Conventional Geothermal Systems and Unconventional Geothermal Developments: An Overview

This paper provides an overview of conventional geothermal systems and unconventional geothermal developments as a common reference is needed for discussions between energy professionals. Conventional geothermal systems have the heat, permeability and fluid, requiring only drilling down to °C, normal heat flow or decaying radiogenic granite as heat sources, and used in district heating. Medium-temperature (MT) 100°C - 190°C, and high-temperature (HT) 190°C - 374°C resources are mostly at plate boundaries, with volcanic intrusive heat source, used mostly for electricity generation. Single well capacities are °C - 500°C) and a range of depths (1 m to 20 Km), but lack permeability or fluid, thus requiring stimulations for heat extraction by conduction. HVAC is 1 - 2 m deep and shallow geothermal down to 500 m in wells, both capturing °C, with °C are either advanced by geothermal developers at <7 Km depth (Enhanced Geothermal Systems (EGS), drilling below brittle-ductile transition zones and under geothermal fields), or by the Oil & Gas industry (Advanced Geothermal Systems, heat recovery from hydrocarbon wells or reservoirs, Superhot Rock Geothermal, and millimeter-wave drilling down to 20 Km). Their primary aim is electricity generation, relying on closed-loops, but EGS uses fractures for heat exchange with earthquake risks during fracking. Unconventional approaches could be everywhere, with shallow geothermal already functional. The deeper and hotter unconventional alternatives are still experimental, overcoming costs and technological challenges to become fully commercial. Meanwhile, the conventional geothermal resources remain the most proven opportunities for investments and development.

Study of relationship between motion of mechanisms in gas operated weapon and its shock absorber

The article deals with the motion of the breech block carrier and the weapon casing of an automatic weapon mounted on a flexible carriage and the base of the weapon.Earlier works,which did not consider the dynamic properties of the base of the weapon,did not allow to reconcile the calculated and experimental results of the weapon casing displacement when shooting from firing rests.For the analysis of the motion of individual parts,the methods of mathematical modelling and firing experiments using a high-speed camera were chosen.Calculations show the best accord with experiment when modelling the system with 4 degrees of freedom.The oscillation of the system regarding the movement of the breech block carrier and the weapon casing was investigated under changed conditions of rate of fire,the use of a muzzle brake and different types of shock absorbers.The velocities and displacements of the weapon casing and the breech block carrier at different values of the impulse of the gases to the breech block carrier were determined.

Ethical and strategic challenges of AI weapons: A call for global action

1 Impending prophecy About a decade ago,theoretical physicist Stephen Hawking expressed extreme concern about the development of artificial intelligence(AI),stating that"the development of full artificial intelligence could spell the end of the human race.Concurrently,in 2014,entrepreneur Elon Musk expressed similar cautionary sentiments,suggesting that AI might surpass nuclear weapons in terms of danger.Despite these warnings,the prevailing sentiment at the time was largely skeptical.However,only a few years later,on May 30,2023,hundreds of artificial intelligence experts and other notable figures issued a 22-word statement[1]warning against the“risk of extinction.”

Resilience-driven cooperative reconfiguration strategy for unmanned weapon system-of-systems

As the unmanned weap system-of systems(UWSoS)becomes complex,the inevitable uncertain interference gradu-ally increases,which leads to a strong emphasis on the resilience of UWSoS.Hence,this paper presents a resilience-driven cooperative reconfiguration strategy to enhance the resilience of UWSoS.First,a unified resilience-driven coopera-tive reconfiguration strategy framework is designed to guide the UWSoS resilience enhancement.Subsequently,a cooperative reconfiguration strategy algorithm is proposed to identify the optimal cooperative reconfiguration sequence,combining the cooperative pair resilience contribution index(CPRCI)and coop-erative pair importance index(CPII).At last,the effectiveness and superiority of the proposed algorithm are demonstrated through various attack scenario simulations that include differ-ent attack modes and intensities.The analysis results can pro-vide a reference for decision-makers to manage UWSoS.

Large Conventional Osteosarcoma of the Proximal Humerus in a 13-Year-Old Child: Case Report

Introduction: Osteosarcoma is the most common primary malignant bone tumor in children. It is highly aggressive and has a poor prognosis. A late presentation modifies and makes difficult the management affecting the survival of children. We report the case of a large conventional osteosarcoma in a 13-year-old girl. Case Presentation: Adolescent girl admitted for painful swelling of the left shoulder with absolute functional impotence of the thoracic limb and severe anemia. The painful swelling was thought to have been caused by a minor trauma that had occurred six months previously. The patient’s general condition was poor, and she presented with a large, shiny, painful mass over the shoulder and upper 2/3 of the left arm, measuring 28 cm long by 28 cm wide and 57 cm in circumference, and a large fistulous axillary adenopathy. CT scan showed a tumour lesion of the left humerus with liver and lung metastases, raising suspicion of osteogenic osteosarcoma. The tumor was classified according to TNM staging: T2N1M1(a + b). Management was modified when uncontrolled bleeding developed. It consisted of an extended amputation of the left thoracic limb. Pathological analysis showed a high-grade conventional osteosarcoma. Quality improvement was obtained for thirty days, followed by the onset of dyspnea. The evolution was towards death at forty days post-operatively. Conclusion: Osteosarcoma is a highly aggressive cancer. Delayed treatment leads to a fatal outcome. Early diagnosis is one of the challenges to be met in order to improve survival.

Spinal Analgesia with Intrathecal Morphine versus Conventional Analgesia after Laparoscopic Colectomy: A Retrospective Cohort Study

Objective: Postoperative pain (POP) following abdominal surgery can vary from a few hours to several days. This acute, unrelieved pain can become chronic, requiring patients to take analgesics on an almost daily basis for comfort. Analgesia using general opioids has many side effects and intrathecal morphine is a good alternative. This study was conducted to evaluate the efficacy of intrathecal morphine (ITM) versus conventional analgesia in the management of postoperative pain in colectomy performed by laparoscopic surgery. Methods: Cohort study conducted at the Hôpital Nord in Marseille, from 01 January to 31 July 2021 in patients aged at least 18 years undergoing anaesthesia for scheduled colectomy by laparoscopic surgery. The primary endpoint was postoperative pain intensity and the secondary endpoints were morphine consumption, treatment side effects and length of hospital stay. Statistical analysis was performed using XLSTAT software. Results: We included 193 patients: 131 in the control group (conventional analgesia) and 62 in the ITM group. We observed: a significant decrease in pain (assessed by numerical scale) in favour of the ITM group in the post-anaesthetic care room, i.e. 3 (±4) vs 1 (±2), p 0 and H2: 2 (±2) vs. 1 (±2);p Conclusion: These results suggest that intrathecal morphine (ITM) in laparoscopic colectomy provides effective postoperative analgesia with low morphine consumption, and a reduction in morphine side-effects compared with conventional analgesia.

Numerical Investigation of Combined Production of Natural Gas Hydrate and Conventional Gas

Natural gas hydrate(NGH)is generally produced and accumulated together with the underlying conventional gas.Therefore,optimizing the production technology of these two gases should be seen as a relevant way to effectively reduce the exploitation cost of the gas hydrate.In this study,three types of models accounting for the coexistence of these gases are considered.Type A considers the upper hydrate-bearing layer(HBL)adjacent to the lower conventional gas layer(CGL);with the Type B a permeable interlayer exists between the upper HBL and the lower CGL;with the type C there is an impermeable interlayer between the upper HBL and the lower CGL.The production performances associated with the above three models are calculated under different conditions,including only a depressurized HBL(only HBL DP);only a depressurized CGL(only CGL DP);and both the HBL and the CGL being depressurized(HBL+CGL DP).The results show that for Type A and Type B coexistence accumulation models,when only HBL or CGL is depressurized,the gas from the other layer will flow into the production layer due to the pressure difference between the two layers.In the coexistence accumulation model of type C,the cumulative gas production is much lower than that of Type A and Type B,regardless of whether only HBL DP,only CGL DP,or HBL+CGL DP are considered.This indicates that the impermeable interlayer restricts the cross-flow of gas between HBL and CGL.For three different coexistence accumulation models,CGL DP has the largest gas-to-water ratio.

Analysis of Maximum Liquid Carrying Capacity Based on Conventional Tubing Plunger Gas Lift

China’s unconventional gas fields have a large number of low-productivity and low-efficiency wells, many of whichare located in remote and environmentally harsh mountainous areas. To address the long-term stable productionof these gas wells, plunger-lift technology plays an important role. In order to fully understand and accurately graspthe drainage and gas production mechanisms of plunger-lift, a mechanical model of plunger-liquid column uplift inthe plunger-lift process was established, focusing on conventional plunger-lift systems and representative wellboreconfigurations in the Linxing region. The operating casing pressure of the plunger-lift process and the calculationmethod for the maximum daily fluid production rate based on the work regime with the highest fluid recovery ratewere determined. For the first time, the critical flow rate method was proposed as a constraint for the maximumliquid-carrying capacity of the plunger-lift, and liquid-carrying capacity charts for conventional plunger-lift withdifferent casing sizes were developed. The results showed that for 23/8 casing plunger-lift, with a well depth ofshallower than 808 m, the maximum drainage rate was 33 m3/d;for 27/8 casing plunger-lift, with a well depth ofshallower than 742 m, the maximum drainage rate was 50.15 m3/d;for 31/2 casing plunger-lift, with a well depthof shallower than 560 m, the maximum drainage rate was 75.14 m3/d. This research provides a foundation for thescientific selection of plunger-lift technology and serves as a decision-making reference for developing reasonableplunger-lift work regimes.

Observation on the Effect of Non-Invasive Ventilator Combined with Conventional Therapy in the Treatment of Chronic Obstructive Pulmonary Disease Complicated with Respiratory Failure

Objective:To explore the clinical effect of a non-invasive ventilator combined with conventional therapy in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:68 patients with COPD combined with respiratory failure treated in our hospital from September 2021 to October 2023 were selected as the research subjects.Using the random number table method,they were divided into a control group and an experimental group of 34 cases each.The control group received conventional symptomatic treatment,and the experimental group received non-invasive ventilator treatment based on the control group.The clinical effects,blood gas indicators(partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))),lung function(forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),6 min walking distance),complications,and inflammatory factor levels(c-reactive protein(CRP),interleukin-6(IL-6),neutrophil-to-lymphocyte ratio(NLR))of the two groups of patients were observed.Results:(1)The clinical efficacy of the patients in the experimental group(33/97.06%)was more significant as compared with the control group(25/73.53%)(P<0.05);(2)After treatment,the clinical efficacy of the two groups of patients in terms of FEV1,FEV1/FVC,6-minute walking distance,PaO_(2)and SaO_(2)all increased in the experimental group as compared to that of the control group(P<0.05);(3)After treatment,the PaCO_(2),CRP,IL-6,and NLR of the two groups of patients decreased,and the decrease in the experimental group was higher than that of the control group(P<0.05);(4)The patients’complication rate in the experimental group(2/5.88%)was lower as compared to that of the control group(9/26.46%)(P<0.05).Conclusion:Non-invasive ventilators combined with conventional therapy achieved good clinical results in treating patients with COPD and respiratory failure.

Study on the Effect of Repetitive Peripheral Magnetic Stimulation Combined with Conventional Rehabilitation Measures on Shoulder Dysfunction in Early Stroke

Objective:To study the effect of repetitive peripheral magnetic stimulation(rPMS)combined with conventional rehabilitation measures on shoulder dysfunction in early stroke.Methods:60 patients with shoulder dysfunction in early stroke were selected,and all of them were admitted to our hospital from August 2021 to August 2023.The patients were randomly grouped into a control group(conventional rehabilitation measures intervention,30 cases)and an intervention group(rPMS and conventional rehabilitation measures intervention,30 cases)according to the lottery method.The pain scores,shoulder mobility,and motor function scores of the two groups were compared.Results:The pain score was lower in the intervention group,and the shoulder mobility and motor function scores were higher in the intervention group(P<0.05)as compared to that of the control group.Conclusion:The effect of combining rPMS and conventional rehabilitation measures in treating shoulder dysfunction in early stroke was remarkable and should be popularized.

Whole petroleum system and ordered distribution pattern of conventional and unconventional oil and gas reservoirs

The classical source-to-trap petroleum system concept only considers the migration and accumulation of conventional oil and gas in traps driven dominantly by buoyance in a basin,although revised and improved,even some new concepts as composite petroleum system,total petroleum system,total composite petroleum system,were proposed,but they do not account for the vast unconventional oil and gas reservoirs within the system,which is not formed and distributed in traps dominantly by buoyancedriven.Therefore,the petroleum system concept is no longer adequate in dealing with all the oil and gas accumulations in a basin where significant amount of the unconventional oil and gas resources are present in addition to the conventional oil and gas accumulations.This paper looked into and analyzed the distribution characteristics of conventional and unconventional oil/gas reservoirs and their differences and correlations in petroliferous basins in China and North America,and then proposed whole petroleum system(WPS)concept,the WPS is defined as a natural system that encompasses all the conventional and unconventional oil and gas,reservoirs and resources originated from organic matter in source rocks,the geological elements and processes involving the formation,evolution,and distribution of these oil and gas,reservoirs and resources.It is found in the WPS that there are three kinds of hydrocarbons dynamic fields,three kinds of original hydrocarbons,three kinds of reservoir rocks,and the coupling of these three essential elements lead to the basic ordered distribution model of shale oil/gas reservoirs contacting or interbeded with tight oil/gas reservoirs and separated conventional oil/gas reservoirs from source rocks upward,which is expressed as“S\T-C”.Abnormal conditions lead to other three special ordered distribution models:The first is that with shale oil/gas reservoirs separated from tight oil/gas reservoirs.The second is that with two direction ordered distributions from source upward and downward.The third is with lateral distribution from source outside.

A bi-population immune algorithm for weapon transportation support scheduling problem with pickup and delivery on aircraft carrier deck

The weapon transportation support scheduling problem on aircraft carrier deck is the key to restricting the sortie rate and combat capability of carrier-based aircraft.This paper studies the problem and presents a novel solution architecture.Taking the interference of the carrier-based aircraft deck layout on the weapon transportation route and precedence constraint into consideration,a mixed integer formulation is established to minimize the total objective,which is constituted of makespan,load variance and accumulative transfer time of support unit.Solution approach is developed for the model.Firstly,based on modeling the carrier aircraft parked on deck as convex obstacles,the path library of weapon transportation is constructed through visibility graph and Warshall-Floyd methods.We then propose a bi-population immune algorithm in which a population-based forward/backward scheduling technique,local search schemes and a chaotic catastrophe operator are embedded.Besides,the randomkey solution representation and serial scheduling generation scheme are adopted to conveniently obtain a better solution.The Taguchi method is additionally employed to determine key parameters of the algorithm.Finally,on a set of generated realistic instances,we demonstrate that the proposed algorithm outperforms all compared algorithms designed for similar optimization problems and can significantly improve the efficiency,and that the established model and the bi-population immune algorithm can effectively respond to the weapon support requirements of carrier-based aircraft under different sortie missions.

An Air Defense Weapon Target Assignment Method Based on Multi-Objective Artificial Bee Colony Algorithm

With the advancement of combat equipment technology and combat concepts,new requirements have been put forward for air defense operations during a group target attack.To achieve high-efficiency and lowloss defensive operations,a reasonable air defense weapon assignment strategy is a key step.In this paper,a multi-objective and multi-constraints weapon target assignment(WTA)model is established that aims to minimize the defensive resource loss,minimize total weapon consumption,and minimize the target residual effectiveness.An optimization framework of air defense weapon mission scheduling based on the multiobjective artificial bee colony(MOABC)algorithm is proposed.The solution for point-to-point saturated attack targets at different operational scales is achieved by encoding the nectar with real numbers.Simulations are performed for an imagined air defense scenario,where air defense weapons are saturated.The non-dominated solution sets are obtained by the MOABC algorithm to meet the operational demand.In the case where there are more weapons than targets,more diverse assignment schemes can be selected.According to the inverse generation distance(IGD)index,the convergence and diversity for the solutions of the non-dominated sorting genetic algorithm III(NSGA-III)algorithm and the MOABC algorithm are compared and analyzed.The results prove that the MOABC algorithm has better convergence and the solutions are more evenly distributed among the solution space.

Short-term efficacy and influencing factors of conventional chemotherapy combined with irinotecan in patients with advanced gastric cancer

BACKGROUND Gastric cancer is one of the most common cancers worldwide, with a 5-year survival rate of only 20%. The age of onset of gastric cancer is in line with the general rule of cancer. Most of them occur after middle age, mostly between 40and 60 years old, with an average age of about 50 years old, and only 5% of patients are under 30 years old. The incidence of male is higher than that of female.AIM To investigate the short-term efficacy and influencing factors of chemotherapy combined with irinotecan in patients with advanced gastric cancer.METHODS Eighty patients with advanced gastric cancer who were treated in our hospital from January 2019 to January 2022 were selected. The patients were divided into an observation group(n = 40) and control group(n = 40) by the envelope method.The control group was given preoperative routine chemotherapy. The observation group was treated with irinotecan in addition to the chemotherapy given to the control group. The short-term efficacy of treatment in the two groups, as well as tumor marker levels and quality of life before and after treatment were evaluated.RESULTS The short-term treatment effect in the observation group was better than that in the control group(P < 0.05), and the total effective rate was 57.50%. The age and proportion of tumor node metastasis(TNM) stage IV patients with ineffective chemotherapy in the observation group were(65.12 ± 5.71) years and 52.94%,respectively, which were notably higher than those of patients with effective chemotherapy(P < 0.05), while the Karnofsky Performance Scale score was(67.70± 3.83) points, which was apparently lower than that of patients with effective chemotherapy(P <0.05). After 3 mo of treatment, the SF-36 scale scores of physiological function, energy, emotional function, and mental health in the observation group were 65.12 ± 8.14, 54.76 ± 6.70, 47.58 ± 7.22,and 66.16 ± 8.11 points, respectively, which were considerably higher than those in the control group(P < 0.05). The incidence rates of grade Ⅲ-Ⅳ diarrhea and grade Ⅲ-Ⅳ thrombocytopenia in the observation group were 32.50% and 25.00%, respectively, which were markedly higher than those in the control group(P < 0.05).CONCLUSION Chemotherapy combined with irinotecan in patients with advanced gastric cancer has a good short-term efficacy and can significantly reduce serum tumor markers and improve the quality of life of patients. The efficacy may be affected by the age and TNM stage of the patients, and its long-term efficacy needs further study.

Mission reliability modeling and evaluation for reconfigurable unmanned weapon system-of-systems based on effective operation loop

The concept of unmanned weapon system-of-systems(UWSoS)involves a collection of various unmanned systems to achieve or accomplish a specific goal or mission.The mission reliability of UWSoS is represented by its ability to finish a required mission above the baselines of a given mission.However,issues with heterogeneity,cooperation between systems,and the emergence of UWSoS cannot be effectively solved by traditional system reliability methods.This study proposes an effective operation-loop-based mission reliability evaluation method for UWSoS by analyzing dynamic reconfiguration.First,we present a new connotation of an effective operation loop by considering the allocation of operational entities and physical resource constraints.Then,we propose an effective operationloop-based mission reliability model for a heterogeneous UWSoS according to the mission baseline.Moreover,a mission reliability evaluation algorithm is proposed under random external shocks and topology reconfiguration,revealing the evolution law of the effective operation loop and mission reliability.Finally,a typical 60-unmanned-aerial-vehicle-swarm is taken as an example to demonstrate the proposed models and methods.The mission reliability is achieved by considering external shocks,which can serve as a reference for evaluating and improving the effectiveness of UWSoS.

Endovenous laser treatment vs conventional surgery for great saphenous vein varicosities: A propensity score matching analysis

BACKGROUND Varicosis is a common venous condition,which is typically treated surgically.However,selection of the optimal surgical approach can be challenging.Previous studies comparing endovenous laser treatment(EVLT)and conventional surgery were retrospective and observational in nature and the results may therefore have been influenced by selection bias and the presence of other confounding factors.In this study,we used propensity score matching to reduce selection bias when comparing EVLT and conventional surgery for the treatment of varicose great saphenous veins.METHODS We retrospectively reviewed the records of 1063 patients treated for primary varicosis of the great saphenous vein at the Second Affiliated Hospital of Xuzhou Medical University between January 2009 and December 2019.Among them,56 patients were excluded owing to additional small saphenous varicose vein involvement,81 owing to recurring varicose veins,83 owing to complicated varicose veins(CEAP clinical classification C5-C6),and 6 owing to perioperative phlebitis.Finally,772 patients were enrolled in this study.Standard demographic and clinicopathological data were collected from the medical records of the patients.For propensity score matching,522 patients(261 who underwent EVLT and 261 who underwent conventional surgery)were randomly matched 1:1 by age,sex,onset time,smoking status,presence of diabetes,family history,stress therapy,C class,and the affected leg.RESULTS Of the 772 patients included in the study,467 underwent EVLT and 305 underwent conventional surgery.There were significant differences in age,onset time,smoking and diabetes status,and family history between the two groups.Following propensity score matching,no significant differences in patients’characteristics remained between the two groups.ELVT was associated with a shorter operation time and hospital stay than conventional surgery,both before and after propensity score matching.There were no differences in complications between the two groups after propensity score matching.Patients who underwent EVLT had a higher recurrence rate during the two-year follow-up period than those who underwent conventional surgery(33.33%vs 21.46%,χ^(2)=11.506,P=0.001),and a greater percentage of patients who underwent EVLT experienced pain one week after the procedure(39.85%vs 19.54%,P=0.000).CONCLUSION EVLT may not always be the best option for the treatment of great saphenous vein varicosis.

Electric Vehicle Charging Capacity of Distribution Network Considering Conventional Load Composition

At present,the large-scale access to electric vehicles(EVs)is exerting considerable pressure on the distribution network.Hence,it is particularly important to analyze the capacity of the distribution network to accommodate EVs.To this end,we propose a method for analyzing the EV capacity of the distribution network by considering the composition of the conventional load.First,the analysis and pretreatment methods for the distribution network architecture and conventional load are proposed.Second,the charging behavior of an EVis simulated by combining the Monte Carlo method and the trip chain theory.After obtaining the temporal and spatial distribution of the EV charging load,themethod of distribution according to the proportion of the same type of conventional load among the nodes is adopted to integrate the EV charging load with the conventional load of the distribution network.By adjusting the EV ownership,the EV capacity in the distribution network is analyzed and solved on the basis of the following indices:node voltage,branch current,and transformer capacity.Finally,by considering the 10-kV distribution network in some areas of an actual city as an example,we show that the proposed analysis method can obtain a more reasonable number of EVs to be accommodated in the distribution network.

Comparative Study between Patients Treated with Conventional Radiotherapy and IMRT with Chemotherapy for Stage III - IVA Nasopharyngeal Carcinoma: A Single Institution Retrospective Report

Introduction: Nasopharyngeal carcinomas are the most radiation-sensitive tumours, and radiotherapy alone provides better local control. Objectives: To evaluate the clinical efficacy and acute and late toxicities of two different treatment regimens for locally advanced nasopharyngeal carcinoma. Methods: From 2014 to 2017, 150 cases of stage III and 68 cases of stage IVA nasopharyngeal carcinoma were treated. Of these, 137 received conventional radiotherapy plus chemotherapy, and 81 received intensity-modulated radiotherapy plus chemotherapy. Chemotherapy was given either as induction, concurrent or adjuvant therapy. Survival rates were calculated according to Kaplan Meier and compared with the Log-rank test. The RTOG or EORTC criteria were used to assess acute and late toxicities. Results: The median follow-up time was 21.5 months, and the 2-year locoregional relapse-free survival, distant metastases-free survival, and overall survival rates in the conventional radiotherapy plus chemotherapy group were 76%, 71% and 77%, respectively;in the intensity-modulated radiotherapy plus chemotherapy group, they were 97%, 84%, and 100%, respectively. The difference in survival between the two groups was significant (χ2 = 5.06, P = 0.028). The incidence of grade 2 and 3 xerostomia one year after radiotherapy was 45.1% and 30.9% versus 33.3% and 0%. Conclusion: Compared with conventional radiotherapy plus chemotherapy, intensity-modulated radiotherapy plus chemotherapy offers better locoregional relapse-free survival and overall survival in patients with stage III and IVA nasopharyngeal carcinoma, and may significantly reduce the occurrence of radiation-induced xerostomia.

Intestinal complications in Brazilian patients with ulcerative colitis treated with conventional therapy between 2011 and 2020

BACKGROUND This was an observational, descriptive, and retrospective study from 2011 to 2020 from the Department of Informatics of the Brazilian Healthcare System database.AIM To describe the intestinal complications(IC) of patients with ulcerative colitis(UC) who started conventional therapies in Brazil’s public Healthcare system.METHODS Patients ≥ 18 years of age who had at least one claim related to UC 10th revision of the International Statistical Classification of Diseases and Related Health Problems(ICD-10) code and at least 2 claims for conventional therapies were included. IC was defined as at least one claim of: UC-related hospitalization, procedures code for rectum or intestinal surgeries, and/or associated disease defined by ICD-10 codes(malignant neoplasia of colon, stenosis, hemorrhage, ulcer and other rectum or anus disease, megacolon, functional diarrhea volvulus, intussusception and erythema nodosum). Descriptive statistics, annual incidence, and incidence rate(IR) [per 100 patient-years(PY)] over the available follow-up period were calculated.RESULTS In total, 41229 UC patients were included(median age, 48 years;65% women) and the median(interquartile range) follow-up period was 3.3(1.8-5.3) years. Conventional therapy used during follow-up period included: mesalazine(87%), sulfasalazine(15%), azathioprine(16%) or methotrexate(1%) with a median duration of 1.9(0.8-4.0) years. Overall IR of IC was 3.2 cases per 100 PY. Among the IC claims, 54% were related to associated diseases, 20% to procedures and 26% to hospitalizations. The overall annual incidence of IC was 2.9%, 2.6% and 2.5% in the first, second and third year after the first claim for therapy(index date), respectively. Over the first 3 years, the annual IR of UC-related hospitalizations ranged from 0.8% to 1.1%;associated diseases from 0.9% to 1.2%-in which anus or rectum disease, and malignant neoplasia of colon were the most frequently reported;and procedure events from 0.6% to 0.7%, being intestinal resection and polyp removal the most frequent ones.CONCLUSION Study shows that UC patients under conventional therapy seem to present progression of disease developing some IC, which may have a negative impact on patients and the burden on the health system.

Intensive follow-up vs conventional follow-up for patients with nonmetastatic colorectal cancer treated with curative intent:A metaanalysis

BACKGROUND The frequency and content of follow-up strategies remain controversial for colorectal cancer(CRC),and scheduled follow-ups have limited value.AIM To compare intensive and conventional follow-up strategies for the prognosis of non-metastatic CRC treated with curative intent using a meta-analysis.METHODS PubMed,Embase,and the Cochrane Library databases were systematically searched for potentially eligible randomized controlled trials(RCTs)from inception until April 2023.The Cochrane risk of bias was used to assess the methodological quality of the included studies.The hazard ratio,relative risk,and 95%confidence interval were used to calculate survival and categorical data,and pooled analyses were performed using the random-effects model.Additional exploratory analyses were performed for sensitivity,subgroups,and publication bias.RESULTS Eighteen RCTs involving 8533 patients with CRC were selected for the final analysis.Intensive follow-up may be superior to conventional follow-up in improving overall survival,but this difference was not statistically significant.Moreover,intensive follow-up was associated with an increased incidence of salvage surgery compared to conventional follow-up.In addition,there was no significant difference in the risk of recurrence between intensive and conventional follow-up strategies,whereas intensive follow-up was associated with a reduced risk of interval recurrence compared to conventional follow-up.Finally,the effects of intensive and conventional follow-up strategies differed when stratified by tumor location and follow-up duration.CONCLUSION Intensive follow-up may have a beneficial effect on the overall survival of patients with non-metastatic CRC treated with curative intent.