Balance Of Factors Research Articles

A pilot study to determine the feasibility of a customized low glycemic load diet in patients with stage I-III colorectal cancer.

4643 Background: Observational evidence associates energy balance factors, particularly diet, with survival in patients with colorectal cancer (CRC). Consumption of a diet with high glycemic indices has been associated with inferior cancer-specific outcomes, but there is limited prospective evidence that alterations in dietary habits improve cancer outcomes. This was a pilot study to determine the feasibility and acceptability of following a low glycemic load (GL) diet in patients with stage I-III CRC and to assess the nutritional resources necessary to follow the diet. Methods: 18 patients with stage I-III CRC, who completed definitive cancer therapy and consumed an avg daily GL > 150 participated in a 12 week, tailored, in-person dietary intervention with a target GL of ≤102. Compliance was assessed using 24 hour telephone recalls. Acceptability of the diet was assessed using a food acceptability questionnaire, and exploratory correlative laboratories were assessed monthly. Results: 67% of patients were compliant with a low GL diet ≥ 75% of the time, over a 12 week time period. Majority of participants experienced a decrease in BMI and waist circumference, 28% experienced meaningful weight loss defined as ≥ 5%. The nutritionist spent an avg of 6.97 hours (SD 2.18) in-person and 1.58 hours (SD 0.68) by phone with each participant. In the overall group, significant decreases were seen in total cholesterol (7.2% decrease; t = -2.33, p = 0.03), VLDL (26.8% decrease; t = -2.33, p = 0.03) and triglycerides (26.6% decrease; t = -2.29; p = 0.04). All participants were satisfied with the diet; 43% were extremely satisfied. 75% of participants liked the foods they were able to eat “very much” or “extremely”. All participants felt the in-person meetings were helpful. 77% did not feel an online video could replace the in-person meetings. 62% of participants did not feel a virtual meeting (e.g skype, etc.) could replace the in- person meeting while 38% felt it could. Conclusions: Patients with stage I-III CRC are able to follow a low GL diet with an in-person dietary intervention. Significant decreases in laboratory measures confirm the efficacy of the diet in altering metabolic indices. All participants who completed the study were satisfied with the diet, the majority of whom enjoyed the foods and planned to continue to follow the diet after study completion. The majority felt in-person contact with the nutritionist was essential to their success. This study was an essential step in designing a larger scale trial to evaluate the impact of low GL diet on cancer outcomes. Clinical trial information: NCT02129218 .

Concentrations of major and trace elements in soil profiles developed over granites across a climosequence in northeastern Brazil

Soils formed from granites are distributed worldwide, therefore, studies regarding their geochemical signature on tropical soils are important to understand key processes of soil weathering and soil chemistry. This paper reports the effect of S- and I-type granitic rocks on the content and distribution of trace and major elements in soil profiles developed across a climosequence in Northeastern Brazil. In general, soils developed from I-types show greater trace and major element concentrations than those originated from S-types, due to their higher proportion of accessory and mafic minerals. Geochemical mass balance and enrichment factor data suggest that climatic effects showed a less evident effect on the distribution pattern of trace and major elements from soil profiles underlain by S-type granitic rocks. The highest enrichment factor results evidenced in soils formed on I-types are explained by the rock mineralogy, which imparts higher CEC values and proportion of clay to soils. Trace elements were less leached than major elements during chemical weathering, except for Al, Fe, and P. Geochemical mass balance showed that, regardless of the granite type, the highest depletion of trace and major elements in the pedosphere took place in the humid zones as a consequence of weathering intensity. In this zone, except for quartz, the primary minerals were altered to form secondary minerals, giving rise to kaolinitic soils. These results can be used as reference contents of trace and major elements developed from different granitic rocks in environments with tropical climate. Besides, this research sheds some light on the effect of contrasting granites and a climosequence on soil geochemistry.

Mediating Effects of Factors Influencing Career Satisfaction of Women Academicians in Higher Education

India is expected to be the largest higher - education system in the world by 2030, overtaking China and USA. With over 900 institutions as in 2017–18 and the largest youth population, it has been predicted that one in every fourth individual graduating will belong to Indian educational institutions. A deeper analysis of the All India Survey of Higher Education (AISHE, 2017–18) revealed a decline of teachers in higher education, thus making it imperative to understand the reasons for the decline, especially among women academicians. Women academicians account for 42% of total higher education teachers’ population with less than 25% at professor level and only a handful occupy the coveted post of vice-chancellor. While various individual and organizational factors may be at play, this study used structural equation modeling to comprehend the influence of career advancement in the career satisfaction of women academicians. Data were collected from 351 women academicians working in higher education institutions in Indian cities using a structured questionnaire, which showed Career Advancement as a full mediator of Career Satisfaction which in turn was influenced by Career Management Techniques and Work – Life Balance factors. Confirmatory factor analysis was used to determine convergent and discriminant validities. The fitment of the model was ascertained by evaluating structural model and the hypothesized relationships. The findings highlighted the importance of Career Advancement and its influence on Career Satisfaction. This research reiterated the need for policy makers, government, and higher education institutions to focus on ensuring a clear career path with suitable opportunities to ensure the longevity and success of women academicians.

Ultrathin PEDOT:PSS Enables Colorful and Efficient Perovskite Light-Emitting Diodes.

Recently, metal halide perovskite light‐emitting diodes (Pero‐LEDs) have achieved significant improvement in device performance, especially for external quantum efficiency (EQE). And EQE is mostly determined by internal quantum efficiency of the emitting material, charge injection balancing factor (ηc), and light extraction efficiency (LEE) of the device. Herein, an ultrathin poly(3,4‐ethylenedioxythiophene):poly(styrene sulfonate) (UT‐PEDOT:PSS) hole transporter layer is prepared by a water stripping method, and the UT‐PEDOT:PSS can enhance ηc and LEE simultaneously in Pero‐LEDs, mostly due to the improved carrier mobility, more matched energy level alignment, and reduced photon loss. More importantly, the performance enhancement from UT‐PEDOT:PSS is quite universal and applicable in different kinds of Pero‐LEDs. As a result, the EQEs of Pero‐LEDs based on 3D, quasi‐3D, and quasi‐2D perovskites obtain enhancements of 42%, 87%, and 111%, and the corresponding maximum EQE reaches 17.6%, 15.0%, and 6.8%, respectively.

Vegetation traits are accurate indicators of how do plants beat the heat in drylands: Diversity and functional traits of vegetation associated with water towers in the Sahara Desert

Abstract Water is the key determinant factor of ecosystem balance, especially in hot desert regions facing multiple climatic and edaphic constraints. In the Sahara Desert, vegetation associated to man-made mesic environments such as open-air irrigation channels and oases is little studied. In order to understand the vegetation–water relationship in xeric environments, the present study focused on estimating diversity and determining functional traits of plant communities established around water points developed near water towers in the region of Adrar (Sahara Desert of Algeria). Based on data collected from 31 phytoecological releves, spontaneous vegetation was analyzed using diversity parameters (viz. species richness, diversity, richness estimation and similarity), and plant functional traits ‘PFT’ (viz. life forms, morphological, phytogeographical and dispersal types, Grime’s and Noy-Meir’s strategies). A total of 4695 individuals belonging to 53 plant species and 23 families were collected. Rarefaction and extrapolation curves applied for all the surveys carried out indicated that the estimated species richness is projected to be 77.2 ± 10 species from 31 survey plots and it is predicted to reach up to 116 ± 30 species from 200 survey plots, which represents an increase of 119% of the observed species richness. According to the real spectrum (abundance-based data) of PFT, plant species are mainly hemicryptophytes (54.12%) and arid-actives (69.97%) that adopt various dispersal strategies including anemochores (57.68%) and barochores (36.68%). Grime’s strategies showed the predominance of competitive and stress-tolerant species (52.76%). The phytogeographical analysis revealed the dominance in the strict sense of the Tropical-Mediterranean-Saharo-Arabian element (36.59%) which adapts well to the Saharan climate. This study showed the role of water in shaping the functional characteristics of vegetation in hyper-arid regions. The functional diversity of Saharan vegetation reflects species strategies for a better exploitation of the water and guaranteeing their coexistence in hyper-arid environments.

Load Balancing at Fog Nodes using Scheduling Algorithms

Cloud Computing proves to be most predominant innovative field in the area of Information technology. Cloud is best suited for small scale to large scale businesses and personal purposes such as storing, computing, managing data & resources, running applications and many more. Due to increasing large volumes of data over cloud servers created subsequent specific issues like data maintainability, network elasticity, managing Internet of Things (I.o.T’s) devices and many more. Recent progresses in Technology are given rise to fog computing or decentralized cloud to overcome cloud server issues called fog nodes. In this paper we present a brief note on how cloud issues can overcome using fog nodes benefits along with elaboration of load balancing factor. To maintain load balancing of fog nodes no much appreciable work took place in the field of fog computing. This paper proposes a scheduler which receives the devices in to a Job Queue to be connected over cloud. To apply scheduling algorithms like F.C.F.S, S.J.F, P.S, R.R and W.R.R. over fog nodes will be discussed along with their merits & demerits. At last we try to compare the various parameters of load balancing among various scheduling algorithms. In this paper we focus on how fog nodes perform functions like considerable storages, low latency, heterogeneity, allocation & interaction with limited IoT devices and Security along with architecture cloud to fog. During allocation of IoT devices to various fog nodes we will come across a serious issues i.e load balancing on fog nodes. Our detailed study presents the comparison of above mentioned scheduling algorithms load balancing factors such as rich resources allocations & Balancing among fog nodes, Identification of devices, Authentication of fog nodes, bandwidth consumption, location awareness, response time, cost maintenances, Intrusion detection, fault forbearances and maintainability.

FACTORS AFFECTING THE PERFORMANCE OF EMPLOYEE IN WORKPLACE

The aim of the study was to dissect the undeviating effects of work-life balance, training, and rewards on employee performance. These variables were identified based on the key outcomes of employee engagement performance. The methodology consists of a thorough literature review after which a model was framed for employee performance. A survey-based empirical study with 101 respondents working in the private sector was conducted using convenience sampling. Structural Equation Model (SEM) was used to validate the model and to find the impact of work-life balance, training, and rewards on employee performance. Upon SEM analysis, the various factors to predict employee performance resulted in a significant (β = 0.726); (P < 0.001) that indicates that only the work-life balance factor is significant in predicting the dependent variable. However, the findings from this study showed training and rewards do not significantly affect the performance of the employee. The study implies that enhancing work-life balance results in employees having a healthy engagement with their work. Thereby his/ her performance also increases that contribute to the effectiveness of the organisation.

Soil and crop response to phosphorus and potassium management under conservation tillage

AbstractIn conservation tillage systems, proper fertilizer phosphorus (P) and potassium (K) management is critical to optimize yield and minimize negative environmental impacts. The objective of this study was to assess the responses of crop yield, nutrient use efficiencies, root growth, and soil test P and K levels to tillage, fertilizer placement, and fertilizer rates in a corn (Zea mays L.)–soybean [Glycine max (L.) Merr.] rotation. Experiments were conducted for 8 yr in Illinois with tillage/fertilizer placement as the main plot (no‐till/broadcast [NTBC], strip‐till/broadcast [STBC], and strip‐till/deep band [STDB]) and PK fertilizer rates as the subplot. The NTBC treatment consistently reduced yields in corn by 6.2 and 4.5% and in soybean by 3.1 and 6.1% relative to STBC and STDB, respectively. Also, NTBC had greater root length density at in‐row and between‐row positions relative to STBC and STDB. Nutrient use efficiency indices (partial nutrient balance, agronomic efficiency, and partial factor productivity) declined with increasing P and K rates but were not affected by tillage/fertilizer placement treatments. Deep banding significantly reduced soil P and K concentrations in surface layers while increasing them at the depth of application. These results underscore the reported potential for deep banding combined with strip‐till to improve conditions for nutrient uptake while reducing the risk for nutrient losses to the environment. Critical soil test P and K levels (21 mg P kg−1 and 217 mg K kg−1) were similar for P and greater for K than the current university recommendations, which highlights the need for continuous refinement of soil fertility recommendations to keep pace with changes in production technologies and yield levels.

Burnout Among United States Orthopaedic Surgery Residents

There is growing interest in the problem of burnout among physicians. Here, we examine the factors associated with burnout in orthopedic surgical training. An Internet-based anonymous survey assessing workload, work-life balance, education, and resident-specific factors such as marital status and postgraduate year was developed. The survey was distributed to United States orthopedic surgery residency directors in September 2018, and program directors were asked to forward the survey to their trainees. Multivariable analysis assessed correlations with burnout. All 161 Accreditation Council for Graduate Medical Education (ACGME)-accredited United States orthopedic surgery residency programs. Two hundred and three United States orthopedic surgery residents. Thirty-eight percent of respondents reported symptoms of burnout. Even so, the vast majority did not regret choosing a medical career (95%) or their choice of residency program (90%). Greater than half of trainees who responded reported educational debt over $200,000. Thirteen percent reported receiving verbal abuse from faculty more than rarely. On multivariable analysis, 3 factors emerged that were associated with higher burnout: working more than 80 hours per week (odds ratio [OR] 2.8; range, 1.1-7.8), use of electronic medical record more than 20 hours per week (OR 2.1; range 1.0-4.5), and receiving verbal abuse from faculty more than rarely (OR 3.7; range, 1.3-11.5). The perception of adequate nursing support was associated with lower burnout (OR 0.2; range, 0.04-0.5). More than one-third of orthopedic trainees are experiencing burnout, but most still maintain high levels of career satisfaction. The key factors strongly associated with resident burnout are modifiable. Targeted interventions related to these factors should be evaluated for their potential to reduce burnout in orthopedic surgery residents. Strategies to reduce the development of burnout have the potential to improve quality of care and decrease medical errors.

Reduced strength, poor balance and concern about falls mediate the relationship between knee pain and fall risk in older people

BackgroundPain is an independent risk factor for falling. One in two older community-dwelling people with musculoskeletal pain fall each year. This study examined physical, psychological and medical factors as potential mediators to explain the relationship between knee pain and falls.MethodsThree hundred and thirty-three community-dwelling people aged 70+ years (52% women) participated in this cohort study with a 1-year follow-up for falls. Participants completed questionnaires (medical history, general health and concern about falls) and underwent physical performance tests. Participants were classified into ‘pain’ and ‘no pain’ groups based on self-reported knee pain. Poisson Regression models were computed to determine the Relative Risk (RR) of having multiple falls and potential mediators for increased fall risk.ResultsOne hundred and eighteen (36%) participants were categorised as having knee pain. This group took more medications and had more medical conditions (P < 0.01) compared to the no pain group. The pain group had poorer balance, physical function and strength and reported increased concern about falls. Sixty one participants (20%) reported ≥2 falls, with the pain group twice as likely to experience multiple falls over the 12 month follow up (RR = 2.0, 95% confidence interval (CI) = 1.27–3.13). Concern about falls, knee extension torque and postural sway with eyes closed were identified as significant and independent mediators of fall risk, and when combined explained 23% of the relationship between knee pain and falls.ConclusionThis study has identified several medical, medication, psychological, sensorimotor, balance and mobility factors to be associated with knee pain, and found the presence of knee pain doubles the risk of multiple falls in older community living people. Alleviating knee pain, as well as addressing associated risk factors may assist in preventing falls in older people with knee pain.

Rinse, Sense, Adjust, Repeat: Biomimetic Continuous Process Water Analysis in Washing Machines Based on the Hammerhead Shark's Olfaction Hydrodynamics

Domestic household appliances (e.g., washing machines) are major factors in the anthropogenic global energy balance, which is why an efficient control of their energy and material consumption are of great importance in the future. At the same time, most of today's washing machines can be considered as “black boxes” which lack dynamic analysis techniques for an automated and optimized resource management. Following a biomimetic approach, rapid prototyping methods are combined with high‐speed videography and 2D particle tracking. In addition, preliminary work on the functional morphology and hydrodynamic characteristics of the olfactory organ of Sphyrna tudes is utilized to generate a flow channel module suitable for the implementation of diverse state‐of‐the‐art sensor technologies into innovative washing machines. The module's fluid dynamics are essentially determined by its optimized channel geometry and the fluid's inflow velocity. Future investigations will reveal whether a precise change of individual hydrodynamic parameters can solely be achieved by a variation of the inflow velocity and whether specific flow profiles can be established to allow for dynamic online analytics of multiple sensors during washing.

The Framework of Competency Facilities Manager in Pre Construction Hospital in Malaysia

This paper distinguishes was conducted on the importance of the facility mnager's competence for a complex construction project such as hospital construction. There is thus a need to study the competence of facilities managers at the level of hospital construction. Directly, the involvement of the facility manager at the construction stage can reduce the cost of operating the building. This paper study was carried out using two methods, namely questionnaire method and interview method. The study involved the construction of architects, engineers, quantity surveyors, public hospital staff and facilities managers directly involved in the construction of public hospitals in Malaysia. The data obtained were analyzed using descriptive analysis techniques, relative value index (RII) and analysis using SEM Smart PLS method. The findings found that almost all respondents felt that leadership factors, communication factors, operating and maintenance factors, human factors, property and property management factors, and business preparedness and business balance factors were factors influencing facility manager competence at the construction stage.

CBFNet: Constraint balance factor for semantic segmentation

The deep neural network model based on spatial pyramid pooling for multi-scale context information has been widely adopted in image semantic segmentation. However, this structure reduces the feature resolution during the inference process, which should be recovered by bilinear interpolation. We find that the performance of boundary location heavily depends on the interpolation operation. Assuming that the foreground object has a boundary with uneven curvature changes, it will be difficult to preserve details in the lower resolution feature map. In this case, if the model achieves near-optimal fitting, the prediction of the boundary point needs to satisfy strict constraints. But this condition is very difficult to meet for the model. For this purpose, we propose a constraint balance factor (CBF) relaxation method to improve the fitting ability of the model. The constraint balance factor is learned end-to-end by a sub-network. This sub-network can be easily embedded into a semantic segmentation network that requires interpolation without too many extra parameter increments. The experimental results illustrate that the proposed CBFNet performs well on PASCAL VOC 2012 and Cityscapes datasets.

Russian regional finances analysis and regional debt sustainability

Russian regions recovered financial stability in 2017—2019 due to high ruble commodities prices, improving tax collection and conservative expenditures and borrowings policy. Panel data analysis shows that social-demographic structure of population is one of the key factors of regional budgets balance. Government measures will contribute to sustainability of regional finances and reducing interregional differences in debt sustainability, but provide negative impact of regional fiscal policy on output dynamics in the coming years. Strengthening of fiscal burden via federal taxes will diminish procyclicality of regional budgets revenues, but require a return of full profit tax rate on regional level for compensating lost incomes. For improving borrowing conditions Bank of Russia and regional governments must develop placement of bonds with floating rates, indexed and amortized nominal.

MicroRNA exporter HuR clears the internalized pathogens by promoting pro‐inflammatory response in infected macrophages

HuR is a miRNA derepressor protein that can act as miRNA sponge for specific miRNAs to negate their action on target mRNAs. Here we have identified how HuR, by inducing extracellular vesicles‐mediated export of miRNAs, ensures robust derepression of miRNA‐repressed cytokines essential for strong pro‐inflammatory response in activated mammalian macrophages. Leishmania donovani, the causative agent of visceral leishmaniasis, on the contrary alters immune response of the host macrophage by a variety of complex mechanisms to promote anti‐inflammatory response essential for the survival of the parasite. We have found that during Leishmania infection, the pathogen targets HuR to promote onset of anti‐inflammatory response in mammalian macrophages. In infected macrophages, Leishmania also upregulate protein phosphatase 2A that acts on Ago2 protein to keep it in dephosphorylated and miRNA‐associated form. This causes robust repression of the miRNA‐targeted pro‐inflammatory cytokines to establish an anti‐inflammatory response in infected macrophages. HuR has an inhibitory effect on protein phosphatase 2A expression, and mathematical modelling of macrophage activation process supports antagonistic miRNA‐modulatory roles of HuR and protein phosphatase 2A which mutually balances immune response in macrophage by targeting miRNA function. Supporting this model, ectopic expression of the protein HuR and simultaneous inhibition of protein phosphatase 2A induce strong pro‐inflammatory response in the host macrophage to prevent the virulent antimonial drug‐sensitive or drug‐resistant form of L. donovani infection. Thus, HuR can act as a balancing factor of immune responses to curtail the macrophage infection process by the protozoan parasite.

Readiness to engage in assertive responding, self-protective dating behaviors, and sexual communication: A transtheoretical model-based analysis of college women

Objective: Most sexual assault prevention approaches are universal in nature. The present study evaluated a Transtheoretical Model (TTM)–based Stages of Change (SOC) measure assessing readiness to utilize sexual assault risk reduction skills. The measure was evaluated with regard to Decisional Balance and Self-Efficacy. Participants: Survey data were collected from 300 college women (M age=18.5, SD = 0.79). Methods: Three SOC measures were developed and evaluated for using: 1) assertive responding; 2) self-protective dating behaviors; and 3) open sexual communication. Item development was followed by exploratory, confirmatory, and external validation analyses. Results: Exploratory Factor Analysis (EFA) indicated two, six-item factors (Positive Outcomes α=.91; Negative Outcomes α=.85) for Decisional Balance. Confirmatory Factor Analyses (CFA) supported a two-factor correlated model, χ2(66)=2101.70, p<.001, CFI=.946, RMSEA=.083. For Self-Efficacy, EFA indicated one, six-item factor (α=.81). Conclusions: These readiness assessments may guide understanding of factors influencing sexual assault risk reduction program outcomes and aid in tailoring program content.

GWO‐C: Grey wolf optimizer‐based clustering scheme for WSNs

SummaryA wireless sensor network (WSN) is a prominent technology that could assist in the fourth industrial revolution. Sensor nodes present in the WSNs are functioned by a battery. It is impossible to recharge or replace the battery, hence energy is the most important resource of WSNs. Many techniques have been devised and used over the years to conserve this scarce resource of WSNs. Clustering has turned out to be one of the most efficient methods for this purpose. This paper intends to propose an efficient technique for election of cluster heads in WSNs to increase the network lifespan. For the achievement of this task, grey wolf optimizer (GWO) has been employed. In this paper, the general GWO has been modified to cater to the specific purpose of cluster head selection in WSNs. The objective function for the proposed formulation considers average intra‐cluster distance, sink distance, residual energy, and CH balancing factor. The simulations are carried out in diverse conditions. On comparison of the proposed protocol, ie, GWO‐C protocol with some well‐known clustering protocols, the obtained results prove that the proposed protocol outperforms with respect to the consumption of the energy, throughput, and the lifespan of the network. The proposed protocol forms energy‐efficient and scalable clusters.

Dangerous food. Climate change induced elevated heavy metal levels in Younger Stone Age seafood in northern Norway

Stable isotope and elemental analyses of the Atlantic cod (Gadus morhua) and harp seal (Phoca groenlandica) bone component of the marine food that dominated the Younger Stone Age (c. 6.1–3.5 ka BP) diet in Varanger, Arctic northern Norway, indicate, at times, climate change induced highly elevated levels of the heavy metals cadmium (Cd) and lead (Pb), and elevated levels of mercury (Hg). On average, the levels of cadmium and lead contamination in cod were up to 22 and 3–4 times, respectively, higher than today's recommended limits in soft tissue. The corresponding figures for seal were 15 and 3–4 times, respectively. The levels of Hg were generally below today's recommended limit in soft tissue, but still of considerable magnitude, almost similar to the measured values in modern fish in the Arctic. This shows that marine food in the Younger Stone Age was unhealthy, if not unsafe. We discuss this unexpected knock-on effect in terms of sea surface temperatures and sea level change. The elevated values may have been detrimental for humans, if not for society; a balancing factor may have been a larger component of terrestrial resources than previously assumed. Concomitantly, this contribution to the paleo base-line record of toxicity may lead to predictions for seafood contamination in the future.

Postoperative Chemotherapy for Thoracic Pathological T3N0M0 Esophageal Squamous Cell Carcinoma.

The role of postoperative chemotherapy (POCT) in pathologic T3N0M0 thoracic esophageal squamous cell carcinoma (TESCC) has not been well addressed. The purpose of this study was to investigate the impact of postoperative adjuvant chemotherapy on survival, recurrence, and toxicities in pathologic T3N0M0 TESCC. This study included 582 patients with pT3N0M0 TESCC who were treated at Sichuan Cancer Hospital from January 2009 to December 2017. The patients were divided into two groups: surgery plus postoperative chemotherapy group (S + POCT), and surgery group (S group). Propensity score matching was used to create patient groups that were balanced across several covariates (n = 236 in each group). Outcome measures included overall survival (OS) and disease-free survival (DFS). After PSM, both groups have balance factors. S + POCT have significantly improved the 5-year OS and DFS (OS, 70.8% vs. 52.8%, p <0.0001; DFS, 66.5% vs. 50.2%, p < 0.0001). Multivariate Cox analyses in the matched samples revealed that S + POCT were independently associated with longer OS (hazard ratio (HR) = 0.56, 95% confidence index (CI) 0.41-0.77, p < 0.0001) and longer DFS (HR = 0.60, 95% CI 0.45-0.82, p = 0.001) than surgery alone. Subgroup analyses showed that prognostic effect of POCT was significantly influenced by the number of resected lymph node (≤ 20) and pStage IIB but not influenced by the number of node > 20 and pStage IIA. Postoperative adjuvant chemotherapy is strongly associated with improved OS and DFS in patients with pT3N0M0 TESCC. A multicenter, randomized, phase III clinical trial is warranted to confirm these findings.

Differences In Starting Pay For Male And Female Physicians Persist; Explanations For The Gender Gap Remain Elusive.

A large literature has documented differences in salary between male and female physicians. While few observers doubt that women earn less, on average, than men do, the extent to which certain factors contribute to the salary difference remains a topic of considerable debate. Using ordinary least squares regression and Oaxaca-Blinder decomposition models for new physicians who accepted positions in patient care for the years 1999-2017, we examined how the gender gap in total starting pay evolved and the extent to which preferences in work-life balance factors affect the gap. We found that the physician earnings gap between men and women persisted over the study period. Interestingly, despite important gender differences in preferences for control over work-life balance, such factors had virtually no ability to explain the gender difference in salary. The implication is that there remain unmeasured factors that result in a large pay gap between men and women.