PurposeTo facilitate localization and resection of small lung nodules, we developed a prospective clinical trial (ClinicalTrials.gov number NCT01847209) for a novel surgical approach which combines placement of fiducials using intra‐operative C‐arm computed tomography (CT) guidance with standard thoracoscopic resection technique using image‐guided video‐assisted thoracoscopic surgery (iVATS).MethodsPretrial training was performed in a porcine model using C‐arm CT and needle guidance software. Methodology and workflow for iVATS was developed, and a multi‐modality team was trained. A prospective phase I‐II clinical trial was initiated with the goal of recruiting eligible patients with small peripheral pulmonary nodules. Intra‐operative C‐arm CT scan was utilized for guidance of percutaneous marking with two T‐bars (Kimberly‐Clark, Roswell, GA) followed by VATS resection of the tumor.ResultsTwenty‐five patients were enrolled; 23 underwent iVATS, one withdrew, and one lesion resolved. Size of lesions were: 0.6–1.8 cm, mean = 1.3 ± 0.38 cm.. All 23 patients underwent complete resection of their lesions. CT imaging of the resected specimens confirmed the removal of the T‐bars and the nodule. Average and total procedure radiation dose was in the acceptable low range (median = 1501 μGy*m2, range 665–16,326). There were no deaths, and all patients were discharged from the hospital (median length of stay = 4 days, range 2–12). Three patients had postoperative complications: one prolonged air‐leak, one pneumonia, and one ileus.ConclusionsA successful and safe step‐wise process has been established for iVATS, combining intra‐operative C‐arm CT scanning and thoracoscopic surgery in a hybrid operating room. J. Surg. Oncol. 2015 111:18–25. © 2015 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.
Malignant pleural mesothelioma (MPM) is an aggressive cancer that occurs more frequently in men, but is associated with longer survival in women. Insight into the survival advantage of female patients may advance the molecular understanding of MPM and identify therapeutic interventions that will improve the prognosis for all MPM patients. In this study, we performed whole-genome sequencing of tumor specimens from 10 MPM patients and matched control samples to identify potential driver mutations underlying MPM. We identified molecular differences associated with gender and histology. Specifically, single-nucleotide variants of BAP1 were observed in 21% of cases, with lower mutation rates observed in sarcomatoid MPM (p<0.001). Chromosome 22q loss was more frequently associated with the epithelioid than that non-epitheliod histology (p=0.037), whereas CDKN2A deletions occurred more frequently in non-epithelioid subtypes among men (p=0.021) and were correlated with shorter overall survival for the entire cohort (p=0.002) and for men (p=0.012). Furthermore, women were more likely to harbor TP53 mutations (p=0.004). Novel mutations were found in genes associated with the integrin-linked kinase pathway, including MYH9 and RHOA. Moreover, expression levels of BAP1, MYH9, and RHOA were significantly higher in non-epithelioid tumors, and were associated with significant reduction in survival of the entire cohort and across gender subgroups. Collectively, our findings indicate that diverse mechanisms highly related to gender and histology appear to drive MPM.
Introduction:The aim of this study was to validate a molecular expression signature [cell cycle progression (CCP) score] that identifies patients with a higher risk of cancer-related death after surgical resection of early stage (I-II) lung adenocarcinoma in a large patient cohort and evaluate the effectiveness of combining CCP score and pathological stage for predicting lung cancer mortality.Methods:Formalin-fixed paraffin-embedded surgical tumor samples from 650 patients diagnosed with stage I and II adenocarcinoma who underwent definitive surgical treatment without adjuvant chemotherapy were analyzed for 31 proliferation genes by quantitative real-time polymerase chain reaction. The prognostic discrimination of the expression score was assessed by Cox proportional hazards analysis using 5-year lung cancer-specific death as primary outcome.Results:The CCP score was a significant predictor of lung cancer-specific mortality above clinical covariates [hazard ratio (HR) = 1.46 per interquartile range (95% confidence interval = 1.12–1.90; p = 0.0050)]. The prognostic score, a combination of CCP score and pathological stage, was a more significant indicator of lung cancer mortality risk than pathological stage in the full cohort (HR = 2.01; p = 2.8 × 10−11) and in stage I patients (HR = 1.67; p = 0.00027). Using the 85th percentile of the prognostic score as a threshold, there was a significant difference in lung cancer survival between low-risk and high-risk patient groups (p = 3.8 × 10−7).Conclusions:This study validates the CCP score and the prognostic score as independent predictors of lung cancer death in patients with early stage lung adenocarcinoma treated with surgery alone. Patients with resected stage I lung adenocarcinoma and a high prognostic score may be candidates for adjuvant therapy to reduce cancer-related mortality.
Deuterated compounds are valuable in synthetic, pharmaceutical and analytical chemistry. The deuteration of halides is a widespread method for its good site-selectivity. However, the facile, efficient and economical deuterium incorporation still remains a big challenge. In this work, we introduced a practical deuteration of (hetero)arylhalides through electrochemical reduction method. This transformation proceeded smoothly under room temperature without metal catalysts, external-reductants, toxic or dangerous reagents. Remarkably, low-cost and chemical equivalent D 2 O was the sole deuterium source in this reaction. The professional electrosynthesis equipment was not essential, but common batteries and electrodes were enough.
Aging is the primary driver of various diseases, including common neurodegenerative diseases such as Alzheimer’s disease (AD) and Parkinson’s disease (PD). Currently there is no cure for AD and PD, and the development of novel drug candidates is demanding. Spermidine is a small anti-aging molecule with elimination of damaged mitochondria via the process of mitophagy identified as a molecular mechanism of action. Here, we show that spermidine inhibits memory loss in AD worms and improves behavioral performance, e.g., locomotor capacity, in a PD worm model, both via the PINK1-PDR1-dependent mitophagy pathway. Additionally, spermidine delays accelerated aging and improves healthspan in the DNA repair-deficient premature aging Werner syndrome (WS) worm model. While possible intertwined interactions between mitophagy/autophagy induction and DNA repair by spermidine are to be determined, our data support further translation of spermidine as a possible therapeutic intervention for such diseases.
We present EasyGen, an efficient model designed to enhance multimodal understanding and generation by harnessing the capabilities of diffusion models and large language models (LLMs). Unlike existing multimodal models that predominately depend on encoders like CLIP or ImageBind and need ample amounts of training data to bridge the gap between modalities, EasyGen is built upon a bidirectional conditional diffusion model named BiDiffuser, which promotes more efficient interactions between modalities. EasyGen handles image-to-text generation by integrating BiDiffuser and an LLM via a simple projection layer. Unlike most existing multimodal models that are limited to generating text responses, EasyGen can also facilitate text-to-image generation by leveraging the LLM to create textual descriptions, which can be interpreted by BiDiffuser to generate appropriate visual responses. Extensive quantitative and qualitative experiments demonstrate the effectiveness of EasyGen, whose training can be easily achieved in a lab setting. The source code is available at https://github.com/zxy556677/EasyGen.
Polysaccharide polymers like pectin can demonstrate striking and reversible changes in their physical properties depending upon relatively small changes in water content.Recent interest in using pectin polysaccharides as mesothelial sealants suggests that water content, rather than nonphysiologic changes in temperature, may be a practical approach to optimize the physical properties of the pectin biopolymers. Here, we used humidified environments to manipulate the water content of dispersed solution of pectins with a high degree of methyl esterification (high-methoxyl pectin; HMP). The gel phase transition was identified by a nonlinear increase in compression resistance at a water content of 50% (w/w). The gel phase was associated with a punched-out fracture pattern and scanning electron microscopy (SEM) images that revealed a cribiform (Swiss cheese-like) pectin microstructure. The glass phase transition was identified by a marked increase in resilience and stiffness. The glass phase was associated with a star-burst fracture pattern and SEM images that demonstrated a homogeneous pectin microstructure.In contrast, the burst strength of the pectin films was largely independent of water content over a range from 5 to 30% (w/w). These observations indicate the potential to use water content in the selective regulation of the physical properties of HMP biopolymers. K E Y W O R D S electron microscopy, fractography, pectin, polysaccharides
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