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To evaluate the clinical relevance of indeterminate lung nodules (ILN) in patients with locally recurrent rectal cancer (LRRC) treated in a tertiary referral centre.

All patients with LRRC diagnosed between 2000 and 2017 were retrospectively reviewed. Reports of staging chest CT-scans were evaluated for ILN. Patients with distant metastases including lung metastases at time of LRRC diagnosis were excluded. Overall (OS), progression-free survival (PFS) and the cumulative incidence of lung metastases were compared between patients with and without ILN.

In total 556 patients with LRRC were treated during the study period. In the 243 patients eligible for analysis, 68 (28%) had ILN at LRRC diagnosis. Median OS was 37 months for both the patients with and without ILN (p=0.37). Median PFS was 14 months for the patients with ILN and 16 months for patients without ILN (p=0.80). GSK 3 inhibitor After correction for potential confounding, ILN present at LRRC diagnosis was not associated with impaired OS or PFS (adjusted hazards ratio [95% confidence interval] 0.81 [0.54-1.22] and 1.09 [0.75-1.59]). The 5-year cumulative incidence of lung metastases was 31% in patients with ILN and 28% in patients without ILN (p=0.19).

Our study shows that ILN are present in roughly a quarter of patients with LRRC. No differences in OS, PFS, or the cumulative incidence of lung metastases were found between patients with and without ILN at LRRC diagnosis. These results suggest that ILN are of little to no clinical relevance in patients with LRRC.

Our study shows that ILN are present in roughly a quarter of patients with LRRC. No differences in OS, PFS, or the cumulative incidence of lung metastases were found between patients with and without ILN at LRRC diagnosis. These results suggest that ILN are of little to no clinical relevance in patients with LRRC.

COPD is a multifactorial disease which causes considerable mortality and morbidity worldwide. Previous studies assessing the possible relationship between indoor radon exposure and COPD have shown inconclusive results.

A multicentric, hospital-based, case-control study was conducted in a Spanish radon-prone area. COPD cases were confirmed by spirometry and controls were selected due to trivial surgery or procedures not related to tobacco consumption. All participants had to have lived for at least 15 years in the same dwelling. Radon measurements were conducted individually in dwellings using alpha-track detectors. Results were obtained using multivariate logistic regression.

189 cases and 747 controls took part. There was no significant association between residential radon concentrations and COPD onset with a OR of 1.12 (95%CI 0.41-3.06) for individuals exposed to more than 200Bq/m

compared to those exposed to less than 50Bq/m

. Heavy smokers seem to increase their COPD risk if exposed to higher radon concentrations vs those exposed to lower concentrations. There was a statistically significant synergy index between radon exposure and tobacco consumption, S-index 11.60 (95%CI 3.71-36.26). Indoor radon concentration was higher in never/light smokers with COPD compared to controls.

No association between indoor radon and COPD has been observed. However, there might be some effect modification on the COPD risk in heavy smokers when high radon exposure is present. This is supported by the additive synergy observed. Also, a possible association between indoor radon and COPD onset in never and light smokers needs to be further studied.

No association between indoor radon and COPD has been observed. However, there might be some effect modification on the COPD risk in heavy smokers when high radon exposure is present. This is supported by the additive synergy observed. Also, a possible association between indoor radon and COPD onset in never and light smokers needs to be further studied.Gestational diabetes mellitus (GDM) is a disease of glucose intolerance during pregnancy and is associated with infant macrosomia, infant hypoglycemia, and increased risk of type 2 diabetes development for both mother and infant. Although breastfeeding potentially mitigates metabolic sequelae for both mother and her offspring, women with GDM are more likely to introduce formula and, therefore, are less likely to exclusively breastfeed, and some studies show less initiation and shorter breastfeeding duration as well. Therefore, women with GDM and their infants warrant investigation of methods by which to increase breastfeeding exclusivity and duration. Exploration of the barriers to breastfeeding for women with GDM demonstrate not only biologic complications such as maternal obesity, increased prevalence of cesarean section, and infant hypoglycemia, but also maternal report of less provider support of breastfeeding and reduced breastfeeding self-efficacy. Consequently, interventions designed to optimize breastfeeding outcomes in this high-risk population should not only focus on the biology but also on provider behavior and maternal social factors.This article focuses on observer-based state feedback H∞ control for a jacket structure against DoS attacks and external wave loads. First, a networked model of the structure is formulated as a switched delay system, in which DoS attacks and network-induced delays are considered simultaneously. A matching switched observer is developed for estimating states of the networked jacket structure system. Then, some new sufficient conditions are provided for the observer-based networked H∞ controller for the resultant switched system. Finally, it is shown from several case studies that the provided mechanism can maintain desired performance of the jacket structure against attacks and wave loads. In addition, the developed control schemes can save the control cost significantly.This paper provides a model-parameter-free control strategy for the trajectory tracking problem of the autonomous underwater vehicle exposed to external disturbances and actuator failures. Two control architectures have been constructed such that the system states could be forced to the desired trajectories with acceptable performance. By combining sliding mode control (SMC) technology and adaptive algorithm, the first control architecture is developed for tracking missions under healthy actuators. Taking actuator failures scenario into account, system reliability is improved considerably by the utilization of a passive fault-tolerant technology in the second controller. Benefitting from properties of Euler-Lagrange systems, the nonlinear dynamics of the underwater vehicles could be handled properly such that the proposed controllers could be developed without model parameters. Finally, the validity of the proposed controllers is demonstrated by theoretical analysis and numerical simulations.This paper proposed a double-layer model predictive control (DLMPC) strategy integrated with zone control. In the steady-state target calculation (SSTC) layer, the controlled output variables are pretreated based on the analysis of process principle and production data. Subsequently, the optimal input-output targets and corresponding zone parameters are obtained by solving the steady-state optimization problem and transmitted to the dynamic control layer for tracking. Meanwhile, the weighted and priority soft constraints relaxation methods are discussed when the SSTC problem is infeasible. Compared with conventional DLMPC and zone model predictive control (ZMPC), the proposed algorithm can not only achieve smooth control, but also have better robustness and economic performance. Finally, a simulation example is taken to show the effectiveness of the proposed method.The global problem of groundwater being contaminated with per- and polyfluoroalkyl substances (PFASs) originating from highly contaminated soils has created a need to remediate these locations. In situ immobilisation of PFASs in soil by applying sorbents is often a preferred low-cost technique to reduce their mobility and leaching to groundwater, but the long-term efficacy of sorbents has not yet been investigated. In this study, the longevity of remediation of two different soils by two common sorbents (RemBind®, and pulverized activated carbon, Filtrasorb™ 400) was assessed. Regulatory agencies often rely on standardised leaching procedures to assess the risk of contaminant mobility in soils. Hence, the Australian Standard Leaching Procedure and the U.S. EPA Leaching Environmental Assessment Framework were applied to quantify the desorption/leaching of a wide range of PFASs from unremediated and remediated soils under a range of pH conditions (pH 2 to 12). Ease of desorption and subsequent leaching from the unremediated soils was related to C-chain length; while short-chain PFASs were easily desorbed and leached, long-chain PFASs were more difficult to desorb. Desorption of long-chain PFASs was also pH dependent in unremediated soils, with desorption being greater at high pH. Both sorbents retained PFASs strongly in the remediated soils (> 99% for most PFASs) across a broad range of pH conditions, with only small differences between the sorbents in terms of efficacy. Both sorbents showed better retention of PFASs under low pH conditions. Remediation of PFAS-contaminated soils with these sorbents could be considered robust and durable in terms of changes in soil pH, with little risk of subsequent PFASs desorption under normal environmental pH conditions. Ultimately, to give regulators and site owners the greatest level of confidence that immobilisation is stable for the longer term, it should also be tested under repeated cycles of leaching and under different conditions.Breast-implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is an uncommon, recently recognized disease that seems to occur only in relation with implants with textured surfaces. Most cases present with late-onset peri-implant effusion or fluid collections that develop more than 12 months after insertion of the implant. The diagnosis is reached by cytological analysis of fluid samples obtained by ultrasound-guided fine-needle aspiration. These patients usually have a good prognosis after surgical removal of the implant. A small percentage of patients present with a nodule or mass adjacent to the implant that usually develops late. In these cases, the diagnosis is reached by the histological analysis of core-needle biopsy specimens. These patients have a worse prognosis and require a combination of surgery and systemic chemotherapy. The main immunophenotypic characteristics of this lymphoma are intense expression of CD30 and a lack of expression of anaplastic lymphoma kinase (ALK). Here we present a case of BIA-ALCL in a patient with implants with a textured surface that presented with peri-implant effusion and incipient formation of a millimetric nodule and was treated with removal of the implant and bilateral capsulectomy. It is important to point out that the disease requires multidisciplinary management and that the Spanish Agency of Medicines and Medical Devices (AEMPS) should be notified when the diagnosis is confirmed.In recent decades, our understanding of the disrupted mechanisms that contribute to major obstetrical diseases, including preeclampsia, fetal growth restriction, preterm birth, and gestational diabetes, has increased exponentially. Common to many of these obstetric diseases is placental maldevelopment and dysfunction; the placenta is a significant component of the maternal-fetal interface involved in coordinating, facilitating, and regulating maternal and fetal nutrient, oxygen and waste exchange, and hormone and cytokine production. Despite the advances in our understanding of placental development and function, there are currently no treatments for placental maldevelopment and dysfunction. However, given the transient nature and accessibility from the maternal circulation, the placenta offers a unique opportunity to develop targeted therapeutics for routine obstetric practices. Furthermore, given the similar developmental paradigms between the placenta and cancer, there is an opportunity to appropriate current knowledge from advances in targeted therapeutics in cancer treatments.

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