Rescheduling trains by crossover tracks to promote service quality of urban rail transit under partial blockages.

This study focuses on the rescheduling problem with disruptions that cause partial blockages in the urban rail transit (URT), contributing to extending the relative train rescheduling studies. The alternative driving measure (ADM), which could be regarded as one train rerouting measure, is used to skip the blocked section, and a mixed-integer nonlinear programming (MINLP) model is built based on it. Time-varying passenger flow as well as the turnaround process of rolling stocks is taken into consideration. To solve the model, a customized genetic algorithm is used to quickly generate high-quality solutions. Real-world data is studied and sensitivity analyses are taken to verify the feasibility and advantage of ADM. The results validate the proposed model and algorithm, as well as confirm that ADM shows significantly better performance than the practical operation measure in promoting passenger service quality of URT under partial blockage.

Progress toward the sustainable development of world cultural heritage sites facing land-cover changes.

The quantification of the extent and dynamics of land-use changes is a key metric employed to assess the progress toward several Sustainable Development Goals (SDGs) that form part of the United Nations 2030 Sustainable Development Agenda. In terms of anthropogenic factors threatening the conservation of heritage properties, such a metric aids in the assessment of achievements toward heritage sustainability solving the problem of insufficient data availability. Therefore, in this study, 589 cultural World Heritage List (WHL) properties from 115 countries were analyzed, encompassing globally distributed and statistically significant samples of "monuments and groups of buildings" (73.2%), "sites" (19.3%), and "cultural landscapes" (7.5%). Land-cover changes in the WHL properties between 2015 and 2020 were automatically extracted from big data collections of high-resolution satellite imagery accessed via Google Earth Engine using intelligent remote sensing classification. Sustainability indexes (SIs) were estimated for the protection zones of each property, and the results were employed, for the first time, to assess the progress of each country toward SDG Target 11.4. Despite the apparent advances in SIs (10.4%), most countries either exhibited steady (20.0%) or declining (69.6%) SIs due to limited cultural investigations and enhanced negative anthropogenic disturbances. This study confirms that land-cover changes are among serious threats for heritage conservation, with heritage in some countries wherein the need to address this threat is most crucial, and the proposed spatiotemporal monitoring approach is recommended.

Highest-Efficiency Flexible Perovskite Solar Module by Interface Engineering for Efficient Charge-Transfer.

The electron-transport layer (ETL) plays an important role in improving the performance of flexible perovskite solar cells (F-PSCs). Herein, a room-temperature-processed SnO2 :OH ETL is demonstrated, that exhibits reduced defect density, in particular lower oxygen vacancy concentration, with better energy band alignment and more wettable surface for quality perovskite deposition. More importantly, an efficient electron-transfer channel is produced between the ETL and the perovskite layer due to the formation of hydrogen bonds at the interface, resulting in enhanced electron extraction from the perovskite. As a result, the efficiency of a large-area (36.50 cm2 ) flexible perovskite solar module based on MAPbI3 is increased to as high as 18.71%; this is thought to be the highest reported PCE value for flexible perovskite solar modules to date. In addition, it exhibits high durability while maintaining over 83% of its initial PCE after flexing test cycles. Further, F-PSCs with SnO2 :OH show remarkably long-term stability, owing to a high quality of the perovskite film and a strong coupling between the SnO2 :OH and perovskite layer caused by hydrogen bonds, which successfully inhibits moisture permeation.

Collaborative optimization for train stop planning and train timetabling on high-speed railways based on passenger demand.

In recent years, with increasing passenger travel demand, high-speed railways have developed rapidly. The stop planning and timetabling problems are the core contents of high-speed railway transport planning and have important practical significance for improving efficiency of passenger travel and railway operation Dong et al. (2020). This study proposes a collaborative optimization approach that can be divided into two phases. In the first phase, a mixed-integer nonlinear programming model is constructed to obtain a stop plan by minimizing the total passenger travel time. The constraints of passenger origin-destination (OD) demand, train capacity, and stop frequency are considered in the first phase. In the second phase, the train timetable is optimized after the stop plan is obtained. A multiobjective mixed-integer linear optimization model is formulated by minimizing the total train travel time and the deviation between the expected and actual departure times from the origin station for all trains. Multiple types of trains and more refined headways are considered in the timetabling model. Finally, the approach is applied to China's high-speed railway, and the GUROBI optimizer is used to solve the models in the above two stages. By analyzing the results, the total passenger travel time and train travel time decreased by 2.81% and 3.34% respectively. The proposed method generates a more efficient solution for the railway system.

Effects of K2TiF6 and Electrolyte Temperatures on Energy Consumption and Properties of MAO Coatings on 6063 Aluminum Alloy.

To decrease energy consumption and improve the performance of micro-arc oxidation (MAO) films on 6063 Al alloy, a policy of K2TiF6 additive and electrolyte temperature control was adapted. The specific energy consumption relied on the K2TiF6 additive and more particularly on the electrolyte temperatures. Scanning electron microscopy demonstrates that electrolytes with 5 g/L K2TiF6 can effectively seal the surface pores and increase the thickness of the compact inner layer. Spectral analysis shows that the surface oxide coating consists of γ-Al2O3 phase. Following 336 h of the total immersion process, the impedance modulus of the oxidation film, prepared at 25 °C (Ti5-25), remained 1.08 × 106 Ω·cm2. Moreover, Ti5-25 has the best performance/energy-consumption ratio with a compact inner layer (2.5 ± 0.3 µm). This research found that the time of the big arc stage increased with the temperature, resulting in producing more internal defects in the film. In this work, we employ a dual-track strategy of additive and temperature providing an avenue to reduce the energy consumption of MAO on alloys.

Microstructure and Tribo-Behavior of WC-Cr3C2-Ni Coatings by Laser Cladding and HVAF Sprayed: A Comparative Assessment.

SK5 steel is the base material used for the preparation of the wrinkle scraper, whose service life strongly affects the working efficiency and economic benefits. In this work, WC-Cr3C2-Ni coating was deposited on the SK5 steel substrate by using High-velocity air fuel spray (HVAF) and Laser cladding (LC) processes respectively, named HVAF-WC coating and LC-WC coating. The microstructure and wear resistance of both coatings were analyzed, and were compared with the substrate sample. Results showed that the coatings were adhesive well onto the substrate. More WC with fine crystals is retained in HVAF-WC coating due to low flame flow temperature, while WC of LC-WC coating is characterized by columnar crystals. The wear rate of HVAF-WC and LC-WC coating was 4.00 × 10-7 mm3/(N•m) and 3.47 × 10-6 mm3/(N•m), respectively, which was two and one orders of magnitude lower than SK5 steel with 3.54 × 10-5 mm3/Nm. HVAF-WC coating exhibited the best wear resistance because of significant fine grain strengthening, which wear mechanism is mainly dominated by abrasive wear. Thus, it was thought that HVAF-WC coating is more effective ways to improve the wear resistance of SK5 steel, comparing with LC-WC coating.

Effects of centrifugation prior to pneumatic tube system transport on routine biochemical and immunological tests of susceptibility to hemolysis.

BACKGROUND: Pneumatic tube system (PTS) may be associated with preanalytical hemolysis. The objective of this study was to evaluate the effects of PTS on biochemical and immunological tests susceptible to hemolysis and try to find ways to reduce the result bias caused by PTS. METHODS: Laboratory parameters were compared between PTS without centrifuging group, PTS after centrifuging group, PTS with serum group, and hand-delivered (HD) group. Studies were performed to access the influence of different PTS transport frequencies on laboratory assays. RESULTS: PTS transportation resulted in obviously increase in LDH (lactate dehydrogenase) and NSE (neuron-specific enolase) results (LDH: Bias = 17.95%, 95% confidence interval (CI) = -3.13-39.02; p < 0.001; NSE: Bias = 64.26%, 95% CI = -21.29-149.82; p < 0.001; respectively). After pre-centrifugation, no statistical difference was observed in LDH results (Bias = 2.83%, 95% CI = -13.00-18.65; p = 0.737). However, the bias of NSE still reach 19.16% (95% CI = -41.78-80.11), which exceeded the clinical acceptable range (p = 0.017). Both LDH(p = 0.931) and NSE(p > 0.999) show no statistical difference between PTS with serum group and HD group (LDH: Bias = -1.60%, 95% CI = -6.00-2.81; NSE: Bias = -3.68%, 95% CI = -11.35-3.99). CONCLUSION: PTS can lead to falsely increased LDH and NSE test results. Only loading the centrifuged upper serum in new tubes during PTS transport can eliminate the results bias of NSE.

Yolk-shell Co3 O4 @Fe3 O4 /C Nanocomposites as a Heterogeneous Fenton-like Catalyst for Organic Dye Removal.

The yolk-shell Co3 O4 @Fe3 O4 /C nanocomposites with Co3 O4 as the core, Fe3 O4 /C as the shell, and a cavity structure were synthesized by the hard template method. The physical and chemical properties of the composites were characterized by SEM, TEM, XRD, TGA, XPS, BET, and VSM. The specific surface area of yolk-shell Co3 O4 @Fe3 O4 /C nanocomposites is 175.9 m2  g-1 , showing superparamagnetic properties. The yolk-shell Co3 O4 @Fe3 O4 /C nanocomposites were used as heterogeneous Fenton catalysts to activate peroxymonosulfate (PMS) to degrade MB, which showed high catalytic degradation performance. The degradation rate of MB reached 100 % within 30 min under the circumstances of the yolk-shell Co3 O4 @Fe3 O4 /C nanocomposites dosage of 0.1 g L-1 , the PMS dosage of 1.0 g L-1 , the initial MB concentration of 100 mg L-1 , an initial pH of 5.5, and a temperature of 30±2 °C. The enhanced catalytic performance of the yolk-shell Co3 O4 @Fe3 O4 /C nanocomposites can be attributed to the synergistic effect of the two catalytically active materials and the middle cavity. The effects of different operating parameters and co-existing anion species on MB degradation were also investigated. Electron paramagnetic resonance (EPR) analysis and quenching experiments confirmed that the formation of SO4 ⋅- in the yolk-shell Co3 O4 @Fe3 O4 /C/PMS system contributes to MB degradation. In addition, yolk-shell Co3 O4 @Fe3 O4 /C nanocomposites can be easily separated from the pollutant solution under the action of an external magnetic field, and the degradation rate of MB can still reach 98 % after five cycles, indicating that it has good stability and reusability and has broad application prospects in the field of water purification.

Neoadjuvant Immunotherapy Combined with Chemotherapy for Local Advanced Non-Small-Cell Lung Cancer in a Patient with a History of Breast Cancer: A Case Report.

Durvalumab consolidation therapy is the standard treatment after concurrent chemoradiotherapy for patients with surgically unresectable stage IIIA (N2) non-small-cell lung cancer (NSCLC). Neoadjuvant therapy followed by surgery could reduce locoregional and distant recurrence and improve the survival rate for surgically resectable NSCLC. However, the value of neoadjuvant therapy in locally advanced potentially resectable NSCLC remains controversial. Herein, we report a locally advanced potentially resectable NSCLC case with a history of breast cancer who achieved a pathologic complete response (pCR) after preoperative treatment with pembrolizumab and chemotherapy. A 50-year-old woman developed squamous cell carcinoma (SCC) (left lower lobe of the lung, stage IIIA-N2) after two years of chemotherapy and anti-HER2 therapy following a diagnosis of HER2-overexpressing breast cancer. Surgical resection was attempted despite an MDT classification as unamenable to curative surgical resection. After two cycles of neoadjuvant chemotherapy combined with anti-PD1 immunotherapy, the tumor significantly shrank, then the patient underwent a left lower lobectomy. Complete resection with negative margins (R0 resection) was achieved in the patient. The patient experienced grade 1-2 adverse effects and no grade 3 or worse adverse effects occurred. Cardiotoxicity did not occur in the patient despite prior anti-HER2 treatment for breast cancer. Our case study contributes to the existing evidence on the feasibility, efficacy, and safety of neoadjuvant immunotherapy combined with chemotherapy in locally advanced unresectable NSCLC. Furthermore, future studies are needed to determine which patients can benefit from immunoadjuvant therapy and the duration and course of preoperative and postoperative immunotherapy.

Regulatory Role of miRNAs and lncRNAs in Gout.

Objective: To explore the regulatory functions of ceRNA networks in the nosogenesis of gout and search for potential therapeutic targets. Methods: We searched the GEO database and downloaded the lncRNA microarray chipset GSE160170. This matrix series was analyzed to yield differentially expressed lncRNAs and mRNAs. Then, the correlations between lncRNAs and miRNAs were obtained by comparing the highly conserved miRNA families. The predicted miRNA-regulating mRNAs were matched to the differentially expressed mRNAs from the chipset analyses to obtain miRNA-mRNA interactions. Next, we used the Cytoscape software to model ceRNA networks and the STRING database to determine their protein-protein interactions. The R software was used to algorithmically screen the functional pathways of key PPI modules in the ceRNA networks. Results: A total of 354 lncRNAs (140 downregulated and 214 upregulated) and 693 mRNAs (399 downregulated and 294 upregulated) were differentially expressed between the gout group and the healthy group. The ceRNA network of differentially expressed lncRNAs contained 86 lncRNAs (35 downregulated and 51 upregulated), 29 miRNAs, and 57 mRNAs. The processes identified in the GO enrichment analysis included gene transcription, RNA polymerase II transcription, and the regulation of cell growth and apoptosis. The pathways identified in the KEGG enrichment analysis included IL-17, TNF, and MAPK signaling. Nine lncRNAs (AC104024, AC084082, AC083843, FAM182A, AC022819, FAM215B, AP000525, TTTY10, and ZNF346-IT1), eleven miRNAs (hsa-miR-1297, hsa-miR-17-5p, hsa-miR-429, hsa-miR-139-5p, hsa-miR-449c-5p, hsa-miR-125a-5p, hsa-miR-125b-5p, hsa-miR-23b-3p, hsa-miR-217, hsa-miR-363-3p, and hsa-miR-20b-5p), and nine mRNAs (JUN, CASP2, PMAIP1, FOS, TNFAIP3, MAP3K8, BTG2, NR4A2, and DUSP2) were identified in the exploration of the key modules. Conclusion: Characterization of ceRNA networks could be a promising approach for better understanding the pathogenesis of gout, with the TTTY10/hsa-miR-139-5p/AP-1 axis likely to be of clinical significance.

Construction and validation of a prognostic model for kidney renal clear cell carcinoma based on podocyte-associated genes.

BACKGROUND: As the most common renal malignancy, kidney renal clear cell carcinoma (KIRC) has a high prevalence and death rate as well as a poor response to treatment. Developing an efficient prognostic model is essential for accurately predicting the outcome and therapeutic benefit of KIRC patients. METHODS: Gene expression profiles of podocyte-associated genes (PAGs) were obtained from The Cancer Genome Atlas and GEO datasets. Cox regression and Lasso regression analyses were then used for filtering prognosis-associated PAGs. Risk score (RS) was computed from these genetic characteristics. Kaplan-Meier analysis and receiver operating characteristic (ROC) curves were applied for ascertaining the prognostic value. Stratified analysis was used to sufficiently validate model performance. Concordance index was used to compare the predictive ability of different models. Immuno-infiltration analysis and immunophenoscore were utilized for the prediction of patient reaction to immune checkpoint inhibitors (ICIs). RESULTS: WT1, ANLN, CUBN, OSGEP, and RHOA were significantly associated with KIRC prognosis. Prognostic analysis indicated that high-RS patients have a significantly poorer outcome. Cox regression analysis demonstrated a potential for RS to be an independent prognostic factor. Pathway enrichment results indicated a lower enrichment of cancer-related biological pathways in the low-RS subgroup. Immune infiltration analysis and IPS demonstrated greater responsiveness to ICIs in the high RS group. CONCLUSIONS: This podocyte-associated KIRC prognostic model can effectively predict KIRC prognosis and immunotherapy response, which may help to provide clinicians with more effective treatment strategies.

Identification of IRF-associated molecular subtypes in clear cell renal cell carcinoma to characterize immunological characteristics and guide therapy.

Background: Recently studies have identified a critical role for interferon regulatory factor (IRF) in modulating tumour immune microenvironment (TME) infiltration and tumorigenesis. Methods: Based on IRF1-9 expression profiles, we classified all ccRCC samples into three molecular subtypes (clusters A-C) and characterized the prognosis and immune infiltration of these clusters. IRFscore constructed by principal component analysis was performed to quantify IRF-related subtypes in individual patients. Results: We proved that IRFscore predicted multiple patient characteristics, with high IRFscore group having poorer prognosis, suppressed TME, increased T-cell exhaustion, increased TMB and greater sensitivity to anti- PD-1/CTLA-4 therapies. Furthermore, analysis of metastatic ccRCC (mccRCC) molecular subtypes and drug sensitivity proved that low IRFscore was more sensitive to targeted therapies. Moreover, IRFscore grouping can be well matched to the immunological and molecular typing of ccRCC. qRT-PCR showed differential expression of IRFs in different cell lines. Conclusions: Evaluating IRF-related molecular subtypes in individual ccRCC patients not only facilitates our understanding of tumour immune infiltration, but also provides more effective clinical ideas for personalised treatment.

Pathological Complete Response Following Neoadjuvant Tislelizumab Monotherapy in Treatment-Naive Locally Advanced, MMR-Deficient/MSI-High Ascending Colon Cancer: A Case Report.

Although recent trials started the use of neoadjuvant immunotherapy (NIT) in instability-high (MSI-H) or mismatch repair deficient (dMMR) early-stage or locally advanced colorectal cancer (LACRC), little data on the treatment strategy of NIT has been shown, and whether the tirelizumab mono-immune checkpoint inhibitor (ICI) can be used as NIT for patients with LACRC has not been reported as yet. In this study we report on a locally advanced ascending colon cancer case with a history of incomplete intestinal obstruction which achieved a pathologic complete response (pCR) after treated with Tirelizumab as NIT. A 32-year-old man was diagnosed with locally advanced ascending colon cancer with MSI-H and dMMR. An incomplete intestinal obstruction accompanied with hyperpyrexia occurred unexpectedly and was eased by symptomatic treatment. There was no peritonitis or other acute complications. NIT (three cycles of Tirelizumab) was suggested by the MDT board and partial response was achieved according to CT scanning, and pCR was further revealed by postoperative pathology. A ctDNA clearance confirmed the R0 resection and some immunotherapy related predictors were also detected using the NGS method. Our case study contributes to the evidence on the feasibility, efficacy, and safety of f Tirelizumab as a mono ICI for an optional neoadjuvant therapy in patients with MSI-H/dMMR LACRC.

Stable CsPbX3/ZnO Heterostructure Nanocrystals for Light-Emitting Application.

Lead halide perovskite nanocrystals (PNCs) are attractive in light-emitting applications with their extraordinary photoluminescent property. However, the inherent instability of mixed Br/I ions poses a major hurdle to the practical application of yellow-red emitting PNCs. In this work, we report the growth of crystalline ZnO on the surface of CsPb(Br/I)3 nanocrystals through a ligand-mediated in situ surface reaction route, which forms monodispersed CsPb(Br/I)3/ZnO heterostructure nanocrystals (PZNCs). The unique heterostructure endows the PZNCs with largely enhanced stability against air, moisture, and polar solvents. Notably, the red-emitting PZNCs exhibit high color quality and superior stability compared with classical CsPb(Br/I)3 PNCs. The PZNCs retain 95% of initial luminescence after 500 h of illumination, and the PZNC-converted red-light LEDs show no obvious change in the peak position and light intensity after continuous operation for 100 h, demonstrating the promising prospect of the materials in light-emitting applications.

Hepatitis D: challenges in the estimation of true prevalence and laboratory diagnosis.

Hepatitis delta virus (HDV) is a defective single negative chain RNA virus, as its envelope protein synthesis is dependent on hepatitis B virus (HBV). Studies have consistently shown that coinfection of HBV and HDV is the most serious form of viral hepatitis, with accelerated progression to liver cirrhosis and hepatocellular carcinoma. About 74 million of HBV surface antigen (HBsAg) positive patients worldwide are also co-infected with HDV. Besides, patients with intravenous drug use and high-risk sexual behavior are at higher risk of HDV infection. Therapeutic schedules for HDV are limited, and relapse of HDV has been observed after treatment with pegylated interferon alpha. To reduce the transmission of HDV, all people infected with HBV should be screened for HDV. At present, several serological and molecular detection methods are widely used in the diagnosis of HDV. However, due to the lack of international standards diagnostic results from different laboratories are often not comparable. Therefore, the true prevalence of HDV is still unclear. In this manuscript, we have analyzed various factors influencing the estimation of HDV prevalence. We have also discussed about the advantages and disadvantages of currently available HDV laboratory diagnostic methods, in order to provide some ideas for improving the detection of HDV.

Association of Serum Neuron-Specific Enolase and C-Reactive Protein With Disease Location and Endoscopic Inflammation Degree in Patients With Crohn's Disease.

Objective: The objective of this study was to explore the association between serum markers neuron-specific enolase (NSE) and C-reactive protein (CRP) with intestinal lesion location and degree of inflammation in patients with Crohn's disease (CD). Design: The levels of serum NSE, CRP, and fecal calprotectin (FC) in patients with CD were analyzed retrospectively. The severity of inflammatory lesions in the intestinal wall was accessed using the Simple Endoscopic Score for Crohn's disease (SES-CD). Results: The levels of NSE in patients with CD were higher than those of healthy individuals (14.87 vs. 12.68 ng/ml, P < 0.001). The levels of CRP in patients with CD were higher than those of healthy individuals (12.30 vs. 3.40 mg/l, P < 0.001). The FC levels in patients with CD were higher than those of patients with non-inflammatory bowel disease (1,143.90 vs. 114.21 µg/g, P < 0.05). The levels of NSE in CD with ileal lesions and simultaneous ileal and colon lesions were significantly higher than those in patients with CD with colonic lesions. However, the CRP was higher in patients with colonic lesions than those with ileal lesions. The levels of NSE in patients with severe inflammation were higher than those in patients with moderate inflammation (15.95 vs. 13.89 ng/ml, P < 0.05). Similarly, the NSE levels in patients with CD with severe inflammation were higher than those in patients with CD with mild inflammation (15.95 vs. 13.53 ng/mL, P < 0.05). The levels of CRP in severe inflammation were higher than those in moderate inflammation (29.80 vs. 19.60 mg/l, P < 0.05). In addition, the CRP levels in severe inflammation were higher than those in mild inflammation (29.80 vs. 5.86 mg/l, P < 0.05). ROC curve analysis showed that when NSE was combined with CRP for distinguishing between patients with CD and those without CD, sensitivity increased to 80.41%, specificity increased to 74.66%, and a highest AUC was equal to 0.843. Conclusion: Our study shows that serum NSE and CRP can be used to assess the severity of CD as well as the location of intestinal involvement. Therefore, NSE and CRP could be used as the non-invasive tests in detecting the location and severity of disease in patients with CD in daily routine practice.

STING and liver disease.

STING (stimulator of interferon genes) also known as transmembrane protein 173 (TMEM173) is a cytoplasmic DNA sensor which can be activated by the upstream cyclic dinucleotides (CDNs). This activation produces cytokines such as interferons and pro-inflammatory factors via the downstream IRF3 and NF-κB pathways, triggering an innate immune response and adaptive immunity to maintain homeostasis. STING is mainly expressed and activated in non-parenchymal cells, thus exerting a corresponding effect to maintain the homeostasis of the liver. In viral hepatitis, interferons and pro-inflammatory factors produced after STING activation initiate the immune response to inhibit virus replication and assembly. In the case of metabolic diseases of the liver, the activation of STING in kupffer cells and hepatic stellate cells leads to inflammation, the proliferation of connective tissue, and metabolic disorders in the hepatocytes, promoting the occurrence and development of the disease. In hepatocellular carcinoma, STING has two contradictory roles. When STING is activated in dendritic cells and macrophages, a large number of cytokines can be produced to initiate innate immune effects directly and to exert adaptive immunity through the recruitment and activation of T cells; however, aberrant activation of the STING pathway leads to a weakening of immune function and promotes oncogenesis and metastasis. Here, we summarize the interactions between STING and liver disease that have currently been identified and how to achieve therapeutic goals by modulating the activity of the STING pathway.

Tristetraprolin, a Potential Safeguard Against Carcinoma: Role in the Tumor Microenvironment.

Tristetraprolin (TTP), a well-known RNA-binding protein, primarily affects the expression of inflammation-related proteins by binding to the targeted AU-rich element in the 3' untranslated region after transcription and subsequently mediates messenger RNA decay. Recent studies have focused on the role of TTP in tumors and their related microenvironments, most of which have referred to TTP as a potential tumor suppressor involved in regulating cell proliferation, apoptosis, and metastasis of various cancers, as well as tumor immunity, inflammation, and metabolism of the microenvironment. Elevated TTP expression levels could aid the diagnosis and treatment of different cancers, improving the prognosis of patients. The aim of this review is to describe the role of TTP as a potential safeguard against carcinoma.