Late effects of the treatment of childhood cancer

Excellent progress has been made in the last few decades in the cure rates of pediatric malignancies,with more than 80%of children with cancer who have access to contemporary treatment being cured.However,the therapies responsible for this survival can also produce adverse physical and psychological long-term outcomes,referred to as late effects,which appear months to years after the completion of cancer treatment.Research has shown that 60%to 90%of childhood cancer survivors(CCSs)develop one or more chronic health conditions,and 20%to 80%of survivors experience severe or life-threatening complications during adulthood.Therefore,understanding the late side effects of such treatments is important to improve the health and quality of life of the growing population of CCSs.

Novel Methodologies for Preventing Crack Propagation in Steel Gas Pipelines Considering the Temperature Effect

Using the software ANSYS-19.2/Explicit Dynamics,this study performedfinite-element modeling of the large-diameter steel pipeline cross-section for the Beineu-Bozoy-Shymkent gas pipeline with a non-through straight crack,strengthened by steel wire wrapping.The effects of the thread tensile force of the steel winding in the form of single rings at the crack edges and the wires with different winding diameters and pitches were also studied.The results showed that the strengthening was preferably executed at a minimum value of the thread tensile force,which was 6.4%more effective than that at its maximum value.The analysis of the influence of the winding dia-meters showed that the equivalent stresses increased by 32%from the beginning of the crack growth until the wire broke.The increment in winding diameter decelerated the disclosure of the edge crack and reduced its length by 8.2%.The analysis of the influence of the winding pitch showed that decreasing the distance between the winding turns also led to a 33.6%reduction in the length of the straight crack and a 7.9%reduction in the maximum stres-ses on the strengthened pipeline cross-section.The analysis of the temperature effect on the pipeline material,within a range from-40℃ to+50℃,resulted in a crack length change of up to 5.8%.As the temperature dropped,the crack length decreased.Within such a temperature range,the maximum stresses were observed along the cen-tral area of the crack,which were equal to 413 MPa at+50℃ and 440 MPa at-40℃.The results also showed that the presence of the steel winding in the pipeline significantly reduced the length of crack propagation up to 8.4 times,depending on the temperature effect and design parameters of prestressing.This work integrated the existing methods for crack localization along steel gas pipelines.

Pathogenesis, diagnosis, and treatment of epilepsy: electromagnetic stimulation-mediated neuromodulation therapy and new technologies

Epilepsy is a severe,relapsing,and multifactorial neurological disorder.Studies regarding the accurate diagnosis,prognosis,and in-depth pathogenesis are crucial for the precise and effective treatment of epilepsy.The pathogenesis of epilepsy is complex and involves alterations in variables such as gene expression,protein expression,ion channel activity,energy metabolites,and gut microbiota composition.Satisfactory results are lacking for conventional treatments for epilepsy.Surgical resection of lesions,drug therapy,and non-drug interventions are mainly used in clinical practice to treat pain associated with epilepsy.Non-pharmacological treatments,such as a ketogenic diet,gene therapy for nerve regeneration,and neural regulation,are currently areas of research focus.This review provides a comprehensive overview of the pathogenesis,diagnostic methods,and treatments of epilepsy.It also elaborates on the theoretical basis,treatment modes,and effects of invasive nerve stimulation in neurotherapy,including percutaneous vagus nerve stimulation,deep brain electrical stimulation,repetitive nerve electrical stimulation,in addition to non-invasive transcranial magnetic stimulation and transcranial direct current stimulation.Numerous studies have shown that electromagnetic stimulation-mediated neuromodulation therapy can markedly improve neurological function and reduce the frequency of epileptic seizures.Additionally,many new technologies for the diagnosis and treatment of epilepsy are being explored.However,current research is mainly focused on analyzing patients’clinical manifestations and exploring relevant diagnostic and treatment methods to study the pathogenesis at a molecular level,which has led to a lack of consensus regarding the mechanisms related to the disease.

Controversies around the treatment of peritoneal metastases of colorectal cancer

In this editorial we examine the article by Wu et al published in the World Journal of Gastrointestinal Oncology.Surgical resection for peritoneal metastases from colorectal cancer(CRC)has been gradually accepted in the medical oncology community.A randomized trial(PRODIGE 7)on cytoreductive surgery(CRS)with hyperthermic intraperitoneal chemotherapy(HIPEC)failed to prove any benefit of oxaliplatin in the overall survival of patients with peritoneal metastases from colorectal origin.Nevertheless,isolated systemic chemotherapy for CRC stage IV has demonstrated a reduced response in peritoneal metastases than that obtained in other metastatic sites such as the liver.Another tool is required in those patients to achieve more local control of the disease.Surgical groups in peritoneal surgery continue to use HIPEC in their procedures,using other agents than oxaliplatin for peritoneal cavity infusion,such as mitomycin C.These patients present with complex surgical issues to manage,and consequently a large burden of complications has to be anticipated.Therefore,identifying patients who will benefit from CRS with or without HIPEC would be of great interest.

Advancing treatment strategies:Insights from network meta-analysis of hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma

This study examines the pivotal findings of the network meta-analysis of Zhou et al,which evaluated the efficacy of hepatic arterial infusion chemotherapy and combination therapies for advanced hepatocellular carcinoma(HCC).This meta-analysis suggests that therapeutic combinations have greater efficacy than do standard treatments.The article highlights the key insights that have the potential to shift current clinical practice and enhance outcomes for patients with advanced HCC.Additionally,this article discusses further research that can be conducted to optimize these treatments and achieve personalized care for patients with HCC.

Efficacy,safety and treatment satisfaction of transition to a regimen of insulin degludec/aspart:A pilot study

BACKGROUND There is a lack of clinical evidence on the efficacy and safety of transitioning from a thrice-daily pre-mixed insulin or basal-prandial regimen to insulin degludec/aspart(IDegAsp)therapy,with insufficient data from the Chinese population.AIM To demonstrate the efficacy,safety,and treatment satisfaction associated with the transition to IDegAsp in type 2 diabetes mellitus(T2DM).METHODS In this 12-week open-label,non-randomized,single-center,pilot study,patients with T2DM receiving thrice-daily insulin or intensive insulin treatment were transitioned to twice-daily injections of insulin IDegAsp.Insulin doses,hemoglobin A1c(HbA1c)levels,fasting blood glucose(FBG),hypoglycemic events,a Diabetes Treatment Satisfaction Questionnaire,and other parameters were assessed at baseline and 12-weeks.RESULTS This study included 21 participants.A marked enhancement was observed in the FBG level(P=0.02),daily total insulin dose(P=0.03),and overall diabetes treatment satisfaction(P<0.01)in the participants who switched to IDegAsp.There was a decrease in HbA1c levels(7.6±1.1 vs 7.4±0.9,P=0.31)and the frequency of hypoglycemic events of those who switched to IDegAsp decreased,however,there was no statistically significant difference.CONCLUSION The present findings suggest that treatment with IDegAsp enhances clinical outcomes,particularly FBG levels,daily cumulative insulin dose,and overall satisfaction with diabetes treatment.

The emerging role of mesenchymal stem cell-derived extracellular vesicles to ameliorate hippocampal NLRP3 inflammation induced by binge-like ethanol treatment in adolescence

Our previous studies have reported that activation of the NLRP3(NOD-,LRR-and pyrin domain-containing protein 3)-inflammasome complex in ethanol-treated astrocytes and chronic alcohol-fed mice could be associated with neuroinflammation and brain damage.Mesenchymal stem cell-derived extracellular vesicles(MSC-EVs)have been shown to restore the neuroinflammatory response,along with myelin and synaptic structural alterations in the prefrontal cortex,and alleviate cognitive and memory dysfunctions induced by binge-like ethanol treatment in adolescent mice.Considering the therapeutic role of the molecules contained in mesenchymal stem cell-derived extracellular vesicles,the present study analyzed whether the administration of mesenchymal stem cell-derived extracellular vesicles isolated from adipose tissue,which inhibited the activation of the NLRP3 inflammasome,was capable of reducing hippocampal neuroinflammation in adolescent mice treated with binge drinking.We demonstrated that the administration of mesenchymal stem cell-derived extracellular vesicles ameliorated the activation of the hippocampal NLRP3 inflammasome complex and other NLRs inflammasomes(e.g.,pyrin domain-containing 1,caspase recruitment domain-containing 4,and absent in melanoma 2,as well as the alterations in inflammatory genes(interleukin-1β,interleukin-18,inducible nitric oxide synthase,nuclear factor-kappa B,monocyte chemoattractant protein-1,and C–X3–C motif chemokine ligand 1)and miRNAs(miR-21a-5p,miR-146a-5p,and miR-141-5p)induced by binge-like ethanol treatment in adolescent mice.Bioinformatic analysis further revealed the involvement of miR-21a-5p and miR-146a-5p with inflammatory target genes and NOD-like receptor signaling pathways.Taken together,these findings provide novel evidence of the therapeutic potential of MSC-derived EVs to ameliorate the hippocampal neuroinflammatory response associated with NLRP3 inflammasome activation induced by binge drinking in adolescence.

Variations in quantifying patient reported outcome measures to estimate treatment effect

In the practice of healthcare,patient-reported outcomes(PROs)and PRO measures(PROMs)are used as an attempt to observe the changes in complex clinical situations.They guide us in making decisions based on the evidence regarding patient care by recording the change in outcomes for a particular treatment to a given condition and finally to understand whether a patient will benefit from a particular treatment and to quantify the treatment effect.For any PROM to be usable in health care,we need it to be reliable,encapsulating the points of interest with the potential to detect any real change.Using structured outcome measures routinely in clinical practice helps the physician to understand the functional limitation of a patient that would otherwise not be clear in an office interview,and this allows the physician and patient to have a meaningful conver-sation as well as a customized plan for each patient.Having mentioned the rationale and the benefits of PROMs,understanding the quantification process is crucial before embarking on management decisions.A better interpretation of change needs to identify the treatment effect based on clinical relevance for a given condition.There are a multiple set of measurement indices to serve this effect and most of them are used interchangeably without clear demarcation on their differences.This article details the various quantification metrics used to evaluate the treatment effect using PROMs,their limitations and the scope of usage and implementation in clinical practice.

Effect of heat treatment on stress corrosion cracking, fracture toughness and strength of 7085 aluminum alloy

The influences of heat treatment on stress corrosion cracking （SCC）, fracture toughness and strength of 7085 aluminum alloy were investigated by slow strain rate testing, Kahn tear testing combined with scanning electron microscopy （SEM） and transmission electron microscopy （TEM）. The results show that the fracture toughness of T74 overaging is increased by 22.9% at the expense of 13.6% strength, and retrogression and reaging （RRA） enhances fracture toughness 14.2% without reducing the strength compared with T6 temper. The fracture toughness of dual-retrogression and reaging （DRRA） is equivalent to that of T74 with an increased strength of 14.6%. The SCC resistance increases in the order： T6〈RRA〈DRRA≈T74. The differences of fracture toughness and SCC were explained on the basis of the role of matrix precipitates and grain boundary orecioitates.

Effect of T7951 secondary aging treatment on crack propagation behavior of 7055 aluminum alloy

The crack propagation rates of T6 peak aging and T7951 secondary aging 7055 aluminium alloys were tested under stress ratios (R) of 0.6, 0.05 and ?1, respectively. The microstructures and fracture surfaces were analyzed by TEM and SEM. The results reveal that the crack propagation rate is affected by the stress ratio and microstructure such as the distribution, dimension and volume fraction of matrix precipitates, grain boundary precipitates and precipitate free zone. For both heat-treated specimens, crack propagation rate increases with the improvement of R when it is a positive value while crack propagation rate at R=?1 is much similar to that at R=0.06. The crack growth rates exhibit no obvious difference in lower stress intensity factor range (ΔK), while the difference starts to be obvious when ΔK exceeds certain value. The fracture analysis testifies a better fracture toughness for 7055-T7951 with a smaller striation space in Paris region.

Effects of Aging Treatment on Intergranular Corrosion and Stress Corrosion Cracking Behavior of AA7003

In order to study the effects of aging treatment on the intergranular corrosion（IGC） and stress corrosion cracking（SCC） of 7003 aluminum alloy（AA7003）, the intergranular corrosion test, electrochemical test and slow strain rate test（SSRT）, combined with optical microscopy（OM） and scanning electron microscopy（SEM） as well as transmission electron microscopy（TEM） observations have been carried out. The IGC and electrochemical test results showed that the IGC resistance of AA7003 for peak aged（PA） temper is the lowest, with double peak aged（DPA） the moderate, and retrogression and re-aging（RRA） the highest among three tempers, which is attributed to the continuous feature of precipitation on grain boundary of PA temper and the interrupted feature of precipitation on grain boundary of DPA and RRA tempers, as well as the wide precipitation free zones（PFZ） of RRA temper. In addition, the SSRT results indicated that all three tempers AA7003 are susceptible to SCC in IGC solution, and the change tendency of SCC susceptibility（ISCC） of AA7003 for three tempers follows the order： ISCC（RRA）

Effect of annealing treatment on microstructure and fatigue crack growth behavior of Al–Zn–Mg–Sc–Zr alloy

Al-Zn-Mg-Sc-Zr alloy samples were annealed to four different states （under-aging, peak-aging, over-aging and double-aging） and then thoroughly investigated by means of electron backscatter diffraction （EBSD）, transmission electron microscopy （TEM）, scanning electron microscopy （SEM）, tensile and fatigue crack growth rate tests to explore the influence of annealing treatment on microstmcture and fatigue crack growth behavior. The results indicate that Al3（Sc,Zr） particles can effectively refine grains and enhance tensile properties and fatigue properties. After annealing treatment, the under-aged sample and double-aged sample obtained average grain sizes of 4.9473 and 4.1257 μm, and the maximum value of yield/tensile strength （561 MPa/581 MPa） was obtained in peak-aged state. In the Paris region, fatigue crack growth rate, crack deflection and bifurcation, crack blunting and inter/trans-granular propagation were discussed based on data fitting and Laird model and Griffith theory. And the results show that the under-aged sample possesses the best resistance to fatigue crack propagation and the most tortuous and bifurcated crack path. For all samples, the fatigue crack growth rate in the rupture region was inversely proportional to yield strength.

Treatment of nutcracker syndrome with spermatic vein ligation and iliac vein anastomosis:Case report of three cases

Three patients with nutcracker syndrome(NCS) were enrolled in the study.Their clinical symptoms mainly included proteinuria and serious varicocele.Color Doppler ultrasound and computed tomography showed that the patients had constricted abdominal aortas,reduced superior mesenteric artery angles,and thinned left renal veins.Patients then underwent left spermatic vein ligation and iliac vein anastomosis.They were checked tliree months after their operation,and results showed that their sperms were improved and their proteinuria disappeared. The color Doppler ultrasound showed new cycle pathways.NCS clinical manifestations are complicated,and need combination diagnosis of symptoms and auxiliary examination to detennine surgical indications.Ligation of spermatic vein and vein anastomosis can be used to treat NCS.

HEALING OF HYDROGEN ATTACK CRACK IN AUSTENITE STAINLESS STEEL UNDER HEAT TREATMENT

The specimens of 304 austenite stainless steel with the hydrogen attackbubbles or cracks were heat treated at 600 deg C for 6h. The SEM and TEM observations on thespecimens before and after the heat treatment showed that the bubbles or cracks could be healedcompletely by heat treatment. The healing of hydrogen attack bubbles or cracks is closely related toheat diffusion of Fe and C atoms in austenite. The driving force of crack healing results from theplastic deforming energy E_s induced by the growth of hydrogen attack bubbles or cracks. Thecritical condition of healing of bubbles or cracks is E_s >= 2 gamma/r (where gamma is the surfacetension, r is the radius of bubbles or half length of crack). During healing of the hydrogen attackbubbles or cracks, the recovery, polygonization and recrystallization of the sub-grain also occured.

Combination of eddy current and heat treatment for crack healing and mechanical-property improvement in magnesium alloy tube

The continuous eddy current pulse treatment(ECPT)combined with heat treatment was employed to heal the microcracks in spin formed Mg alloy tubes and improve their mechanical properties in this study.The results show that all the microcracks in different tube specimens were almost healed after different continuous ECPT schemes up to 15 cycles.The schemes with less cooling intervals exhibited better healing effect and increased the strength and elongation of Mg alloy tubes more obviously.After aging treatment,the strength improvement of the specimens with ECPT was more remarkable than that of the specimens without ECPT,and the elongation decrease of the specimens with ECPT was less evident than that of specimens without ECPT due to the segregation of RE elements on the crack surface.Besides,after solution treatment,the strength reduction and ductility improvement of the specimens with ECPT were more pronounced than that of the specimens without ECPT owing to the notable decrease of dislocation density of the specimens with ECPT.Both narrowed cracks induced by ECPT and the segregation of precipitates in the vicinity of microcrack surface during aging treatment contributed to the maximum strength in the as-spun specimens with ECPT followed by aging treatment.

Susceptibility to Hot Cracking and Weldment Heat Treatment of Haynes 230 Superalloy

This study investigates the susceptibility of hot cracking and weldment heat treatment of Haynes 230 superalloy. The Varestriant test was conducted to evaluate this susceptibility. Welding was performed by gas tungsten arc welding （GTAW） and plasma arc welding （PAW） with stress relief heat treatment and solid solution heat treatment. A tensile test is then performed to measure the changes in the mechanical properties of the heattreated material. The results indicate that the number of thermal cycles does not affect the susceptibility of Haynes 230 superalloy to hot cracking. However, it does increase the strain. In weldment of heat treatment, stress relief annealing increases the yield strength and tensile strength of the welded parts. The section of the tensile specimens shows fibrous fractures on the welded parts, regardless of whether they are heat-treated.

Analysis of Detection and Treatment Schemes of Highway Tunnel Lining Cracks

Highway tunnels play a very important role in people's daily life.Among them,lining is an essential part of tunnel engineering,and the quality of lining greatly affects the overall quality of the tunnel.On this basis,the causes of lining cracks and the detection methods of existing highway tunnel lining cracks are analyzed,and the treatment countermeasures for highway tunnel lining cracks are proposed.

EFFECTS OF HEAT TREATMENT AND ENVIRONMENT ON CRACK PROPAGATION RATE IN STEEL GC-4 UNDER CORROSION FATIGUE AND STRESS CORROSION

Comparative investigations were carried out of the effect of heat treatment regimes Jor steel GC-4(40CrMnSiMoVA)on its crack propagating rates,from corrosion fatigue, (da/dN)_(CF),or stress corrosion cracking,(da/dt)_(SCC),in media with various constituents and pH values.Both(da/dN)_(CF) and(da/dt)_(SCC) accelerate with the increase of yield stress of the steel,yet the former is far less than the later.In comparison with media,the (da/dt)_(SCC) in distilled water is slightly greater than that in 3.5% NaCl solution,and the (da/dN)_(CF) in distilled water is far less than that in 3.5% NaCl solution.With the pH value increasing in 3.5% NaCl solution,the(da/dN)_(CF) lowers down and the(da/dt)_(SCC) speeds up.An explanation was also proposed with concept of the cyclic hardening and softening at crack tip,as well as the crack closure and occluded cell effect.

Healing of hydrogen-attacked cracks in split specimens with recovering heat treatment in vacuum

The healing mechanism of hydrogen-attacked cracks in low carbon steel andCr-Mo steel and its influencing factors during the healing process were studied by recovering heattreatment of split specimens in vacuum. The result showed that crack pacing turns much smaller underthe condition of pure heating, especially for crack tips. The healing effect is well related to thelength of cracks with the shorter in priority. By the primary mechanism of thermal diffusion, ironand carbon atoms must diffuse at the high speed in steel to realize that plasticity deformationenergy exceeds and overcomes surface tensile force energy. In addition, phase transformation andstress-stain relationship also have positive effects on the process.

The Impact of Matrix Treatment (Family Training) in Reducing the Amount of Drug Consumption in Heroin and Crack Addicts

The purpose of this study is to investigate the impact of family training based on matrix model in reducing the amount of drug consumption by heroin and crack addicts. The subjects were referral to Karaj Clinic, Karaj City, Iran, for crack abuse in 2013. In order to select participants convenience sampling was been used and totally 45 patients were selected (15 heroin addict, 15 crack addict, and 15 with combination of heroin and crack addiction) and put into two groups of experimental and control groups randomly. For collecting the data, Addiction Severity Index questionnaire was used. Descriptive and inferential statistics were used through one-way analysis of covariance for data analyzing. The results indicated that there was statistical difference between the experimental and control group with consumption of heroin and crack in family status, mental and substance use and also it has been shown that the experimental group with heroine consumption achieved better performance compared with the control group in the amount of consumption.