Background The treatment for stage III non-small cell lung cancer (NSCLC) often involves multi-modality treatment. This retrospective study aimed to evaluate whether multidisciplinary team (MDT) discussion results in better patient survival. Materials and methods MDT discussion was optional before February 2016 and was actively encouraged by the MDT committee beginning February 2016. We reviewed the medical charts and computer records of patients with stage III NSCLC between January 2013 and December 2018. Results A total of 515 patients were included. The median survival of all the patients was 33.9 months (M). The median survival of patients who were treated after MDT discussion was 41.2 M and that of patients treated without MDT discussion was 25.7 M (p = 0.018). The median survival of patients treated before February 2016 was 25.7 M and that of patients treated after February 2016 was 33.9 M (p = 0.003). The median survival of patients with stage IIIA tumors and those with stage IIIB tumors was 39.4 M and 25.7 M, respectively (p = 0.141). Multivariate analysis showed that MDT or not (p<0.001), T staging (p = 0.009), performance status (p<0.001), and surgery (p = 0.016) to be significant prognostic factors.
Introduction The increased prevalence of erectile dysfunction (ED) has been reported in patients with chronic obstructive pulmonary disease, and sustained systemic inflammation seems to play a central role in this linkage. Asthma is also a chronic inflammatory airway disorder, eliciting a low-grade systemic inflammation; however, the influence of asthma on ED has not been investigated. Aim Our study strived to explore the relationship of asthma and the subsequent development of ED using a nationwide, population-based database. Methods From 2000 to 2007, we identified newly diagnosed asthma cases involving male patients 18–55 years old. A control cohort without asthma, which was matched for age and comorbidities, was selected for comparison. Main Outcome Measures The two cohorts were followed up, and we observed the occurrence of ED by registry of ED diagnosis in the database. Results Of the 17,302 sampled patients (3,466 asthma patients vs. 13,836 control), 114 (0.66%) experienced ED during a mean follow-up period of 4.56 years, including 34 (0.98% of the asthma patients) from the asthma cohort and 80 (0.58%) from the control group. Subjects with asthma experienced a 1.909-fold (95% confidence interval [CI], 1.276–2.856; P =0.002) increase in incident ED, which was independent of age, the number of clinical visits for urologist, and other comorbidities. Kaplan–Meier analysis also revealed the tendency of asthma patients for ED development (log rank test, P =0.002). The risk of ED was higher in cases with more frequent clinical visits for asthma (asthma patients with clinical visits with >24 times/year vs. <12 times/year: hazard ratio [HR]: 4.154 [95% CI:1.392–12.396], P =0.011; clinical visits with 12–24 times/year vs. <12 times/year HR: 3.534 [95% CI:1.245–10.032], P =0.018). Conclusions Asthma may be an independent risk factor for ED, and risk of ED probably increases in accordance with asthma severity.
In this paper, we study the determination of downlink (DL) and uplink (UL) channel split ratio for Time Division Duplex (TDD)-based IEEE 802.16 (WiMAX) wireless networks. In a TDD system, uplink and downlink transmissions share the same frequency at different time intervals. The TDD framing in WiMAX is adaptive in the sense that the downlink to uplink bandwidth ratio may vary with time. In this work, we focus on TCP based traffic and explore the impact of improper bandwidth allocation to DL and UL channels on the performance of TCP. We then propose an Adaptive Split Ratio (ASR) scheme which adjusts the bandwidth ratio of DL to UL adaptively according to the current traffic profile, wireless interference, and transport layer parameters, so as to maximize the aggregate throughput of TCP based traffic. Our scheme can also cooperate with the Base Station (BS) scheduler to throttle the TCP source when acknowledgements (ACKs) are transmitted infrequently. The performance of the proposed ASR scheme is validated via ns-2 simulations. The results show that our scheme outperforms static allocation (such as the default value specified in the WiMAX standard and other possible settings in existing access networks) in terms of higher aggregate throughput and better adaptivity to network dynamics.
Higher AHI did not cause more frequent awakenings and arousals at high altitude. Central sleep apneas were observed in non-AMS but not in AMS group. Subjects unacclimatized to acute hypobaric hypoxia might have delayed and less REM sleep.
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