CT-based radiomics model to predict spread through air space in resectable lung cancer.

BACKGROUND: Spread through air space (STAS) has been identified as a pathological pattern associated with lung cancer progression. Patients with STAS were related to a worse prognosis compared with patients without STAS. The objective of this study was to establish a radiomics model capable of forecasting STAS before surgery, which can assist surgeons in selecting the most appropriate operation type for patients with STAS. METHOD: There were 537 eligible patients retrospectively included in this study. ROI segmentation was performed manually on all CT images to identify the region of interest. From each segmented lesion, a total of 1688 features were extracted. The tumor size, maximum tumor diameters, and tumor type were also recorded. Using Spearman's correlation coefficient to calculate the correlation and redundancy of elements, and redundant features less than 0.80 were removed. In order to reduce the level of overfitting and avoid statistical biases, a dimension reduction process of the dataset was conducted to decrease the number of features. Finally, a radiomics model included 44 features was established to predict STAS. To evaluate the performance of the model, the receiver operating characteristic (ROC) curve was used, and the area under the curve (AUC) was calculated, and the accuracy of the model was verified by 10-fold cross-validation. RESULTS: The incidence of STAS was 38.2% (205/537). The tumor type, maximum tumor diameters, and consolidation tumor ratio were significantly different between STAS group and non-STAS group. The training group included 430 patients, while the test group was consisted with 107. The training group achieved an AUC of 0.825 (sensitivity, 0.875; specificity, 0.621; and accuracy, 0.749) and the test group had an AUC of 0.802 (sensitivity, 0.797; specificity,0.688; and accuracy, 0.748). The 10-fold cross-validation had an AUC of 0.834. CONCLUSION: CT-based radiomic model can predict STAS effectively, which is of great importance to guide the selection of operation types before surgery.

Different Language Modalities Yet Similar Cognitive Processes in Arithmetic Fact Retrieval.

Does experience with signed language impact the neurocognitive processes recruited by adults solving arithmetic problems? We used event-related potentials (ERPs) to identify the components that are modulated by operation type and problem size in Deaf American Sign Language (ASL) native signers and in hearing English-speaking participants. Participants were presented with single-digit subtraction and multiplication problems in a delayed verification task. Problem size was manipulated in small and large problems with an additional extra-large subtraction condition to equate the overall magnitude of large multiplication problems. Results show comparable behavioral results and similar ERP dissociations across groups. First, an early operation type effect is observed around 200 ms post-problem onset, suggesting that both groups have a similar attentional differentiation for processing subtraction and multiplication problems. Second, for the posterior-occipital component between 240 ms and 300 ms, subtraction problems show a similar modulation with problem size in both groups, suggesting that only subtraction problems recruit quantity-related processes. Control analyses exclude possible perceptual and cross-operation magnitude-related effects. These results are the first evidence that the two operation types rely on distinct cognitive processes within the ASL native signing population and that they are equivalent to those observed in the English-speaking population.

Meta-analysis of Lobectomy and Sublobar Resection for Stage I Non-small Cell Lung Cancer With Spread Through Air Spaces.

Surgery is the preferred treatment for early-stage non-small cell lung cancer (NSCLC). Numerous studies have shown that spread through air spaces (STAS) can predict the survival of patients with stage I NSCLC. However, for stage I NSCLC, it is not known whether sublobar resection or lobectomy should be performed if STAS is present. In the present study, we compared the survival outcomes of patients with STAS who underwent lobectomy versus those who underwent sublobar resection. A search was performed on the PubMed, Cochrane Library and EMBASE on March 6, 2021 to identify relevant studies. Predetermined criteria were utilized to screen studies. A meta-analysis was performed using hazard ratio (HR). In total, 13 studies involving 5947 patients were included in the meta-analysis. It was found that STAS was significantly correlated with worse RFS (HR = 2.58, 95% CI: 2.16-3.07) and OS (HR = 2.41, 95% CI: 1.97-2.95) in patients with stage I NSCLC. Lobectomy resulted in a longer RFS (HR = 2.59, 95% CI: 1.99-3.37) and OS (HR = 2.78, 95% CI: 1.92-4.02) than sublobar resection in stage I NSCLC patients with STAS. STAS is an independent prognostic factor in NSCLC. Lobectomy may be more effective for stage I NSCLC patients who underwent sublobar resection previously if STAS is present.

The Relationship between Working Memory and Arithmetic in Primary School Children: A Meta-Analysis.

Working memory (WM) plays a crucial role in the development of arithmetic ability. However, research findings related to which factors influence the relationship between WM and arithmetic skills are inconsistent. The present meta-analysis aimed to examine the links between WM and arithmetic in primary school children and investigate whether this is dependent on WM domains (i.e., verbal, visual, spatial), child age, arithmetic operation type, and arithmetic task type. A total of 11,224 participants with an age range of 6- to 12 years, from 55 independent samples were included in the meta-analysis. Analysis of 46 studies with 187 effect sizes revealed an overall significant and medium correlation between WM and arithmetic. Heterogeneity analyses indicated that verbal WM showed a stronger correlation with arithmetic than visuospatial WM, and that correlations between verbal WM and arithmetic declined with age, whereas correlations between spatial-sequential, and spatial-simultaneous WM and arithmetic remained stable throughout development. Addition and subtraction were more involved in verbal WM than multiplication and division. Moreover, mental and written arithmetic showed comparable correlations with WM in all domains. These findings suggest moderation effects of WM domains, age, and operation types in the WM-arithmetic relationship and highlight the significant role of verbal WM in arithmetic ability in primary school children.

Risk Factors That Influence Surgical Decision-Making for Patients with Low-Risk Differentiated Thyroid Cancer with Tumor Diameters of 1-4 cm.

BACKGROUND: There are several controversies between thyroid lobectomy and total thyroidectomy for surgical management of low-risk differentiated thyroid cancer (DTC) with a tumor diameter of 1-4 cm. PATIENTS AND METHODS: In this study, we explore the factors related to selection of type of surgical procedure for 103 low-risk DTC patients with a tumor diameter of 1-4 cm. RESULTS: Among 103 low-risk DTC patients with tumor diameters of 1-4 cm, 43 patients underwent total thyroidectomy and 60 patients underwent thyroid lobectomy based on postoperative pathology. A ROC curve showed that the optimal diagnostic threshold for selecting surgical modality was a tumor diameter of 2.15 cm. For these low-risk DTC patients, the sensitivity and specificity for predicting thyroid lobectomy when tumor diameter <2.15 cm while total thyroidectomy when tumor diameter ≥2.15 cm are 46.5% and 78.3%, respectively. There were significant differences between the selection of type of surgical procedure in patient groups with 1) tumors with multiple foci group vs a single focus (P<0.05), and 2) tumor diameter of ≥2.15 cm vs <2.15 cm (P<0.05). There was no significant difference between gender and age groups (P>0.05). Multivariate analysis confirmed that tumors with multiple foci and diameter ≥2.15 cm were the primary risk factors for implementation of total thyroidectomy (P<0.05). CONCLUSION: The diameter and multifocal nature of low-risk DTC tumors are the primary factors related to preferred surgical modality. This study revealed that thyroid lobectomy is more applicable to patients with tumor diameter <2.15 cm and a single focus, whereas, total thyroidectomy was preferred in patients with tumor diameter ≥2.15 cm and/or multiple foci.

Antimicrobial use in 33 township central hospitals / 中国感染控制杂志

Objective To investigate antimicrobial use in 33 township central hospitals,and improve the rational use of antimicrobial agents. Methods Thirty-three township central hospitals in 1 1 counties were randomly select-ed,7 920 outpatient prescriptions,medical records of 465 non-surgery patients and 213 surgery patients were inves-tigated and analyzed. Results Of 33 hospitals,antimicrobial usage rate in outpatients and inpatients was 56.60%and 89.68% respectively,combined antimicrobial usage rate was 24.16% and 43.58% respectively. Antimicrobial use density in inpatients was 147.25DDDs. Antimicrobial usage rate in surgery patients was 97.18% ,combined an-timicrobial usage rate was 59.90% ,the percentage of one drug,two-drug combination and three-drug combination was 40.10% ,47.82% ,and 12.08% respectively. The percentage of antimicrobial use in patients of type Ⅰ,Ⅱ, and Ⅲincision was 97.56% (40/41),96.93% (158/163)and 100.00% (9/9)respectively,combined antimicrobial us-age rate was 30.00% ,67.72% ,and 44.44% respectively.Conclusion The overuse of antimicrobial agents exists in 33 township central hospitals,antimicrobial usage rate,combined usage rate,antimicrobial use density and antimi-crobial prophylaxis in typeⅠincision operations are all high.

Prognostic factors in the Surgical Treatment of Hilar Cholangiocarcinoma / 한국간담췌외과학회지

BACKGROUND: Although much progress has been made in the management of hilar cholangiocarcinoma, long-term survival for most patients remains poor. The reasons of poor prognosis are due to mainly the difficulty of curative resection of the tumor, frequent postoperative recurrence and also the concomitant cholangitis, hyperbilirubinemia and impaired hepatic function resulted from progressive bile duct obstruction. In spite of many obstacles to surgical treatment for hilar cholangiocarcinoma, recent reports support that the surgical resection is the only promising way of treatment for better long-term survival. But there are still many problems and risks of high morbidity and mortality associated with the operation. AIMS: The appropriate selection of the patient for operation and the operation method by careful evaluation of the clinical status of the patient and the disease is very important for both improving the long-term survival and decreasing the postoperative complication. METHODS: This study was investigated to evaluate the prognostic factors in the surgical treatment of hilar cholagiocarcinoma which influence the postoperative morbidity and survival rate. RESULTS: 1) The postoperative complications were developed in 4 cases(11%) and 1 case of them was dead due to acute respiratory distress syndrome. The postoperative recurrence was observed in 6 cases(25%) and the recurred sites were local recurrences in 5 cases and bone metastasis in 1 case. Ten patients(41.7%) were dead and the causes of deaths were recurrence in 5 cases. Postoperative mean survival time was 16.46 months and 3, 7, 12 month cumulative survival rates were 84%, 67%, 51% respectively. 2) The clinicopathological factors including clinical findings, laboratory results and microscopic findings were not related significantly to the postoperative prognosis. 3) The mean survival time was 5.54 months in bile duct resection group and 26.2 months in bile duct resection with hepatic resection group. Ten month cumulative survival rate was 40% in bile duct resection group and 92.8% in bile duct resection with hepatc resection group, which means that the extent of resection is significantly related to survival rate(p=0.012). CONCLUSION: Clinicopathological factors were not associated with the postoperative prognosis and the difference of operation type(extent of resection) was significantly related to the postoperative survival rate in the surgical treatment of hilar cholangiocarcinoma. The result suggests that more wide surgical resection including hepatic resection increases the possibility of curative resection and improve the long-term survival of the patient.

Biological behavior of gastric cancer as a guide for choosing type of operation / 中国癌症杂志

0.05;AGC R 1 to R 2 P 0.05.The invasive depth of the lesion corresponded to the degree of lymph node metastases.No relation was found between tumor size and the survival rate.The prognosis of type Ⅲ EGC and AGC with infiltration was poor.Conclusions: Biological behavior of gastric cancer can be used as a guide to operation type.We proposed that EGC should undergo subtotal gastrectomy plus R 1 or selective R 2 ,and AGC should undergo subtotal gastrectomy or near total gastrectomy plus R 2 or selective R 3 ,with a margin of at least 5 cm from the tumor.

A Quality of Worklife : A Study of the Perceptions of University Foodservice Employees

The purposes of this research were to assess the quality of worklife of university foodservice managers and workers by operation type, and to investigate the characteristics of demographic variables in university foodservice employees. A questionnaire was administered to 27 managers and 180 personnels who are working in 9 university foodservice facilities. And 21 managers and 160 workers were responded with a response rate of 78% and 89%, respectively. Statistical data analysis was completed using the SPSS programs for descriptive analysis, ANOVA, T-test and SNK test. The results of this study can be summarized as follows : 1. Almost all respondents were female(87%), 40.5 percent of the respondents were between 40 to 49 years of age, 42.9 percent of the respondents had been in their current job between 2 to 5 years, and 55.2 percent of the respondents eamed pays between 500,000won to 800,000won per month, Only 42.6% percent of the respondents were full-time employee. 2. The mean scores for the quality of worklife was 3.07 on a 5-point scales of 1=disagree very much and 5 = agree very much. 3. Factors receiving the higher ratings included "optimum levels of work variety"(3.83), "positive attitude toward work"(4.14), and "cooperative relationship with coworkers"(4.22). But respondents were least satisfied with "promotion"(2.07), "temperature of workplace"(2.17) "rest time"(2.25), and "pay"(2.28) factors. 4. There was a significant difference in the perception of the quality of worklife according to the operation type(self-operated, contracted, and rented management), but no difference was noted by position(managers vs workers) Results can be user to develop intervention and training strategies for enhancing positive attitude and the quality of work of employees.