Background: Localized pancreatic cancer, including resectable (R), borderline resectable (BR) and locally advanced unresectable disease (LAU), is considered in clinical guidelines for diverse treatment options based o...Background: Localized pancreatic cancer, including resectable (R), borderline resectable (BR) and locally advanced unresectable disease (LAU), is considered in clinical guidelines for diverse treatment options based on clinical trials in selected populations. Hence, exploring with real world evidence (RWE) clinicians’ preferences for treatment options and their results seems pertinent. Methods: In a set of consecutive patients with localized pancreatic cancer assisted in a third level hospital from January 2013 to December 2022, medical records, symptoms, diagnostic process, distribution between subtypes, and treatment plans, with safety and efficacy results, were assessed. Results: A total of 152 patients with localized disease were included (43.4% R, 21.0% BR, 33.6% LAU). The population characteristics exemplified differences between daily practice and clinical trials. Tumor location and symptoms were as expected. Treatment plan was conditioned by PS or comorbidities in 23.0% of patients. In patients with R disease, surgery followed by different adjuvant chemotherapy (CT) regimes was the antineoplastic treatment of choice (64.8%) with efficacy results (OS 37.5 months;95% CI 18.4 - 56.7), in the range of contemporary standards. The common use of neoadjuvant CT for BR disease (94.4%), with surgery in 50% of them, and its results (OS 30.8 months;95% CI 10.5 - 51.2) reflected current controversies of treatment recommendations and evolution in this scenario. Paliative CT with or without radiotherapy was the standard specific treatment in LAU disease (95.1%) with survival results (PFS: 10.8 months;95% CI 8.8 - 12.7. OS: 20.3 months;95% CI 13.5 - 27.2) that justify the distinct character and the specific study of this entity. Conclusion: RWE for localized pancreatic cancer aroused from the analysis of this population confirms the distinct nature of patients assisted in daily practice, as well as mirrors the complexity of decision making in clinical assumptions in which achieving stronger evidence should be paramount.展开更多
Twenty-six years ago, a small committee report built upon earlier studies to articulate a compelling and poetic vision for the future of astronomy. This vision called for an infrared-optimized space telescope with an ...Twenty-six years ago, a small committee report built upon earlier studies to articulate a compelling and poetic vision for the future of astronomy. This vision called for an infrared-optimized space telescope with an aperture of at least four meters. With the support of their governments in the US, Europe, and Canada, 20,000 people brought this vision to life as the 6.5-meter James Webb Space Telescope (JWST). The telescope is working perfectly, delivering much better image quality than expected [1]. JWST is one hundred times more powerful than the Hubble Space Telescope and has already captured spectacular images of the distant universe. A view of a tiny part of the sky reveals many well-formed spiral galaxies, some over thirteen billion light-years away. These observations challenge the standard Big Bang Model (BBM), which posits that early galaxies should be small and lack well-formed spiral structures. JWST’s findings are prompting scientists to reconsider the BBM in its current form. Throughout the history of science, technological advancements have led to new results that challenge established theories, sometimes necessitating their modification or even abandonment. This happened with the geocentric model four centuries ago, and the BBM may face a similar reevaluation as JWST provides more images of the distant universe. In 1937, P. Dirac proposed the Large Number Hypothesis and the Hypothesis of Variable Gravitational Constant, later incorporating the concept of Continuous Creation of Matter in the universe. The Hypersphere World-Universe Model (WUM) builds on these ideas, introducing a distinct mechanism for matter creation. WUM is proposed as an alternative to the prevailing BBM. Its main advantage is the elimination of the “Initial Singularity” and “Inflation”, offering explanations for many unresolved problems in Cosmology. WUM is presented as a natural extension of Classical Physics with the potential to bring about a significant transformation in both Cosmology and Classical Physics. Considering JWST’s discoveries, WUM’s achievements, and 87 years of Dirac’s proposals, it is time to initiate a fundamental transformation in Astronomy, Cosmology, and Classical Physics. The present paper is a continuation of the published article “JWST Discoveries—Confirmation of World-Universe Model Predictions” [2] and a summary of the paper “Hypersphere World-Universe Model: Digest of Presentations John Chappell Natural Philosophy Society” [3]. Many results obtained there are quoted in the current work without full justification;interested readers are encouraged to view the referenced papers for detailed explanations.展开更多
In this paper, we discuss a Many Worlds Interpretation (MWI) of Dark Energy and Dark Matter. The universe is viewed cosmologically as a fermionic fluid with a hydrostatic pressure from “Zitterbewegung”, the quantum ...In this paper, we discuss a Many Worlds Interpretation (MWI) of Dark Energy and Dark Matter. The universe is viewed cosmologically as a fermionic fluid with a hydrostatic pressure from “Zitterbewegung”, the quantum “zig-zagging” of Dirac particles. At each point in space-time, the pressure from all possible velocity states existing in the Many Worlds sums to provide a dark energy. This provides a ratio of matter energy to pressure energy close to that observed experimentally. Visible matter is the matter observed or measured in a particular velocity state and dark matter is then considered as the unobserved fermion contributions from different orthogonal spatial directions.展开更多
In this paper, we present a novel approach to model user request patterns in the World Wide Web. Instead of focusing on the user traffic for web pages, we capture the user interaction at the object level of the web pa...In this paper, we present a novel approach to model user request patterns in the World Wide Web. Instead of focusing on the user traffic for web pages, we capture the user interaction at the object level of the web pages. Our framework model consists of three sub-models: one for user file access, one for web pages, and one for storage servers. Web pages are assumed to consist of different types and sizes of objects, which are characterized using several categories: articles, media, and mosaics. The model is implemented with a discrete event simulation and then used to investigate the performance of our system over a variety of parameters in our model. Our performance measure of choice is mean response time and by varying the composition of web pages through our categories, we find that our framework model is able to capture a wide range of conditions that serve as a basis for generating a variety of user request patterns. In addition, we are able to establish a set of parameters that can be used as base cases. One of the goals of this research is for the framework model to be general enough that the parameters can be varied such that it can serve as input for investigating other distributed applications that require the generation of user request access patterns.展开更多
This paper explores the transformative impact of virtual worlds, augmented reality (AR), and the metaverse in the healthcare sector. It delves into the ways these technologies are reshaping patient care, medical educa...This paper explores the transformative impact of virtual worlds, augmented reality (AR), and the metaverse in the healthcare sector. It delves into the ways these technologies are reshaping patient care, medical education, and research, while also addressing the challenges and opportunities they present. The paper highlights the potential benefits of these technologies and emphasizes the need for comprehensive regulatory frameworks and ethical guidelines to ensure responsible integration. Finally it outlines their transformative impact and discusses the challenges and opportunities they present for the future of healthcare provision.展开更多
World Wind是NASA发布的开放源码的地理软件,是提供丰富数据的数字地球平台之一。但是,如何在其已发布数据基础上,通过网络应用来扩展其数据应用,如何将用户的应用数据或其它数据提供者的数据与现有数据结合使用,是我们需要解决的问题...World Wind是NASA发布的开放源码的地理软件,是提供丰富数据的数字地球平台之一。但是,如何在其已发布数据基础上,通过网络应用来扩展其数据应用,如何将用户的应用数据或其它数据提供者的数据与现有数据结合使用,是我们需要解决的问题。通过采用WebService技术进行地理信息服务和发布,使用GeoServer作为地图服务器,将OpenGIS Webservice规范和PostGIS空间数据库进行整合,通过网络空间数据扩展使WorldWind客户端与其自身的数据服务集成使用。在其平台基础上基本实现可自由扩展和发布数据供WorldWind客户端使用,实现更广泛和深入的扩展应用。展开更多
文摘Background: Localized pancreatic cancer, including resectable (R), borderline resectable (BR) and locally advanced unresectable disease (LAU), is considered in clinical guidelines for diverse treatment options based on clinical trials in selected populations. Hence, exploring with real world evidence (RWE) clinicians’ preferences for treatment options and their results seems pertinent. Methods: In a set of consecutive patients with localized pancreatic cancer assisted in a third level hospital from January 2013 to December 2022, medical records, symptoms, diagnostic process, distribution between subtypes, and treatment plans, with safety and efficacy results, were assessed. Results: A total of 152 patients with localized disease were included (43.4% R, 21.0% BR, 33.6% LAU). The population characteristics exemplified differences between daily practice and clinical trials. Tumor location and symptoms were as expected. Treatment plan was conditioned by PS or comorbidities in 23.0% of patients. In patients with R disease, surgery followed by different adjuvant chemotherapy (CT) regimes was the antineoplastic treatment of choice (64.8%) with efficacy results (OS 37.5 months;95% CI 18.4 - 56.7), in the range of contemporary standards. The common use of neoadjuvant CT for BR disease (94.4%), with surgery in 50% of them, and its results (OS 30.8 months;95% CI 10.5 - 51.2) reflected current controversies of treatment recommendations and evolution in this scenario. Paliative CT with or without radiotherapy was the standard specific treatment in LAU disease (95.1%) with survival results (PFS: 10.8 months;95% CI 8.8 - 12.7. OS: 20.3 months;95% CI 13.5 - 27.2) that justify the distinct character and the specific study of this entity. Conclusion: RWE for localized pancreatic cancer aroused from the analysis of this population confirms the distinct nature of patients assisted in daily practice, as well as mirrors the complexity of decision making in clinical assumptions in which achieving stronger evidence should be paramount.
文摘Twenty-six years ago, a small committee report built upon earlier studies to articulate a compelling and poetic vision for the future of astronomy. This vision called for an infrared-optimized space telescope with an aperture of at least four meters. With the support of their governments in the US, Europe, and Canada, 20,000 people brought this vision to life as the 6.5-meter James Webb Space Telescope (JWST). The telescope is working perfectly, delivering much better image quality than expected [1]. JWST is one hundred times more powerful than the Hubble Space Telescope and has already captured spectacular images of the distant universe. A view of a tiny part of the sky reveals many well-formed spiral galaxies, some over thirteen billion light-years away. These observations challenge the standard Big Bang Model (BBM), which posits that early galaxies should be small and lack well-formed spiral structures. JWST’s findings are prompting scientists to reconsider the BBM in its current form. Throughout the history of science, technological advancements have led to new results that challenge established theories, sometimes necessitating their modification or even abandonment. This happened with the geocentric model four centuries ago, and the BBM may face a similar reevaluation as JWST provides more images of the distant universe. In 1937, P. Dirac proposed the Large Number Hypothesis and the Hypothesis of Variable Gravitational Constant, later incorporating the concept of Continuous Creation of Matter in the universe. The Hypersphere World-Universe Model (WUM) builds on these ideas, introducing a distinct mechanism for matter creation. WUM is proposed as an alternative to the prevailing BBM. Its main advantage is the elimination of the “Initial Singularity” and “Inflation”, offering explanations for many unresolved problems in Cosmology. WUM is presented as a natural extension of Classical Physics with the potential to bring about a significant transformation in both Cosmology and Classical Physics. Considering JWST’s discoveries, WUM’s achievements, and 87 years of Dirac’s proposals, it is time to initiate a fundamental transformation in Astronomy, Cosmology, and Classical Physics. The present paper is a continuation of the published article “JWST Discoveries—Confirmation of World-Universe Model Predictions” [2] and a summary of the paper “Hypersphere World-Universe Model: Digest of Presentations John Chappell Natural Philosophy Society” [3]. Many results obtained there are quoted in the current work without full justification;interested readers are encouraged to view the referenced papers for detailed explanations.
文摘In this paper, we discuss a Many Worlds Interpretation (MWI) of Dark Energy and Dark Matter. The universe is viewed cosmologically as a fermionic fluid with a hydrostatic pressure from “Zitterbewegung”, the quantum “zig-zagging” of Dirac particles. At each point in space-time, the pressure from all possible velocity states existing in the Many Worlds sums to provide a dark energy. This provides a ratio of matter energy to pressure energy close to that observed experimentally. Visible matter is the matter observed or measured in a particular velocity state and dark matter is then considered as the unobserved fermion contributions from different orthogonal spatial directions.
文摘In this paper, we present a novel approach to model user request patterns in the World Wide Web. Instead of focusing on the user traffic for web pages, we capture the user interaction at the object level of the web pages. Our framework model consists of three sub-models: one for user file access, one for web pages, and one for storage servers. Web pages are assumed to consist of different types and sizes of objects, which are characterized using several categories: articles, media, and mosaics. The model is implemented with a discrete event simulation and then used to investigate the performance of our system over a variety of parameters in our model. Our performance measure of choice is mean response time and by varying the composition of web pages through our categories, we find that our framework model is able to capture a wide range of conditions that serve as a basis for generating a variety of user request patterns. In addition, we are able to establish a set of parameters that can be used as base cases. One of the goals of this research is for the framework model to be general enough that the parameters can be varied such that it can serve as input for investigating other distributed applications that require the generation of user request access patterns.
文摘This paper explores the transformative impact of virtual worlds, augmented reality (AR), and the metaverse in the healthcare sector. It delves into the ways these technologies are reshaping patient care, medical education, and research, while also addressing the challenges and opportunities they present. The paper highlights the potential benefits of these technologies and emphasizes the need for comprehensive regulatory frameworks and ethical guidelines to ensure responsible integration. Finally it outlines their transformative impact and discusses the challenges and opportunities they present for the future of healthcare provision.
