Effect of Si3N4 Additive on Microstructure and Mechanical Properties of Ti(C,N)-Based Cermet Cutting Tools.

Development of high-performance cutting tool materials is one of the critical parameters enhancing the surface finishing of high-speed machined products. Ti(C,N)-based cermets reinforced with and without different contents of silicon nitride were designed and evaluated to satisfy the requirements. In fact, the effect of silicon nitride addition to Ti(C,N)-based cermet remains unclear. The purpose of this study is to investigate the influence of Si3N4 additive on microstructure, mechanical properties, and thermal stability of Ti(C,N)-based cermet cutting tools. In the present work, α-Si3N4 "grade SN-E10" was utilized with various fractions up to 6 wt.% in the designed cermets. A two-step reactive sintering process under vacuum was carried out for the green compact of Ti(C,N)-based cermet samples. The samples with 4 wt.% Si3N4 have an apparent solid density of about 6.75 g/cm3 (relative density of about 98 %); however, the cermet samples with 2 wt.% Si3N4 exhibit a superior fracture toughness of 10.82 MPa.m1/2 and a traverse rupture strength of 1425.8 MPa. With an increase in the contents of Si3N4, the Vickers hardness and fracture toughness of Ti(C,N)-based cermets have an inverse behavior trend. The influence of Si3N4 addition on thermal stability is clarified to better understand the relationship between thermal stability and mechanical properties of Ti(C,N)-based cermets.

Immunotherapy with radiotherapy fails to improve prognosis of patients with stage IV non-small cell lung cancer: a retrospective cohort analysis of the THUNDER-2 study.

Background: Radiotherapy (RT) may enhance the systemic antitumor reaction to immunotherapy (IT). Currently, the effect of RT in stage IV non-small cell lung cancer (NSCLC) patients treated with IT is uncertain. This study aimed to confirm the role of RT in these patients. Methods: We enrolled 120 stage IV NSCLC patients who had been treated with IT and had received external beam radiation therapy (EBRT) or radioactive particle implantation (RPI) at 3 oncology centers in Shandong province between 2019 and 2021. We assessed relevant clinical factors and regular follow-up was conducted via electronic medical records and telephone. The primary endpoint was overall survival (OS). Different combination models in various populations were compared by generating Kaplan-Meier curves and Cox regression analysis. Results: The OS for the overall population was 5 months (range, 0-31 months) and the overall survival rate was 47.5%. Patients receiving IT with RPI had the least favorable prognostic trend (median survival: 2 months) compared to those receiving IT without RT (median survival: 9 months) and IT with EBRT (median survival: 10 months), but this difference was not significant (P=0.148). In subgroup analysis, patients treated with IT with RPI appeared to have a worse prognosis in some specific cohorts, such as males [hazard ratio (HR) =2.433, P=0.031], non-squamous carcinoma histologies (HR =2.680, P=0.034), patients with oligometastases (HR =7.967, P=0.024), patients with liver metastases (HR =10.808, P=0.011) or brain metastases (HR =20.087, P=0.005), and those with Eastern Cooperative Oncology Group (ECOG) performance score ≥2 (HR =2.769, P=0.043). Multivariate Cox analysis of total population revealed that ECOG score and IT stage were the independent prognostic factors. IT combined with EBRT did not have a significant survival benefit in all subgroups. Concurrent IT with RT and first-line and second-line IT combined with RT trended toward improved long-term prognosis. Conclusions: While the robustness of the present conclusions is limited by relatively small sample size and retrospective nature of this research, the addition of EBRT or RPI to IT did not significantly improve patients' OS in stage IV NSCLC. Early combination IT after RT may benefit patients with long-term survival.

Age-Associated Changes in Adverse Events Arising From Anti-PD-(L)1 Therapy.

BACKGROUND: Immune-related adverse events (irAEs) may complicate the immune checkpoint inhibition (ICI) therapy. The effect of age on these irAEs is not elucidated. The aim of the study was to compare the occurrence of irAEs in different age groups. METHODS: Patients with lung cancer receiving anti-programmed death- (ligand)1 (PD-(L)1) were selected from the US Food and Drug Administration Adverse Event Reporting System (FAERS) database. Immune cell infiltration data set was obtained from TIMER 2.0 web server. The patients were stratified for age as follows: <65 year-old (young patients, YP), 65 to 75 year-old (middle aged patients, MP), ≥75 year-old (old patients, OP). The severity of irAEs was compared using logistic binary regression model. The distribution differences of immune cell infiltration were estimated using non-parametric tests. RESULTS: Of all the 17,006 patients treated by anti-PD-(L)1, 7,355 were <65 (YP), 6,706 were 65-75 (MP), and 2,945 were ≥75 (OP). In general, we analyzed a total of 16 irAEs in this article and found that pulmonary toxicity was more frequent in OP (OP vs. YP: OR = 1.45, 95% CI: 1.28-1.64) and MP (MP vs. YP: OR = 1.38, 95% CI: 1.24-1.52), but hepatitis was less frequent in OP (OP vs. YP: OR = 0.56, 95% CI: 0.32-0.97) and MP (MP vs. YP: OR = 0.57, 95%CI: 0.38-0.85). Further analysis demonstrated that older patients showed less B cell, CD8+ T cell and myeloid dendritic cell infiltration than younger patients. CONCLUSIONS: Elderly patients exhibited higher incidences of pulmonary toxicity, while hepatitis was found at low incidence. Therefore, clinicians should carefully monitor comorbidities in elderly patients.

[Study on the comparison of high risk behaviors related to AIDS among different status of income in men who have had sex with men].

OBJECTIVE: To explore the risk sexual behaviors related to AIDS among different status of income among men who have had sex with men and to provide relevant interventions for AIDS control and prevention. METHODS: Study objectives were recruited through target sampling and anonymous questionnaires were adopted. Men's sexual behaviors were reported under the categories as high, mid or low-income. RESULTS: The total number of same-gender partners with high and mid-income was 110.17 with an average of 71.97. Among high and mid-income men, the number of partners for oral sex was 62.45, with an average of 46.6 respectively. The number of partners having anal intercourse was 52.21, with an average of 32.3, obviously more than in the low-income group (P < 0.01). The rates of condom use among high-income and mid-income men were 79.03% and 77.29% respectively and were higher than that those among low-income men (P < 0.01). The percentage of high-income men who recently had had sex with male sex workers was 3.81%, higher than that of the mid-income and the low-income men (P < 0.01). The rates of high-income and mid-income men who had paid for sex from men were 24.27% and 14.7% respectively and were all higher than that of the low-income men with the highest in the high-income group (P < 0.01). The rates of high-income and mid-income men who were male sex workers were 6.72% and 11.05% respectively, which were all lower than that from the low-income group (P < 0.01). CONCLUSION: The characteristics of sexual behaviors related to AIDS were different in the three groups. In high-income group, risk sexual behaviors also existed, suggesting that different interventions for different people should be developed.

[Study on 1389 men who have sex with men regarding their HIV high-risk behaviors and associated factors in mainland China in 2004].

OBJECTIVE: To study the HIV related high-risk behaviors and associated factors on the spread of HIV among men having sex with men(MSM) who lived in mainland China and to provide evidence for developing related policies and intervention measures. METHODS: Questionnaires were distributed at gay bars and volunteer activity venues in six big cities of China. Data on 1389 valid cases was collected and urine HIV screening test was provided. Data was analyzed with SPSS 11.0. RESULTS: The respondents were 27.62 year olds on average with an average age for first intercourse at 19.18. The most commonly available way of finding a sex partner was through internet(43.07%), followed by gay bar and public bathrooms(35.29 % ). 6 months prior to the study, the average number of their male sex partners was 5.69 including 4.37 unfamiliar sex partners and the average number of anal-intercourse was 4.33 with 11.61 per cent of them had experienced group sex. 13 cases of them showed positive results for preliminary urine HIV screening test. In the prior 6 months, 32.46 per cent of those who had experienced intercourse using condom every time while 76.37 per cent of them during the last sex episode. In the previous 6 months, 47.18 per cent of those who had experienced intercourse with women never used condoms. CONCLUSION: HIV high-risk behaviors are ubiquitous among MSM and AIDS intervention measures should be significantly strengthened in reaching MSM via a wide variety of conduits, especially internet. Meanwhile, a gay-friendly environment for prevention and control of AIDS is vital.