Recent advances in zinc-ion dehydration strategies for optimized Zn-metal batteries.

Aqueous Zn-metal batteries have attracted increasing interest for large-scale energy storage owing to their outstanding merits in terms of safety, cost and production. However, they constantly suffer from inadequate energy density and poor cycling stability due to the presence of zinc ions in the fully hydrated solvation state. Thus, designing the dehydrated solvation structure of zinc ions can effectively address the current drawbacks of aqueous Zn-metal batteries. In this case, considering the lack of studies focused on strategies for the dehydration of zinc ions, herein, we present a systematic and comprehensive review to deepen the understanding of zinc-ion solvation regulation. Two fundamental design principles of component regulation and pre-desolvation are summarized in terms of solvation environment formation and interfacial desolvation behavior. Subsequently, specific strategy based distinct principles are carefully discussed, including preparation methods, working mechanisms, analysis approaches and performance improvements. Finally, we present a general summary of the issues addressed using zinc-ion dehydration strategies, and four critical aspects to promote zinc-ion solvation regulation are presented as an outlook, involving updating (de)solvation theories, revealing interfacial evolution, enhancing analysis techniques and developing functional materials. We believe that this review will not only stimulate more creativity in optimizing aqueous electrolytes but also provide valuable insights into designing other battery systems.

MFPINC: prediction of plant ncRNAs based on multi-source feature fusion.

Non-coding RNAs (ncRNAs) are recognized as pivotal players in the regulation of essential physiological processes such as nutrient homeostasis, development, and stress responses in plants. Common methods for predicting ncRNAs are susceptible to significant effects of experimental conditions and computational methods, resulting in the need for significant investment of time and resources. Therefore, we constructed an ncRNA predictor(MFPINC), to predict potential ncRNA in plants which is based on the PINC tool proposed by our previous studies. Specifically, sequence features were carefully refined using variance thresholding and F-test methods, while deep features were extracted and feature fusion were performed by applying the GRU model. The comprehensive evaluation of multiple standard datasets shows that MFPINC not only achieves more comprehensive and accurate identification of gene sequences, but also significantly improves the expressive and generalization performance of the model, and MFPINC significantly outperforms the existing competing methods in ncRNA identification. In addition, it is worth mentioning that our tool can also be found on Github ( https://github.com/Zhenj-Nie/MFPINC ) the data and source code can also be downloaded for free.

From Oxygen Redox to Sulfur Redox: A Paradigm for Li-Rich Layered Cathodes.

The utilization of anionic redox chemistry provides an opportunity to further improve the energy density of Li-ion batteries, particularly for Li-rich layered oxides. However, oxygen-based hosts still suffer from unfavorable structural rearrangement, including the oxygen release and transition metal (TM)-ion migration, in association with the tenuous framework rooted in the ionicity of the TM-O bonding. An intrinsic solution, by using a sulfur-based host with strong TM-S covalency, is proposed here to buffer the lattice distortion upon the highly activating sulfur redox process, and it achieves howling success in stabilizing the host frameworks. Experimental results demonstrate the prolonged preservation of the layered sulfur lattice, especially the honeycomb superlattice, during the Li+ extraction/insertion process in contrast to the large structural degeneration in Li-rich oxides. Moreover, the Li-rich sulfide cathodes exhibited a negligible overpotential of 0.08 V and a voltage drop of 0.13 mV/cycle, while maintaining a substantial reversible capacity upon cycling. These superior electrochemical performances can be unambiguously ascribed to the much shorter trajectories of sulfur in comparison to those of oxygen revealed by molecular dynamics simulations at a large scale (∼30 nm) and a long time scale (∼300 ps) via high-dimensional neural network potentials during the delithiation process. Our findings highlight the importance of stabilizing host frameworks and establish general guidance for designing Li-rich cathodes with durable anionic redox chemistry.

Constructing An Oxyhalide Interface for 4.8†V-Tolerant High-Nickel Cathodes in All-Solid-State Lithium-Ion Batteries.

All-solid-state lithium batteries (ASSBs) have received increasing attentions as one promising candidate for the next-generation energy storage devices. Among various solid electrolytes, sulfide-based ASSBs combined with layered oxide cathodes have emerged due to the high energy density and safety performance, even at high-voltage conditions. However, the interface compatibility issues remain to be solved at the interface between the oxide cathode and sulfide electrolyte. To circumvent this issue, we propose a simple but effective approach to magic the adverse surface alkali into a uniform oxyhalide coating on LiNi0.8Co0.1Mn0.1O2 (NCM811) via a controllable gas-solid reaction. Due to the enhancement of the close contact at interface, the ASSBs exhibit improved kinetic performance across a broad temperature range, especially at the freezing point. Besides, owing to the high-voltage tolerance of the protective layer, ASSBs demonstrate excellent cyclic stability under high cutoff voltages (500 cycles~94.0 % at 4.5 V, 200 cycles~80.4 % at 4.8 V). This work provides insights into using a high voltage stable oxyhalide coating strategy to enhance the development of high energy density ASSBs.

Nonlinear error reduction for phase-shifting profilometry considering periodicity and symmetry of a phase histogram.

Phase-shifting profilometry is extensively utilized for three-dimensional (3D) measurement. However, because of gamma nonlinearity, the image intensities of the captured fringe patterns are regrettably distorted. An effective nonlinear error reduction method without requiring parameter estimation is presented in this paper. Differing from the traditional whole-period phase histogram equalization (PHE) method, our method takes into account not only the periodicity but also the symmetry of the phase histogram. Taking a three-step phase-shifting algorithm as an example, the phase error frequency triples the fringe frequency; thus, we first propose a 1/3-period PHE method. Moreover, since the phase error distribution is sinusoidal with symmetry, we further propose a 1/6-period PHE method. Simulations and experiments both indicate that the 1/6-period PHE method, compared with the whole-period PHE and 1/3-period PHE methods, can further reduce the nonlinear error.

FA-Net: A Fused Feature for Multi-Head Attention Recoding Network for Pear Leaf Nutritional Deficiency Diagnosis with Visual RGB-Image Depth and Shallow Features.

Accurate diagnosis of pear tree nutrient deficiency symptoms is vital for the timely adoption of fertilization and treatment. This study proposes a novel method on the fused feature multi-head attention recording network with image depth and shallow feature fusion for diagnosing nutrient deficiency symptoms in pear leaves. First, the shallow features of nutrient-deficient pear leaf images are extracted using manual feature extraction methods, and the depth features are extracted by the deep network model. Second, the shallow features are fused with the depth features using serial fusion. In addition, the fused features are trained using three classification algorithms, F-Net, FC-Net, and FA-Net, proposed in this paper. Finally, we compare the performance of single feature-based and fusion feature-based identification algorithms in the nutrient-deficient pear leaf diagnostic task. The best classification performance is achieved by fusing the depth features output from the ConvNeXt-Base deep network model with shallow features using the proposed FA-Net network, which improved the average accuracy by 15.34 and 10.19 percentage points, respectively, compared with the original ConvNeXt-Base model and the shallow feature-based recognition model. The result can accurately recognize pear leaf deficiency images by providing a theoretical foundation for identifying plant nutrient-deficient leaves.

Platinum Nanoparticles Loaded Graphitic Carbon Nitride Nanosheets with Enhanced Peroxidase-like Activity for H2O2 and Oxidase-Based Sensing.

Platinum nanoparticles (PtNPs) are classical peroxidase-like nanozyme; self-agglomeration of nanoparticles leads to the undesirable reduction in stability and catalytic activity. Herein, a hybrid peroxidase-like nanocatalyst consisting of PtNPs in situ growing on g-C3N4 nanosheets with enhanced peroxidase-mimic catalytic activity (PtNP@g-C3N4 nanosheets) was prepared for H2O2 and oxidase-based colorimetric assay. g-C3N4 nanosheets can be used as carriers to solve the problem of poor stability of PtNPs. We observed that the catalytic ability could be maintained for more than 90 days. PtNP@g-C3N4 nanosheets could quickly catalyze the oxidation of 3,3',5,5'-tetramethylbenzidine (TMB), and the absorbance of blue color oxidized TMB (oxTMB) showed a robust linear relationship with the concentration of H2O2 (the detection limit (LOD): 3.33 µM). By utilizing H2O2 as a mediator, this strategy can be applied to oxidase-based biomolecules (glucose, organophosphorus, and so on, that generate or consume hydrogen peroxide) sensing. As a proof of concept, a sensitive assay of cholesterol that combined PtNP@g-C3N4 nanosheets with cholesterol oxidase (ChOx) cascade catalytic reaction was constructed with an LOD of 9.35 µM in a widespread range from 10 to 800 µM (R2 = 0.9981). In addition, we also verified its ability to detect cholesterol in fetal bovine serum. These results showed application prospect of PtNP@g-C3N4 nanosheets-based colorimetry in sensing and clinical medical detection.

Sabatier Relations in Electrocatalysts Based on High-entropy Alloys with Wide-distributed d-band Centers for Li-O2 Batteries.

Li-O2 battery (LOB) is a promising "beyond Li-ion" technology with ultrahigh theoretical energy density (3457 Wh kg-1 ), while currently impeded by the sluggish cathodic kinetics of the reversible gas-solid reaction between O2 and Li2 O2 . Despite many catalysts are developed for accelerating the conversion process, the lack of design guidance for achieving high performance makes catalysts exploring aleatory. The Sabatier principle is an acknowledged theory connecting the scaling relationship with heterogeneous catalytic activity, providing a tradeoff strategy for the topmost performance. Herein, a series of catalysts with wide-distributed d-band centers (i.e., wide range of adsorption strength) are elaborately constructed via high-entropy strategy, enabling an in-depth study of the Sabatier relations in electrocatalysts for LOBs. A volcano-type correlation of d-band center and catalytic activity emerges. Both theoretical and experimental results indicate that a moderate d-band center with appropriate adsorption strength propels the catalysts up to the top. As a demonstration of concept, the LOB using FeCoNiMnPtIr as catalyst provides an exceptional energy conversion efficiency of over 80 %, and works steadily for 2000 h with a high fixed specific capacity of 4000 mAh g-1 . This work certifies the applicability of Sabatier principle as a guidance for designing advanced heterogeneous catalysts assembled in LOBs.

V2 O3 /MnS Arrays as Bifunctional Air Electrode for Long-Lasting and Flexible Rechargeable Zn-Air Batteries.

Exploring highly efficient, stable, and cost-effective bifunctional electrocatalysts is crucial for the wide commercialization of rechargeable Zn-air batteries. Herein, a vanadium-oxide-based hybrid air electrode comprising a heterostructure of V2 O3 and MnS (V2 O3 /MnS) is reported. The V2 O3 /MnS catalyst shows a decent catalytic activity that is comparable to Pt/C toward the oxygen reduction reaction and acceptable toward oxygen evolution. The extraordinary stability as well as the low cost set the V2 O3 /MnS among the best bifunctional oxygen electrocatalysts. In a demonstration of an assembled liquid-state Zn-air battery using V2 O3 /MnS as cathode, high power density (118 mW cm-2 ), specific capacity (808 mAh gZn -1 ), and energy density (970 Wh kgZn -1 ), as well as the outstanding rechargeability and durability for 4000 cycles (>1333 h, i.e., >55 days) are enabled. The V2 O3 /MnS is also integrated into an all-solid-state Zn-air battery to demonstrate its great potential as a flexible power source for next-generation electronics. Density functional theory calculations further elucidate the origin of the intrinsic activity and stability of the V2 O3 /MnS heterostructure.

Trends in guideline-adherent chemoradiation therapy for locally advanced cervical cancer before and after the affordable care act.

OBJECTIVE: To assess trends in guideline-adherent chemoradiation therapy (GA-CRT) for locally advanced cervical cancer relative to Patient Protection and Affordable Care Act (ACA) implementation. METHODS: National Cancer Database patients treated with chemoradiation for locally advanced cervical cancer (FIGO 2018 Stage IB3-IVA) from 2004 to 2016 were included. GA-CRT was defined according to NCCN guidelines and included: 1) delivery of external beam radiation, 2) brachytherapy, and 3) chemotherapy, 4) no radical hysterectomy. Logistic regression was used to determine trends in GA-CRT relative to the ACA. Survival was also estimated using Kaplan-Meier analysis. RESULTS: 37,772 patients met inclusion criteria (Pre-ACA:16,169; Post-ACA:21,673). A total of 33,116 patients had squamous cell carcinoma and 4626 patients had other histologies. Forty-five percent of patients had lymph node-positive disease. A total of 14.6% of patients had Stage I disease, 41.8% had Stage II disease, 36.4% had Stage III disease, and 7.9% had Stage IVA disease. On multivariable analysis, medicare insurance (OR 0.91; 95%CI: 0.84-0.99 compared to commercial insurance), non-squamous histology (OR 0.83; 95%CI: 0.77-0.89 for adenocarcinoma) and increasing Charlson-Deyo score were associated with decreased odds of receiving GA care. Increasing T-stage was associated with greater receipt of GA-CRT. The percentage of the population that received guideline adherent care increased post-ACA (Pre-ACA 28%; Post-ACA 34%; p < 0.001). Adherence to treatment guidelines increased 2-year survival by 15% (GA 76%; Not GA 61%; p < 0.001). Increased 2-year survival was seen in the post-ACA cohort (Pre-ACA 62%; Post-ACA 69%; p < 0.001). CONCLUSIONS: Implementation of the ACA was associated with improved GA-CRT and survival in patients with locally advanced cervical cancer.

YOLOv5s-FP: A Novel Method for In-Field Pear Detection Using a Transformer Encoder and Multi-Scale Collaboration Perception.

Precise pear detection and recognition is an essential step toward modernizing orchard management. However, due to the ubiquitous occlusion in orchards and various locations of image acquisition, the pears in the acquired images may be quite small and occluded, causing high false detection and object loss rate. In this paper, a multi-scale collaborative perception network YOLOv5s-FP (Fusion and Perception) was proposed for pear detection, which coupled local and global features. Specifically, a pear dataset with a high proportion of small and occluded pears was proposed, comprising 3680 images acquired with cameras mounted on a ground tripod and a UAV platform. The cross-stage partial (CSP) module was optimized to extract global features through a transformer encoder, which was then fused with local features by an attentional feature fusion mechanism. Subsequently, a modified path aggregation network oriented to collaboration perception of multi-scale features was proposed by incorporating a transformer encoder, the optimized CSP, and new skip connections. The quantitative results of utilizing the YOLOv5s-FP for pear detection were compared with other typical object detection networks of the YOLO series, recording the highest average precision of 96.12% with less detection time and computational cost. In qualitative experiments, the proposed network achieved superior visual performance with stronger robustness to the changes in occlusion and illumination conditions, particularly providing the ability to detect pears with different sizes in highly dense, overlapping environments and non-normal illumination areas. Therefore, the proposed YOLOv5s-FP network was practicable for detecting in-field pears in a real-time and accurate way, which could be an advantageous component of the technology for monitoring pear growth status and implementing automated harvesting in unmanned orchards.

Incidence, Mortality, and Treatment Patterns of Synchronous Lower Genital Tract Squamous Cell Carcinoma.

OBJECTIVE: The aim of the study was to define the incidence, prognosis, and treatment patterns associated with synchronous lower genital tract squamous cell carcinoma (LGTSCC) among women diagnosed with any LGTSCC. MATERIALS AND METHODS: Surveillance, Epidemiology, and End Results (SEER) database patients diagnosed with synchronous cervical, vaginal, vulvar, and/or anal SCC from 2000 to 2016 were included. Incidence and mortality were evaluated using Kaplan-Meier curves. Multivariable Cox proportional hazards regression was used to identify treatment patterns, risk factors, and mortality associated with LGTSCC. RESULTS: Among 15,424 women with LGTSCC, 138 had synchronous LGTSCC (0.89%). Vulvar and vaginal SCC was the most common combination (49.3%), and cervical with anal SCC was the least common (1.4%). Only one patient had 3 or more primary LGTSCC. Synchronous LGTSCC was independently associated with higher mortality compared with single-site LGTSCC (adjusted hazards ratio [aHR] = 1.67; p < .001). Synchronous LGTSCC was significantly associated with older age (63 vs. 58 years, p < .001) and lower stage (adjusted odds ratio [aOR] = 0.38; p < .001) and grade of disease (aOR = 0.32; p < .001). Patients with synchronous LGTSCC were more likely to receive radiation (aOR = 1.74; p = .005) and were more likely to receive adjuvant radiation after primary surgical resection compared with single-site LGTSCC (aOR = 1.88; p = .007). Receipt of any treatment including radiation (aHR = 0.85; p < .001), chemotherapy (aHR = 0.50; p < .001), and surgery (aHR = 0.70; p < .001) was independently associated with decreased mortality hazard. CONCLUSIONS: Synchronous LGTSCC is rare but is associated with increased mortality and higher rates of adjuvant radiation compared with single-site LGTSCC despite lower stage and grade at diagnosis. More research is needed to define optimal therapy for these patients.

Trends in inpatient palliative care use for primary brain malignancies.

INTRODUCTION: Primary brain malignancies (PBMs) pose significant morbidity and poor prognosis. Despite NCCN recommendations that palliative care should be integrated into general oncologic care plans, it has been historically underused in patients with PBM. We sought to examine trends and factors associated with inpatient palliative care use in patients with PBM. METHODS: Data from the 2007-2016 National (Nationwide) Inpatient Sample was analyzed for descriptive statistics and trends. Multivariable logistic regression was used to identify factors associated with inpatient palliative care in patients with PBMs. RESULTS: Of the 510,238 observed hospitalizations of adults with PBM in a 10-year period, 37,365 (7.3%) had an associated inpatient palliative care consult. Rates of inpatient palliative care have increased significantly over the 10-year period, from 2.3 in 2007 to 11.9% in 2011. Patients receiving inpatient palliative care were less likely to receive inpatient oncologic treatment such as brain surgery, chemotherapy, or radiation compared to those without palliative care (14.6% with palliative care vs. 42.4% without, p < 0.001). They were more likely to receive life-sustaining treatments such as intubation, mechanical ventilation, tracheostomy, nutritional support, hemodialysis, or CPR (21.0% with palliative care vs. 10.4% without, p < 0.001). Palliative care was associated with decreased cost of admission ($18,602 with palliative care vs. $20,077 without). In a multiple variable logistic regression, age, non-elective admission, comorbidities, history of chemotherapy and radiation, and mechanical ventilation were associated with significantly increased odds of receiving palliative care. CONCLUSIONS: Inpatient palliative care utilization for patients hospitalized with PBM significantly increased between 2007 and 2016, though the service is still underutilized in the context of the severe symptoms and poor prognosis associated with PBM.

Promoting Formation of Oxygen Vacancies in Two-Dimensional Cobalt-Doped Ceria Nanosheets for Efficient Hydrogen Evolution.

As an alternative for depleting fossil fuel energy, hydrogen economy desires low-cost and efficient hydrogen production from water splitting. In order to explore a cheap, abundant, active, and durable catalyst for the electrocatalytic hydrogen evolution reaction (HER), two-dimensional (2D) ceria nanosheets are produced through a thermal decomposition exfoliation method from CeCO3OH with a layer-stacked structure. The additional cobalt dopant promotes formation of oxygen vacancies in ceria nanosheets and, in turn, optimizes hydrogen binding/water dissociation and increases the active sites. As a result, the 2D Co-doped CeO2 nanosheets exhibit an excellent catalytic performance in alkaline HER such that the overpotential is as low as 132 and 215 mV to deliver a high current density of 100 and 500 mA cm-2, respectively, outperforming Pt. Such 2D Co-doped CeO2 nanosheets are also durable HER electrocatalysts, as the activity loss during an extended period of operation is nearly negligible.

Trends in guideline-adherent fertility-sparing surgery for early-stage cervical cancer before and after the Affordable Care Act.

OBJECTIVE: To assess trends in guideline-adherent fertility-sparing surgery (GA-FSS) for early-stage cervical cancer relative to Patient Protection and Affordable Care Act (ACA) implementation. METHODS: National Cancer Database patients treated for Stage IA1-IB1 cervical cancer from 2004 to 2016 were included. Multivariable logistic regression was used to determined trends in GA-FSS relative to the ACA and identify patient factors independently associated with GA-FSS. RESULTS: Odds of GA-FSS increased in the post- compared to pre-ACA cohort (aOR = 1.65; 95%CI: 1.34-2.03). Decreasing age, Asian/Pacific Islander race, higher education and income levels, more recent treatment year, and lower clinical stage were independently associated with increased odds of receiving GA-FSS. In the pre- and post-ACA samples, decreasing age (per 1 year age increase; pre-ACA aOR = 0.87, 95%CI:0.85-0.90; post-ACA aOR = 0.85, 95%CI:0.83-0.87), higher education level (top vs. lowest education quartile; pre-ACA aOR = 2.08, 95%CI:1.19-3.65; post-ACA aOR = 2.00, 95%CI:1.43-2.80), and lower clinical stage (stages IA2 [pre-ACA aOR = 0.19, 95%CI:0.09-0.41; post-ACA aOR = 0.29, 95%CI:0.19-0.45] and IB1 [pre-ACA aOR = 0.06, 95%CI:0.06-0.16; post-ACA aOR = 0.16, 95%CI: 0.12-0.20] relative to stage IA1) were independently associated with increased odds of GA-FSS receipt. After the ACA, Asian/Pacific Islander race (aOR = 2.81, 95%CI: 1.81-4.36) and more recent treatment year (Spearman's ρ = 0.0348, p-value = 0.008) were also independently associated with increased odds of GA-FSS receipt. When adjusted for the pre- vs. post-ACA treatment periods, Medicaid patients were less likely to undergo GA-FSS than privately-insured patients (aOR = 1.65; 95%CI:1.34-2.03). CONCLUSIONS: Patients were more likely to receive GA-FSS post-ACA. Though the proportion of publicly-insured women increased after ACA implementation, women on Medicaid remained less likely to receive GA-FSS than women with private insurance.

Radiologic Assessment of Groin Lymph Nodes in Pelvic Malignancies.

INTRODUCTION: Metastatic involvement of groin nodes can alter radiation therapy planning for pelvic tumors. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) can identify nodal metastases; however, interpretation of PET/CT-positive nodes can be complicated by non-malignant processes. We evaluated quantitative metrics as methods to identify groin metastases in patients with pelvic tumors by comparison with standard subjective interpretive criteria, with pathology as the reference standard. METHODS: We retrospectively identified patients with vulvar, vaginal, or anal cancers who underwent 18F-FDG PET/CT before pathologic evaluation of groin nodes between 2007 and 2017. Because patho-radiologic correlation was not possible for every node, one index node identified on imaging was selected for each groin. For each index node, standardized uptake value measurements, total lesion glycolysis, metabolic tumor volume, CT-based volume, and short and long axes were measured. Multivariate logistic regression was used to identify metrics predictive for pathologically positive groins and generate a probabilistic model. Area under the receiver-operating characteristic curves (AUCs) for the model were compared with clinical interpretation from the diagnostic report via a Wald's χ2 test. RESULTS: Of 55 patients identified for analysis, 75 groins had pathologic evaluation resulting in 75 index groin nodes for analysis with 35 groins pathologically positive for malignancy. Logistic regression identified mean standardized-uptake-value (50% threshold) and short-axis length as the most predictive imaging metrics for metastatic nodal involvement. The probabilistic model performed better at predicting pathologic involvement compared with standard clinical interpretation on analysis (AUC 0.91, 95% CI 0.84 to 0.97 vs 0.80, 95% CI 0.71 to 0.89; p<0.01). DISCUSSION: Accuracy of 18F-FDG PET/CT for detecting groin nodal metastases in patients with pelvic tumors may be improved with the use of quantitative metrics. Improving prediction of nodal metastases can aid with appropriate selection of patients for pathologic node evaluation and guide radiation volumes and doses.

Adaptive Data Acquisition with Energy Efficiency and Critical-Sensing Guarantee for Wireless Sensor Networks.

Due to the limited energy budget, great efforts have been made to improve energy efficiency for wireless sensor networks. The advantage of compressed sensing is that it saves energy because of its sparse sampling; however, it suffers inherent shortcomings in relation to timely data acquisition. In contrast, prediction-based approaches are able to offer timely data acquisition, but the overhead of frequent model synchronization and data sampling weakens the gain in the data reduction. The integration of compressed sensing and prediction-based approaches is one promising data acquisition scheme for the suppression of data transmission, as well as timely collection of critical data, but it is challenging to adaptively and effectively conduct appropriate switching between the two aforementioned data gathering modes. Taking into account the characteristics of data gathering modes and monitored data, this research focuses on several key issues, such as integration framework, adaptive deviation tolerance, and adaptive switching mechanism of data gathering modes. In particular, the adaptive deviation tolerance is proposed for improving the flexibility of data acquisition scheme. The adaptive switching mechanism aims at overcoming the drawbacks in the traditional method that fails to effectively react to the phenomena change unless the sampling frequency is sufficiently high. Through experiments, it is demonstrated that the proposed scheme has good flexibility and scalability, and is capable of simultaneously achieving good energy efficiency and high-quality sensing of critical events.

Treatment Patterns and Overall Survival Outcomes of Octogenarians with Muscle Invasive Cancer of the Bladder: An Analysis of the National Cancer Database.

PURPOSE: Elderly patients with muscle invasive bladder cancer can pose a therapeutic dilemma, given multiple comorbidities which may preclude surgery. In this registry based analysis we investigated treatment patterns and survival outcomes in this group of patients. MATERIALS AND METHODS: We queried the National Cancer Database for muscle invasive (cT2-T4aN0M0) bladder cancer in patients 80 years old or older who were diagnosed from 2004 to 2013. Patients included in study underwent transurethral resection of bladder tumor followed by radical cystectomy, radical cystectomy plus chemotherapy, radiation therapy alone, chemotherapy alone, chemoradiation or no treatment. We performed Kaplan-Meier, log rank and multivariate Cox proportional hazards regression and propensity score matching. RESULTS: A total of 9,270 patients were identified with a median followup of 12.8 months. Median overall survival in patients treated with radical cystectomy alone was 23.2 months (95% CI 19.8-26.6), which was superior to that of chemotherapy alone or radiation therapy alone (p <0.0001). Those treated with chemoradiation had a median overall survival of 27.3 months (95% CI 25.0-29.7), which did not statistically differ from that of radical cystectomy alone (p = 0.39). Surgery plus chemotherapy showed the longest median overall survival of 34.5 months (95% CI 22.2-46.7, vs chemoradiation and radical cystectomy alone p <0.0001). On multivariate analysis and propensity score matching the best overall survival was seen in patients treated with surgery plus chemotherapy and there was no difference in overall survival between chemoradiation and radical cystectomy alone. CONCLUSIONS: In elderly patients with muscle invasive bladder cancer chemoradiation is an alternative definitive treatment strategy with survival equal to that of surgery alone and superior to that of chemotherapy alone or radiation therapy alone. If a patient was able to receive neoadjuvant or adjuvant chemotherapy with surgery, additional survival was observed in this nonrandomized study.

Impact of concurrent versus adjuvant chemotherapy on the severity and duration of lymphopenia in glioma patients treated with radiation therapy.

Prolonged severe lymphopenia has been shown to persist beyond a year in glioma patients after radiation therapy (RT) with concurrent and adjuvant chemotherapy. This study examines the differential impact of concurrent versus adjuvant chemotherapy on lymphopenia after RT. WHO grade II-III glioma patients who received RT with concurrent and/or adjuvant chemotherapy from 2007 to 2016 were retrospectively analyzed. Concurrent chemotherapy was temozolomide (TMZ), and adjuvant chemotherapy was either TMZ or procarbazine/lomustine/vincristine (PCV). Absolute lymphocyte count (ALC) was analyzed at baseline, 1.5, 3, 6, and 12 months after the start of RT. Univariable and multivariable logistic regression were used to identify the clinical variables in predicting acute or late lymphopenia. There were 151 patients with evaluable ALC: 91 received concurrent and adjuvant TMZ (CRT + ADJ), 32 received only concurrent TMZ (CRT), and 28 received only adjuvant TMZ or PCV (ADJ). There were 9 (10%) versus 6 (19%) versus 0 (0%) cases of grade 3 lymphopenia (ALC < 500/mm3) at 6 weeks and 4 (6%) versus 0 (0%) versus 3 (17%) cases at 12 months in CRT + ADJ, CRT and ADJ groups, respectively. On multivariable analyses, concurrent chemotherapy (odds ratio [OR] 72.3, p < 0.001), female sex (OR 10.8, p < 0.001), and older age (OR 1.06, p = 0.002) were the most significant predictors for any grade ≥ 1 lymphopenia (ALC < 1000/mm3) at 1.5 months. Older age (OR 1.08, p = 0.02) and duration of adjuvant chemotherapy (OR 1.19, p = 0.003) were significantly associated with grade ≥ 1 lymphopenia at 12 months. Thus, concurrent chemotherapy appears as the dominant contributor to the severity of acute lymphopenia after RT in WHO grade II-III glioma patients, and duration of adjuvant chemotherapy appears as the key factor to prolonged lymphopenia.

Assessment of the treatment approach and survival outcomes in a modern cohort of patients with atypical teratoid rhabdoid tumors using the National Cancer Database.

BACKGROUND: Atypical teratoid rhabdoid tumors (ATRTs) are rare brain tumors that occur primarily in children under the age of 3 years. This report evaluates the treatment approach and survival outcomes in a large cohort of patients treated in the United States. METHODS: Using the National Cancer Database, the analysis included all ATRT patients aged 0 to 18 years who were diagnosed between 2004 and 2012 and had complete treatment data. RESULTS: Three hundred sixty-one ATRT patients were evaluated. The 5-year overall survival (OS) rate was 29.9%, and it was significantly lower for children who were less than 3 years old (5-year OS, 27.7%) versus those who were 3 years old or older (5-year OS, 37.5%; P < .001). The best outcome was seen for patients with localized disease who received trimodality therapy (surgery, chemotherapy, and radiation therapy [RT]) with a 5-year OS rate of 46.8%. The utilization of trimodality therapy significantly increased during the study period (27.7% in 2004-2008 vs 45.1% in 2009-2012; P < .01), largely because of the increased use of RT. In a multivariate analysis, treatment that did not utilize trimodality therapy was associated with significantly worse OS (hazard ratio, 2.52; 95% confidence interval (1.82-3.51). Children aged 0 to 2 years were significantly less likely to receive trimodality therapy because of decreased utilization of RT in this age group. CONCLUSIONS: The use of trimodality therapy significantly increased during the study period and was associated with improved outcomes. For patients with localized disease who received trimodality therapy, the OS rate at 5 years approached 50%. However, further research into the optimal management of children less than 3 years old is needed because of their significantly worse OS in comparison with older children. Cancer 2017;123:682-687. © 2016 American Cancer Society.