mean ± SD age of 51.5 ± 18.3 years (range, 14-92 years) were studied. Duodenal perforation accounted for 344 (78.9%) of 436 cases. The mortality rate was 7.8% (34/436), and 89 patients had postoperative complications. Multivariate analysis demonstrated that only the APACHE II score predicted both mortality and morbidity. Although the Boey score predicted mortality, it failed to predict morbidity. However, the Boey score predicted the chance of conversion in patients undergoing laparoscopic repair. Conclusions The APACHE II score may be a useful tool for stratifying patients into various risk groups, and the Boey score might select appropriate patients for laparoscopic repair.

In evaluating the seismic safety of a 10‐story Uniform Building Code‐designed steel moment‐resisting building, three major sources of uncertainty have been extensively examined: (1) The representation of earthquake environment; (2) the structural dynamic properties; and (3) the method of structural analysis. By combining these uncertainties, the reliability of local inelastic response conditional on the peak ground acceleration is assessed for the frame. The overall seismic safety is investigated by introducing the site‐specific seismic risk. Based on the annual local ductility exceedance probability for each story, approximate bounds are established on the “system reliability” of the example building. Using empirical relationship between structural and nonstructural damage and local ductility ratio, the annual risk of damages due to future earthquakes is investigated for the steel frame.