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Background: Using a previously unreported Peruvian registry of patients treated for early-stage non-small cell lung cancer (NSCLC), this study explored whether wedge resection and lobectomy were equivalent regarding survival and impact on radiologic-pathologic variables. Methods: This observational, analytical, longitudinal study used propensity score-matched (PSM) analysis of a single-center retrospective registry of 2,570 patients with pathologic stage I-II NSCLC who were treated with wedge resection (n=1,845) or lobectomy (n=725) during 2000-2020. After PSM, 650 cases were analyzed (resection, n=325; lobectomy, n=325) through preoperative and clinical variables, including patients with ≥1 lymph node removed. Kaplan-Meier curves and multivariable Cox proportional hazard models were created for 5-year overall survival (OS), disease-free survival (DFS), and locoregional-recurrence-free survival (LRFS). Results: The principal complication was operative pain persisting >7 days for lobectomy versus wedge resection (58% vs. 23%, p=0.034) and shorter hospital stays for resection than for lobectomy (5.3 days vs. 12.8 days, p=0.009). The 5-year OS (84.3% vs. 81.2%, p=0.09) and DFS (79.1% vs. 74.1%, p=0.07) were similar and statistically insignificant between resections and lobectomies, respectively. LRFS was worse overall following wedge resection than lobectomy (79.8% vs. 91.1%, p<0.02). Nevertheless, in the PSM analysis, both groups experienced similar LRFS when the resection margin was >10 mm (90.9% vs. 87.3%, p<0.048) and ≥4 lymph nodes were removed (82.8% vs. 79.1%, p<0.011). Conclusion: Both techniques led to similar OS and DFS at 5 years; however, successful LRFS required a wedge resection with a surgical margin and adequate lymph node removal to obtain outcomes similar to lobectomy.
ABSTRACT
Systemic lupus erythematosus (SLE) is an autoimmune disease that presents a broad spectrum of clinical manifestations. Alveolar hemorrhage in SLE is rare and has a poor prognosis. We present the case of a patient with a diagnosis of SLE and lupus nephropathy on hemodialysis who presented criteria for alveolar hemorrhage with unilateral involvement, with clinical improvement after the administration of steroid boluses. The uncommon presentation of unilateral pulmonary involvement and the importance of making an adequate protocol for ruling out differential diagnoses are highlighted.
ABSTRACT
The Colombian sugarcane industry yields significant residues, categorized as agricultural and industrial. While bagasse, a widely studied industrial residue, is employed for energy recovery through combustion, agricultural residues are often left in fields. This study assesses the combustion behavior of these residues in typical collection scenarios. Additionally, it encompasses the characterization of residues from genetically modified sugarcane varieties in Colombia, potentially exhibiting distinct properties not previously documented. Non-isothermal thermogravimetrical analysis was employed to study the thermal behavior of sugarcane industrial residues (bagasse and pith) alongside agricultural residues from two different sugarcane varieties. This facilitated the determination of combustion reactivity through characteristic combustion process temperatures and technical parameters like ignition and combustion indexes. Proximate, elemental, and biochemical analyses revealed slight compositional differences. Agricultural residues demonstrated higher ash content (up to 34%) due to foreign matter adhering during harvesting, as well as soil and mud attachment during collection. Lignin content also varied, being lower for bagasse and pith, attributed to the juice extraction and milling processes that remove soluble lignin. Thermogravimetric analysis unveiled a two-stage burning process in all samples: devolatilization and char formation (~170°C), followed by char combustion (~310°C). Characteristic temperatures displayed subtle differences, with agricultural residues exhibiting lower temperatures and decomposition rates, resulting in reduced ignition and combustion indexes. This indicates heightened combustion reactivity in industrial residues, attributed to their elevated oxygen percentage, leading to more reactive functional groups and greater combustion stability compared to agricultural residues. This information is pertinent for optimizing sugarcane residues utilization in energy applications.
Weather in collection time affects composition of sugarcane agricultural residues.Combustion of sugarcane residues occurs over similar temperature ranges.Industrial residues are more reactive to combustion than agricultural residues.Overall thermal behavior of sugarcane residues depends on their composition.
Subject(s)
Lignin , Saccharum , Temperature , Oxygen , BiomassABSTRACT
Wet coal beneficiation in Colombia is prohibitive due to the high cost and scarcity of commonly used dense media. The practical value of this study is that it demonstrates for the first time that a common fertilizer, calcium nitrate, can be used in the beneficiation of low-grade Colombian coals. Three high-ash low-grade Colombian coals (Valle, Cundinamarca, and Antioquia) commonly used in Colombian sugar mill stoker furnaces were tested. Coal mineralogy and prevalence were analyzed before and after washing using mineral liberation analysis. The swelling potential of the coals was assessed using a novel application of thermal mechanical analysis (TMA) and an ash fusion oven (AFO). Calcium nitrate reduced ash levels across all size fractions, even for high-ash coals like Valle (29% to below 7%) to acceptable levels for coke manufacturing or pulverized fuel combustion. The novel use of TMA and AFO to analyze coal swelling demonstrated that swelling varies under constrained and unconstrained conditions and the small sample size allows for rapid testing of coal swelling. This study has demonstrated that the use of common fertilizers can allow beneficiation to become a processing option for low-grade coals in Official Development Assistance countries where conventional dense media is prohibitively expensive.
ABSTRACT
Is vision necessary for the development of the categorical organization of the Ventral Occipito-Temporal Cortex (VOTC)? We used fMRI to characterize VOTC responses to eight categories presented acoustically in sighted and early blind individuals, and visually in a separate sighted group. We observed that VOTC reliably encodes sound categories in sighted and blind people using a representational structure and connectivity partially similar to the one found in vision. Sound categories were, however, more reliably encoded in the blind than the sighted group, using a representational format closer to the one found in vision. Crucially, VOTC in blind represents the categorical membership of sounds rather than their acoustic features. Our results suggest that sounds trigger categorical responses in the VOTC of congenitally blind and sighted people that partially match the topography and functional profile of the visual response, despite qualitative nuances in the categorical organization of VOTC between modalities and groups.
The world is full of rich and dynamic visual information. To avoid information overload, the human brain groups inputs into categories such as faces, houses, or tools. A part of the brain called the ventral occipito-temporal cortex (VOTC) helps categorize visual information. Specific parts of the VOTC prefer different types of visual input; for example, one part may tend to respond more to faces, whilst another may prefer houses. However, it is not clear how the VOTC characterizes information. One idea is that similarities between certain types of visual information may drive how information is organized in the VOTC. For example, looking at faces requires using central vision, while looking at houses requires using peripheral vision. Furthermore, all faces have a roundish shape while houses tend to have a more rectangular shape. Another possibility, however, is that the categorization of different inputs cannot be explained just by vision, and is also be driven by higher-level aspects of each category. For instance, how humans use or interact with something may also influence how an input is categorized. If categories are established depending (at least partially) on these higher-level aspects, rather than purely through visual likeness, it is likely that the VOTC would respond similarly to both sounds and images representing these categories. Now, Mattioni et al. have tested how individuals with and without sight respond to eight different categories of information to find out whether or not categorization is driven purely by visual likeness. Each category was presented to participants using sounds while measuring their brain activity. In addition, a group of participants who could see were also presented with the categories visually. Mattioni et al. then compared what happened in the VOTC of the three groups sighted people presented with sounds, blind people presented with sounds, and sighted people presented with images in response to each category. The experiment revealed that the VOTC organizes both auditory and visual information in a similar way. However, there were more similarities between the way blind people categorized auditory information and how sighted people categorized visual information than between how sighted people categorized each type of input. Mattioni et al. also found that the region of the VOTC that responds to inanimate objects massively overlapped across the three groups, whereas the part of the VOTC that responds to living things was more variable. These findings suggest that the way that the VOTC organizes information is, at least partly, independent from vision. The experiments also provide some information about how the brain reorganizes in people who are born blind. Further studies may reveal how differences in the VOTC of people with and without sight affect regions typically associated with auditory categorization, and potentially explain how the brain reorganizes in people who become blind later in life.
Subject(s)
Auditory Perception , Blindness/physiopathology , Occipital Lobe/physiopathology , Temporal Lobe/physiopathology , Acoustic Stimulation , Case-Control Studies , HumansABSTRACT
BACKGROUND: The prevalence of psychological disorders in bariatric surgery candidates is well established, where anxiety and depression are commonly observed. Depression prevalence and evolution after gastric bypass, and its impact on weight loss, have been less explored, especially among low-income patients. METHODS: A retrospective study with low-income patients undergoing bariatric surgery from 2015 to 2016. A comparative analysis of preoperative depression (the Beck Depression Inventory II) was performed and compared at 6 and 12 months. A demographic and weight loss analysis was also performed. RESULTS: Seventy-three patients were included. Female sex comprised 76.7% of cases, and baseline depression was present in 45.2%, being severe in 2.7%. The analysis at 6 months showed Beck's score improvement (12.3 baseline vs. 4.2 points at 6 months, p = 0.006), as well as for individual items (excepting irritability). At 12 months, the mean score was 5 points, without difference vs. 6 months. At 6 and 12 months, depression (any degree) was present in 9.6 and 8.6%, corresponding to percentage change rates of - 65.8 and - 59.3%. Only one patient (2.7%) presented severe depression. Depression status before surgery had no influence in weight loss amount at 12 months. CONCLUSION: Almost half of bariatric surgery candidates have some degree of depression that improves dramatically soon after bariatric surgery. Such change continues stable during the first year. Improvement was independent of gender, and depression has no influence on weight loss. In low-income bariatric patients, depression is lower than reports from developed countries, but similar improvement has been observed.
Subject(s)
Bariatric Surgery/statistics & numerical data , Depression , Obesity, Morbid , Depression/complications , Depression/epidemiology , Female , Humans , Male , Obesity, Morbid/complications , Obesity, Morbid/epidemiology , Obesity, Morbid/surgery , Psychiatric Status Rating Scales , Retrospective StudiesABSTRACT
Es urgente recopilar las sabidurías y tradiciones que son parte sustancial de la identidad nacional y cultural de una nación. La idea de realizar el presente estudio es para generar información sobre la flora útil de Chinandega y del país, debido a que no se tienen datos del uso que le dan a las plantas los pobladores de la comunidad San Benito # 1 ubicada en el municipio de Chinandega, departamento de Chinandega Nicaragua. Esto se debe a que no se han hecho estudios florísticos en esta comunidad. El presente estudio tiene como propósito conocer y determinar, mediante el trabajo de campo y la información brindada por los pobladores que habitan en la zona, el uso que estos le dan a las plantas existentes en la comunidad de San Benito #1.