Survival benefit of younger gastric cancer patients in China and the United States:A comparative study

BACKGROUND The impact of racial and regional disparity on younger patients with gastric cancer(GC) remains unclear.AIM To investigate the clinicopathological characteristics, prognostic nomogram, and biological analysis of younger GC patients in China and the United States.METHODS From 2000 to 2018, GC patients aged less than 40 years were enrolled from the China National Cancer Center and the Surveillance Epidemiology and End Results database. Biological analysis was performed based on the Gene Expression Omnibus database. Survival analysis was conducted via Kaplan-Meier estimates and Cox proportional hazards models.RESULTS A total of 6098 younger GC patients were selected from 2000 to 2018, of which 1159 were enrolled in the China National Cancer Center, and 4939 were collected from the Surveillance Epidemiology and End Results database. Compared with the United States group, younger patients in China revealed better survival outcomes(P < 0.01). For race/ethnicity, younger Chinese cases also enjoyed a better prognosis than that in White and Black datasets(P < 0.01). After stratification by pathological Tumor-Node-Metastasis(pTNM) stage, a survival advantage was observed in China with pathological stage Ⅰ, Ⅲ, and Ⅳ(all P < 0.01), whereas younger GC patients with stage Ⅱ showed no difference(P = 0.16). In multivariate analysis, predictors in China involved period of diagnosis, linitis plastica, and pTNM stage, while race, diagnostic period, sex, location, differentiation, linitis plastica, signet ring cell, pTNM stage, surgery, and chemotherapy were confirmed in the United States group. Prognostic nomograms for younger patients were established, with the area under the curve of 0.786 in the China group and of 0.842 in the United States group. Moreover, three gene expression profiles(GSE27342, GSE51105, and GSE38749) were enrolled in further biological analysis, and distinctive molecular characteristics were identified in younger GC patients among different regions.CONCLUSION Except for younger cases with pTNM stage Ⅱ, a survival advantage was observed in the China group with pathological stage Ⅰ, Ⅲ, and Ⅳ compared to the United States group, which might be partly due to differences in surgical approaches and the improvement of the cancer screening in China. The nomogram model provided an insightful and applicable tool to evaluate the prognosis of younger patients in China and the United States. Furthermore, biological analysis of younger patients was performed among different regions, which might partly explain the histopathological behavior and survival disparity in the subpopulations.

Artificial intelligence in gastric cancer: Application and future perspectives

Gastric cancer is the fourth leading cause of cancer-related mortality across the globe,with a 5-year survival rate of less than 40%.In recent years,several applications of artificial intelligence(AI)have emerged in the gastric cancer field based on its efficient computational power and learning capacities,such as imagebased diagnosis and prognosis prediction.AI-assisted diagnosis includes pathology,endoscopy,and computerized tomography,while researchers in the prognosis circle focus on recurrence,metastasis,and survival prediction.In this review,a comprehensive literature search was performed on articles published up to April 2020 from the databases of PubMed,Embase,Web of Science,and the Cochrane Library.Thereby the current status of AI-applications was systematically summarized in gastric cancer.Moreover,future directions that target this field were also analyzed to overcome the risk of overfitting AI models and enhance their accuracy as well as the applicability in clinical practice.

Lifestyle factors and long-term survival of gastric cancer patients:A large bidirectional cohort study from China

BACKGROUND Lifestyle factors such as body mass index(BMI),alcohol drinking,and cigarette smoking,are likely to impact the prognosis of gastric cancer,but the evidence has been inconsistent.AIM To investigate the association of lifestyle factors and long-term prognosis of gastric cancer patients in the China National Cancer Center.METHODS Patients with gastric cancer were identified from the China National Cancer Center Gastric Cancer Database 1998-2018.Survival analysis was performed via Kaplan-Meier estimates and Cox proportional hazards models.RESULTS In this study,we reviewed 18441 cases of gastric cancer.Individuals who were overweight or obese were associated with a positive smoking and drinking history(P=0.002 and P<0.001,respectively).Current smokers were more likely to be current alcohol drinkers(61.3%vs 10.1%vs 43.2%for current,never,and former smokers,respectively,P<0.001).Multivariable results indicated that BMI at diagnosis had no significant effect on prognosis.In gastrectomy patients,factors independently associated with poor survival included older age(HR=1.20,95%CI:1.05-1.38,P=0.001),any weight loss(P<0.001),smoking history of more than 30 years(HR=1.14,95%CI:1.04-1.24,P=0.004),and increasing pTNM stage(P<0.001).CONCLUSION In conclusion,our results contribute to a better understanding of lifestyle factors on the overall burden of gastric cancer and long-term prognosis.In these patients,weight loss(both in the 0 to 10%and>10%groups)but not BMI at diagnosis was related to survival outcomes.With regard to other factors,smoking history of more than 30 years conferred a worse prognosis only in patients who underwent gastrectomy.Extensive efforts are needed to elucidate mechanisms targeting the complex effects of lifestyle factors.

Left univentricular pacing for cardiac resynchronization therapy using rate-adaptive atrioventricular delay

Objective To evaluate left univentricular （LUV） pacing for cardiac resynchronization therapy （CRT） using a rate-adaptive atrioven- tricular delay （RAAVD） algorithm to track physiological atrioventricular delay （AVD）. Methods A total of 72 patients with congestive heart failure （CHF） were randomized to RAAVD LUV pacing versus standard biventricular （BiV） pacing in a 1 ： 1 ratio. Echocardiography was used to optimize AVD for both groups. The effects of sequential BiV pacing and LUV pacing with optimized A-V （right atrio-LV） delay using an RAAVD algorithm were compared. The standard deviation （SD） of the S/R ratio in lead VI at five heart rate （HR） segments （Rs/R-SD5）, defined as the ＂tracking index,＂ was used to evaluate the accuracy of the RAAVD algorithm for tracking physiological AVD. Results TheQRS complex duration （132 ± 9.8 vs. 138± 10ms, P 〈 0.05）, the time required for optimization （21 ±5 vs. 50±8min, P〈 0.001）, the mitral regurgitant area （1.9 ± 1.1 vs. 2.5 ± 1.3 em2, P 〈 0.05）, the interventricular mechanical delay time （60.7 ± 13.3 ms vs. 68.3 ± 14.2 ms, P 〈 0.05）, and the average annual cost （13,200 ± 1000 vs. 21,600 ± 2000 RMB, P 〈 0.001） in the RAAVD LUV pacing group were significantly less than those in the standard BiV pacing group. The aortic valve velocity-time integral in the RAAVD LUV pacing group was greater than that in the standard BiV pacing group （22.7 ± 2.2 vs. 21.4 ± 2.1 cm, P 〈 0.05）. The Rs/R-SD5 was 4.08 ± 1.91 in the RAAVD LUV pacing group, and was significantly negatively correlated with improved left ventricular ejection fraction （LVEF） （ALVEF, Pearson＇s r = -0.427, P = 0.009）, and positively correlated with New York Heart Association class （Spearman＇s r - 0.348, P 0.037）. Conclusions RAAVD LUV pacing is as effective as standard BiV pacing, can be more physiological than standard BiV pacing, and can de- crease the average annual cost of CRT.

Effect of microstructure on short pulse duration shock initiation of TATB and initial response mechanism

Micro-TATB particles with different sizes and 3D nanoporous TATB architectures with different specific surface areas were prepared through recrystallization to study short pulse duration shock initiation properties by electric gun technology.For micro-TATB,the initiation threshold significantly decreases with TATB average size ranging from 79.7μm to 0.5μm.For 3D nanoporous TATB architecture,the initiation threshold decreases and then increases with specific surface areas increased from 9.6 m^2/g to36.2 m^2/g.The lowest initiation thresholds are obtained for the micro-TATB with average sizes of 1.3μm and 0.5μm,and 3D nanoporous TATB architecture with specific surface area of 22.4 m^2/g.The shock initiation thresholds of micro-TATB and 3D nanoporous TATB architectures show significantly decreases with the porosity increased.The decomposition reaction and thermal conductivity properties were further investigated to understand the initial response mechanism.High porosity provides more collapse sites to generate high temperature for formation of hot spots.The low thermal conductivity and decomposition temperature could enhance the formation and ignition of the hot spots,and initial decomposition reaction of TATB.The effect of the decomposition temperature is higher than that of the thermal conductivity on the shock initiation properties.The enhanced decomposition reaction could pro mote energy release and transfer process from the ignition to the combustio n.This work offe rs a new insight to understand the effects of microstructure on the shock initiation properties and the initial response mechanism of TATB.

Well-dispersed Sb particles embedded on N-doped carbon nanofibers toward high-performance Li-ion battery

The alloy-type material Sb is widely used in the anode materials of lithium-ion batteries(LIBs)due to its high theoretical specific capacity.However,its serious volume expansion problem during alloying/dealloying of Li~+limits its practical application.In this work,C-Sb composite was constructed as anode material of LIBs by electrospinning route for the first time,Sb was introduced into the polyacrylonitrile-based hard carbon and coal tar pitch-based soft carbon composite amorphous carbon fiber with a diameter of 300-600 nm,which realized high cycling stability.The C-Sb-2(the mass ratio of polyacrylonitrile to Sb source is 1:2)electrode displayed charge capacities of 1098.5,930.3,841.7,753.5,643.9 and 545.8 mAh·g^(-1)at 0.1,0.2,0.3,0.5,1 and 2 A·g^(-1),respectively.And when the current density returned to 0.1 A·g^(-1),the charge capacity was 939.3 mAh·g^(-1),revealing good stability and reversibility.The introduction of Sb into the amorphous carbon improved its conductivity and addressed the volume expansion issue of high specific capacity Sb during charge/discharge.Ex-situ XRD analysis confirmed the high reversibility of the C-Sb-2 during charging and discharging.Density functional theory(DFT)calculations revealed the gradual enhancement of the interface interaction between Sb_(x)Li_(y) and amorphous carbon(AMC)with increasing lithium content,contributing to the anchoring of alloy nanoparticles on the AMC surface and buffering the volume change of the alloy.Moreover,the gradual lithiation of Sb facilitated the electron transfer from Sb_(x)Li_(y) to AMC.These findings hold promise for designing lithium storage materials with exceptional performance,highlighting the potential of C-Sb composites as anode materials for efficient next-generation lithium storage.

Optimization of a robust collaborative-relay beamforming design for simultaneous wireless information and power transfer

We investigate a collaborative-relay beamforming design for simultaneous wireless information and power transfer. A non-robust beamforming design that assumes availability of perfect channel state information(CSI) in the relay nodes is addressed. In practical scenarios, CSI errors are usually inevitable; therefore, a robust collaborativerelay beamforming design is proposed. By applying the bisection method and the semidefinite relaxation(SDR)technique, the non-convex optimization problems of both non-robust and robust beamforming designs can be solved.Moreover, the solution returned by the SDR technique may not always be rank-one; thus, an iterative sub-gradient method is presented to acquire the rank-one solution. Simulation results show that under an imperfect CSI case, the proposed robust beamforming design can obtain a better performance than the non-robust one.