Optimal postoperative surveillance strategies for cancer survivors with gastric neuroendocrine carcinoma based on individual risk: a multicenter real-world cohort study.

BACKGROUND: The best follow-up strategy for cancer survivors after treatment should balance the effectiveness and cost of disease detection while detecting recurrence as early as possible. Due to the low incidence of gastric neuroendocrine carcinoma and mixed adenoneuroendocrine carcinoma [G-(MA)NEC], high-level evidence-based follow-up strategies is limited. Currently, there is a lack of consensus among clinical practice guidelines regarding the appropriate follow-up strategies for patients with resectable G-(MA)NEC. MATERIALS AND METHODS: The study included patients diagnosed with G-(MA)NEC from 21 centers in China. The random forest survival model simulated the monthly probability of recurrence to establish an optimal surveillance schedule maximizing the power of detecting recurrence at each follow-up. The power and cost-effectiveness were compared with the National Comprehensive Cancer Network, European Neuroendocrine Tumor Society, and European Society for Medical Oncology Guidelines. RESULTS: A total of 801 patients with G-(MA)NEC were included. The patients were stratified into four distinct risk groups utilizing the modified TNM staging system. The study cohort comprised 106 (13.2%), 120 (15.0%), 379 (47.3%), and 196 cases (24.5%) for modified groups IIA, IIB, IIIA, and IIIB, respectively. Based on the monthly probability of disease recurrence, the authors established four distinct follow-up strategies for each risk group. The total number of follow-ups 5 years after surgery in the four groups was 12, 12, 13, and 13 times, respectively. The risk-based follow-up strategies demonstrated improved detection efficiency compared to existing clinical guidelines. Further Markov decision-analytic models verified that the risk-based follow-up strategies were better and more cost-effective than the control strategy recommended by the guidelines. CONCLUSIONS: This study developed four different monitoring strategies based on individualized risks for patients with G-(MA)NEC, which may improve the detection power at each visit and were more economical, effective. Even though our results are limited by the biases related to the retrospective study design, we believe that, in the absence of a randomized clinical trial, our findings should be considered when recommending follow-up strategies for G-(MA)NEC.

A sponge heated by electromagnetic induction and solar energy for quick, efficient, and safe cleanup of high-viscosity crude oil spills.

Frequent oil spills have caused severe environmental and ecological damage. Effective cleanup has become a complex challenge owing to the poor flowability of viscous crude oils. The current method of solar heating to reduce the viscosity of heavy oil is only suitable during sunny days, while the use of Joule heating is limited by the risk of direct exposure to high-voltage electricity. Herein, we demonstrate a noncontact electromagnetic induction and solar dual-heating sponge for the quick, safe, and energy-saving cleanup of ultrahigh-viscosity heavy oil. The resulting sponge with magnetic, conductive, and hydrophobic properties can be rapidly heated to absorb heavy oil under alternating magnetic fields, solar irradiation, or both of these conditions. By constructing theoretical models and fitting the actual data, an in-depth analysis of induction and solar heating processes is carried out. The sponge has excellent resilience and stability, indicating its reusability, fast and continuous adsorption (16.17 g in 10 s), and large capacity (75-81 g/g, the highest value ever) for soft asphalt (a highly viscous crude oil). This work provides a new noncontact dual-heating strategy for heavy oil cleanup, in which absorbents use induction heating during an emergency and then switch to partial or full solar heating to save energy in sunny conditions. ENVIRONMENTAL IMPLICATION: Heavy oils stranded on the beach or floating on water can kill underwater plants by blocking sunlight, or trap water birds and other animals. Heavy oil also contains aromatic substances that are toxic to aquatic organisms. Although oil spills near shallow water cannot be cleaned up by fences or other machinery, an oil adsorbent can deal with this problem. However, common adsorbents cannot effectively absorb high-viscosity oils, such as heavy oil. In this paper, an induction and solar dual-heating sponge is developed for the effective cleanup of high-viscosity oil.

Sphenopalatine ganglion stimulation with one acupuncture needle for moderate-severe persistent allergic rhinitis: study protocol for a multicenter randomized controlled trial.

BACKGROUND: Allergic rhinitis is a symptomatic allergic disease of the nose that affects 10 to 20% of the global population. Chinese otolaryngologists use one acupuncture needle to stimulate the sphenopalatine ganglion because of its potential advantages for treating moderate-severe persistent allergic rhinitis compared with traditional Chinese acupuncture (verum acupuncture); however, little evidence is available to support the wide clinical use thus far. Therefore, we propose a protocol for a parallel, multicenter, assessor-blinded, randomized controlled trial to evaluate sphenopalatine ganglion stimulation with one acupuncture needle compared to verum acupuncture for treatment of moderate-severe persistent allergic rhinitis. METHODS: In the trial, 96 patients previously diagnosed with moderate-severe persistent allergic rhinitis and meeting all inclusion criteria will be allocated to one of two equal therapeutic groups by using a computer-generated randomization list. The interventional group will receive sphenopalatine ganglion stimulation with one acupuncture needle for 4 weeks (once or twice weekly, total four to eight sessions); attending physicians will decide whether the second session is required in a week by examining signs and symptoms. The control group will receive individualized verum acupuncture for 4 weeks (twice weekly, total eight sessions). Follow-up evaluations will be performed 1 month later. The primary outcome measure is the change in the total nasal symptom score from the baseline to week 4. The secondary outcome measures include onset time and duration of effectiveness in every session, change in number of days with moderate-severe persistent allergic rhinitis from the baseline to week 8, change in total immunoglobulin E level and eosinophil count in venous blood from the baseline to week 4, change in Rhinoconjunctivitis Quality of Life Questionnaire score from the baseline to week 4, and clinical waiting time. DISCUSSION: The trial should provide evidence for the benefits of sphenopalatine ganglion stimulation with one acupuncture needle for treating moderate-severe persistent allergic rhinitis, including better change in total nasal symptom score, faster onset time, longer duration of effectiveness, and shorter treatment time. TRIAL REGISTRATION: Current Controlled Trials: ISRCTN21980724 (registered on 27 March 2014).