ABSTRACT
Glioblastoma multiforme (GBM) is known for its dismal prognosis, though its dependence on patients' readily available RBCs parameters is not fully established. In this work, 170 GBM patients, diagnosed and treated in Soroka University Medical Center (SUMC) over the last 12 years were retrospectively inspected for their survival dependency on pre-operative RBCs parameters. Besides KPS and tumor resection supplemented by oncological treatment, age under 70 (HR = 0.4, 95% CI 0.24-0.65, p = 0.00073), low hemoglobin level (HR = 1.79, 95% CI 1.06-2.99, p = 0.031), and Red Cell Distribution Width (RDW) < 14% (HR = 0.57, 95% CI 0.37-0.88, p = 0.018) were found to be prognostic of patients' overall survival in multivariate analysis, accounting for a false discovery rate of < 5% due to multiple hypothesis testing. According to these results, a stratification tree was made, from which a favorable route highlighted a subgroup of nearly 30% of the cohorts' patients whose median overall survival was 21.1 months (95% CI 16.2-27.2)-higher than the established chemo-radiation standard first-line treatment regimen overall median survival average of about 15 months. The beneficial or detrimental effect of RBCs parameters on GBM prognosis and its possible causes is discussed.
ABSTRACT
We study mode-I fracture in lattices using atomistic simulations with randomly distributed bond lengths. By using a small parameter that measures the variation of the bond length between the atoms in perfect lattices and using a three-body force law, simulations reproduce the qualitative behavior of the beyond-steady-state cracks in the high-velocity regime, including reasonable microbranching. In particular, the effect of the lattice structure on the crack appears minimal, even though in terms of the physical properties such as the structure factor g(r) and the radial or angular distributions, these lattices share the physical properties of perfect lattices rather than those of an amorphous material (e.g., the continuous random network model). A clear transition can be seen between steady-state cracks, where a single crack propagates in the midline of the sample, and the regime of unstable cracks, where microbranches start to appear near the main crack, in line with previous experimental results. This is seen in both a honeycomb lattice and a fully hexagonal lattice. This model reproduces the main physical features of propagating cracks in brittle materials, including the total length of microbranches as a function of driving displacement and the increasing amplitude of oscillations of the electrical resistance. In addition, preliminary indications of power-law behavior of the microbranch shapes can be seen, potentially reproducing one of the most intriguing experimental results of brittle fracture. There was found to exist a critical degree of disorder, i.e., a sharp threshold between the cleaving behavior characterizing perfect lattices and the microbranching behavior that characterizes amorphous materials.
