Observation Research Articles

The China GEO Data Center: Bringing order to open Earth-observation data

Numerous remote-sensing devices observe the Earth every day, generating large amounts of remotesensing images and metadata. The extensive Earth obser vation (EO) data made available on the Internet by different EO agencies in multiple countries pose challenges for integration, storage, access, and collaborative applications. The capacity to explore and utilize all these heterogeneous EO data from across the world is very limited. In this article, we introduce the China Group on Earth Observations (GEO) Data Center, which is devoted to the efficient integration of EO data on the Internet and opening China's EO data to the world. We describe the infrastructure of the China GEO Data Center and discuss the design and implementation of the China Global Earth Observation System of Systems (GEOSS). We demonstrate the use of the GEO discovery and access broker (DAB) to harvest the large amounts of open EO data brokered by the GEO from different agencies around the world. We describe a data model we have designed to express the relations among EO data and capture the implicit semantic knowledge in EO data through rules (a model implemented using the Apache Jena framework). Finally, we describe the mechanisms for opening China's EO data to the world.

(Invited) Some Observations on the Electrochemical Interface of Hematite in Alkaline Electrolyte during Solar Water Oxidatiob

Iron oxide, in particular a-Fe2O3 hematite has been investigated as model photoanode for solar water oxidation for many decades. We have investigated this material with soft x-ray spectroscopy methods and found some chemical changes at the surface when the material is operated as photoelectrode. The first observ ation is that the surface is sub-stoichiometric; it contains an Fe2+-enriched surface. Under anodic bias, the Fe2+ becomes converted to Fe3+ with a parabolic growth law. Also, hole doping is observed on the same samples. Additionally, the surface appears to become hydroxylated or oxy-hydroxylated. The relative abundance of the OH or OOH groups increases with increasing bias potential to the point where the water oxidation sets on. At higher potentials, the surface groups disappear gradually. In the same course, the hydrogen bonds which hold water molecules together become increased and decreased. We have also done in situ and operando experiments which show a nice parallel process of photo hole formation and delection depending on the applied bias. We are therefore able to sketch a realistic scenario of physics and chemistry going on at the surface and subsurface during water oxidation.

Neck observation versus elective neck dissection in management of clinical T1/2N0 oral squamous cell carcinoma: a retrospective study of 232 patients.

ObjectiveThe management of early-stage (cT1/2N0) oral squamous cell carcinoma (OSCC) remains a controversial issue. The aim of this study was to compare the clinical outcomes of neck observation (OBS) and elective neck dissection (END) in treating patients with cT1/2N0 OSCC.MethodsA total of 232 patients with cT1/2N0 OSCC were included in this retrospective study. Of these patients, 181 were treated with END and 51 with OBS. The survival curves of 5-year overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) rates were plotted using the Kaplan-Meier method for each group, and compared using the Log-rank test.ResultsThere was no significant difference in 5-year OS and DSS rates between END and OBS groups (OS: 89.0% vs. 88.2%, P=0.906; DSS: 92.3% vs. 92.2%, P=0.998). However, the END group had a higher 5-year RFS rate than the OBS group (90.1% vs. 76.5%, P=0.009). Patients with occult metastases in OBS group (7/51) had similar 5-year OS rate (57.1% vs. 64.1%, P=0.839) and DSS rate (71.4% vs. 74.4%, P=0.982) to those in END group (39/181). In the regional recurrence patients, the 5-year OS rate (57.1% vs. 11.1%, P=0.011) and DSS rate (71.4% vs. 22.2%, P=0.022) in OBS group (7/51) were higher than those in END group (9/181). ConclusionsThe results indicated that OBS policy could obtain the same 5-year OS and DSS as END. Under close follow-up, OBS policy may be an available treatment option for patients with clinical T1/2N0 OSCC.

Myastenia and small doses of ionizing radiation: experience of successful use of rituximab for treatment of an irradiated with myasthenia gravis

A clinical case of the rituximab («Rituksim», «Mabthera») use to treat a man affected by the Chornobyl NPP acci dent with malignant resistant form of myasthenia gravis in conjunction with chronic mixed infection by Toxoplasma, Epstein Barr virus, Cytomegalovirus and Herpes simplex virus is described. In the dynamics of two year's observa tion the clinical efficacy of monoclonal antibodies was shown as the main symptoms stabilization and reducing doses of glucocorticoid and anticholinergic therapy. The positive effect was marked in the nearest and remote peri ods. Taking to account the efficacy, safety and good tolerability of rituximab, it is advisable to recommend treat ment for people exposed to ionizing radiation and developing myasthenia associated with chronic mixed infection by Toxoplasma, Epstein Barr, Cytomegalovirus and Herpes simplex virus.

Population morbidity in the Zaporizhzhia Nuclear Power Plant observation zone as an integral part of public health

To evaluate the health status of adult population living in the Ukrainian nuclear power industry obser vation zone on the example of Zaporizhzhia Nuclear Power Plant. System review, analytic, sociological survey and statistical methods. There was established an increase in the incidence of digestive diseases among adult population in Nikopol of Dnipropetrovsk region, which is included in the Zaporizhzhia NPP observation zone. The highest increase was observed in the incidence of peptic ulcer, gastritis and duodenitis, cholecystitis and cholangitis by 340 %, 305 % and 83 %, respectively. In connection with the residence in industrially developed region and NPP life extension in Ukraine, the possible influence of harmful factors on health status of the population of observation zones, an increase in the incidence of digestive diseases among adult population, there is required continuous monitoring and detailed study of public health.

Improved overall survival with adjuvant radiotherapy for high-intermediate and high risk Stage I endometrial cancer

Background/purposeTo perform a large analysis of Stage I endometrioid-type endometrial cancer patients to determine the impact of adjuvant radiotherapy (ART) on survival. Material/methods132,976 FIGO Stage I endometrioid-type endometrial cancer patients treated surgically were identified within the National Cancer Database (NCDB) comprising Commission on Cancer facilities in the United States. Patients were categorized as observation (OBS) or ART (vaginal brachytherapy, external beam radiotherapy, or both). Univariable generalized linear mixed effects models were used to estimate the odds of receiving ART, and a multivariable frailty survival model was used to estimate the instantaneous hazard of death for those receiving OBS versus ART. Due to the presence of a significant interaction, these estimates were stratified by PORTEC-based low, low-intermediate, high-intermediate, and high risk groups. Results104,645 (79%) underwent OBS while 28,331 (21%) received ART. Of those receiving ART, 12,913 (46%) received VBT alone, 12,857 (45%) received EBRT alone, and 2561 (9%) received EBRT+VBT. On univariable analysis, increasing stage/myometrial invasion, higher grade, older age, presence of lymphovascular space invasion, and larger tumor size predicted poorer survival (all p<0.01). On multivariable analysis, patients at high-intermediate risk and high risk experienced improved survival with ART with a hazard ratio of 0.796 (95% CI: 0.731–0.867; p<0.001) and 0.783 (95% CI: 0.693–0.885; p<0.001), respectively. There was no survival benefit for ART among patients at low or low-intermediate risk. ConclusionsIn Stage I high-intermediate and high risk endometrioid-type endometrial cancer patients, ART significantly improves overall survival.

Patient- versus physician-reported facial disability in vestibular schwannoma: an international cross-sectional study.

OBJECTIVE Patient-reported outcomes are increasingly used in studies of vestibular schwannoma (VS); however, few studies have examined self-evaluated facial nerve function and its relation to physician-reported outcomes. The primary objective of this study was to compare patient self-evaluations of facial disability with physician-evaluated facial nerve status and with self-evaluations of a healthy control group. The second objective was to provide insight into the controversial subject of the optimal initial management of small- and medium-sized VSs; consequently, the authors compared patient-reported facial nerve disability following treatment via observation (OBS), Gamma Knife surgery (GKS), or microsurgery (MS). Lastly, the authors sought to identify risk factors for facial nerve dysfunction following treatment for small- and medium-sized VSs. METHODS All patients with a VS 3 cm or smaller that was singly treated with OBS, GKS, or MS at either of 2 independent treatment centers between 1998 and 2008 were retrospectively identified. Longitudinal facial nerve measures and clinical data, including facial nerve evaluation according to the House-Brackmann (HB) grading system, were extracted from existing VS databases. Supplementing the objective data were Facial Disability Index (FDI) scores, which were obtained via survey of patients a mean of 7.7 years after initial treatment. RESULTS The response rate among the 682 eligible patients was 79%; thus, data from a total of 539 patients were analyzed. One hundred forty-eight patients had been managed by OBS, 247 with GKS, and 144 with MS. Patients who underwent microsurgery had larger tumors and were younger than those who underwent OBS or GKS. Overall, facial nerve outcomes were satisfactory following treatment, with more than 90% of patients having HB Grade I function at the last clinical follow-up. Treatment was the major risk factor for facial nerve dysfunction. Almost one-fifth of the patients treated with MS had an objective decline in facial nerve function, whereas only 2% in the GKS group and 0% in the OBS cohort had a decline. The physical subscale of the FDI in the VS patients was highly associated with HB grade; however, the social/well-being subscale of the FDI was not. Thus, any social disability caused by facial palsy was not detectable by use of this questionnaire. CONCLUSIONS The majority of patients with small- and medium-sized VSs attain excellent long-term facial nerve function and low facial nerve disability regardless of treatment modality. Tumor size and microsurgical treatment are risk factors for facial nerve dysfunction and self-reported disability. The FDI questionnaire is sensitive to the physical but not the social impairment associated with facial dysfunction.

Complications and Radiographic Outcomes of Posterior Spinal Fusion and Observation in Patients Who Have Undergone Distraction-Based Treatment for Early Onset Scoliosis

Study DesignRetrospective, multicenter. ObjectivesTo compare surgical and radiographic outcomes of early-onset scoliosis (EOS) patients who had stopped lengthening for ≥2 years without additional surgery to those who had posterior spinal fusion (PSF) at the end of lengthening. Summary of Background DataBecause of the risk of significant complications with PSF in patients with EOS, “watchful waiting” at the end of lengthening has been suggested as a viable alternative. MethodsRetrospective review of the Children's Spine Study Group (CSSG) database identified all patients with the diagnosis of EOS who had distraction-based treatment, who were ≥2 years from their last distraction, and who had complete records. Radiographic measures were obtained by a single unbiased trained observer. Treatment outcomes including curve correction, height and length gain, as well as complications were recorded. ResultsThe 37 patients (21 females and 16 males) had a mean age of 7.2 years; 12 were in the observation (OBS) and 25 in the PSF group. The PSF group had a slightly greater coronal Cobb angle and maximal kyphosis at the end of distraction. Although there was some correction of the coronal Cobb angle and maximal kyphosis following PSF, the differences between the two groups were not statistically significant at final follow-up. At final follow-up, the OBS group obtained 88% of T1–T12 height and 90% of T1–L1 length of that obtained by the PSF group. Twenty-six complications occurred in 15 patients, all in the PSF group. ConclusionsObservation may be a viable alternative to PSF after distraction-based treatment in a subset of patients with EOS. PSF was found to provide no significant curve correction or gains in spine height and length compared to observation and carries a significant risk of complications. Level of EvidenceLevel III, therapeutic.

From sparse to dense functional data and beyond

Nonparametric estimation of mean and covariance functions is important in functional data analysis. We investigate the performance of local linear smoothers for both mean and covariance functions with a general weighing scheme, which includes two commonly used schemes, equal weight per observation (OBS), and equal weight per subject (SUBJ), as two special cases. We provide a comprehensive analysis of their asymptotic properties on a unified platform for all types of sampling plan, be it dense, sparse or neither. Three types of asymptotic properties are investigated in this paper: asymptotic normality, $L^{2}$ convergence and uniform convergence. The asymptotic theories are unified on two aspects: (1) the weighing scheme is very general; (2) the magnitude of the number $N_{i}$ of measurements for the $i$th subject relative to the sample size $n$ can vary freely. Based on the relative order of $N_{i}$ to $n$, functional data are partitioned into three types: non-dense, dense and ultra-dense functional data for the OBS and SUBJ schemes. These two weighing schemes are compared both theoretically and numerically. We also propose a new class of weighing schemes in terms of a mixture of the OBS and SUBJ weights, of which theoretical and numerical performances are examined and compared.

O campo das políticas culturais em Rio Grande-RS diante das mudanças propostas no Governo Lula

Resumo Este artigo discute o campo das políticas culturais de Rio Grande-RS, tomando por base as políticas para cultura articuladas pelo governo do ex-presidente Luiz Inácio Lula da Silva. Com foco no Programa Cultura Viva e no Sistema Nacional de Cultura, discutimos as implicações que essas políticas geraram e sua força no campo cultural do município. Para a realização do estudo foram utilizados os conceitos teóricometodológicos de Pierre Bourdieu. A partir dos conceitos de campo, capital, habitus e estratégia, foram identificados no campo os agentes envolvidos nas políticas culturais no município, suas relações, disputas e estratégias. O estudo é de cunho qualitativo e os elementos para análise foram obtidos por meio de pesquisa documental, observação direta e entrevistas com diferentes agentes do campo e das instituições que o compõe. Dadas as características políticas de Rio Grande nos últimos 16 anos, fica evidente a estratégia de utilização de outros atores locais para a inserção dos programas vinculados às políticas nacionais e a pequena participação da prefeitura nas políticas culturais locais. Percebe-se que as políticas do Governo Lula influenciaram o campo das políticas culturais do município, mobilizando agentes e impulsionando novas políticas. No entanto, essas políticas ainda não atingem a maioria da população, estando centradas em alguns grupos - agentes com poder no campo.

Randomized phase 3 study in low‐grade lymphoma comparing maintenance anti‐CD20 antibody with observation after induction therapy: A trial of the ECOG‐ACRIN Cancer Research Group (E1496)

In an ECOG-ACRIN Cancer Research Group study (E1496), maintenance rituximab (MR) was reported to prolong progression-free survival (PFS) in comparison with observation (OBS) alone in patients with indolent lymphoma after induction chemotherapy. Here the long-term follow-up of the same patient cohort is presented. Patients with indolent lymphoma received induction chemotherapy with cyclophosphamide, vincristine, and prednisone (CVP). Patients with stable disease or a better response were then randomized to weekly rituximab (375 mg/m(2) × 4 doses) every 6 months for 2 years (MR) or to OBS. The primary endpoint was PFS; the secondary endpoints were overall survival (OS), response rate, and toxicities. Of the 387 patients who initially received CVP induction, 158 were randomized to MR, and 153 were randomized to OBS. After a median follow-up of 11.5 years, patients on MR had longer median PFS (4.8 years) than patients on OBS (1.3 years; hazard ratio [HR], 0.49; P < .0001). However, there was no difference in OS between MR and OBS (10-year OS, 67% vs 59%; median OS, 13.5 years vs not reached; HR, 0.91; P = .69). Other than MR, only minimal residual disease after induction therapy was significantly associated with PFS on multivariate analysis (HR, 0.71; P = .02). A low initial tumor burden, minimal residual disease, follicular histology, a low Follicular Lymphoma International Prognostic Index score, and female sex were associated with longer OS. There was no increase in the rate of second primary malignancies with MR vs OBS. With long-term follow-up, MR did not influence OS. The PFS benefit was maintained. MR should be considered optional for patients with indolent B-cell lymphoma. Cancer 2016;122:2996-3004. © 2016 American Cancer Society.

Temporal changes in hematologic markers after splenectomy, splenic embolization, and observation for trauma.

The spleen is one of the most commonly injured abdominal solid organs during blunt trauma. Modern management of splenic trauma has evolved to include non-operative therapies, including observation and angioembolization to preclude splenectomy in most cases of blunt splenic injury. Despite the shift in management strategies, relatively little is known about the hematologic changes associated with these various modalities. The aim of this study was to determine if there are significant differences in hematologic characteristics over time based on the treatment modality employed following splenic trauma. We hypothesized that alterations seen in hematologic parameters would vary between observation (OBS), embolization (EMB), and splenectomy (SPL) in the setting of splenic injury. An institutional review board-approved, retrospective study of routine hematologic indices examined data between March 2000 and December 2014 at three academic trauma centers. A convenience sample of patients with splenic trauma and admission lengths of stay >96h was selected for inclusion, resulting in a representative sample of each sub-group (OBS, EMB, and SPL). Basic demographics and injury severity data (ISS) were abstracted. Platelet count, red blood cell (RBC) count and RBC indices, and white blood cell (WBC) count with differential were analyzed between the time of admission and a maximum of 1080h (45days) post-injury. Comparisons between OBS, EMB, and SPL groups were then performed using non-parametric statistical testing, with statistical significance set at p<0.05. Data from 130 patients (40 SPL, 40 EMB, and 50 OBS) were analyzed. The median age was 40years, with 67% males. Median ISS was 21.5 (21 for SPL, 19 for EMB, and 22 for OBS, p=n/s) and median Glasgow Coma Scale (GCS) was 15. Median splenic injury grade varied by interventional modality (grade 4 for SPL, 3 for EMB, and 2 for OBS, p<0.05). Inter-group comparisons demonstrated no significant differences in RBC counts. However, mean corpuscular volume (MCV) and RBC distribution width (RDW) were elevated in the SPL and EMB groups (p<0.01). Similarly, EMB and SPL groups had higher platelet counts than the OBS group (p<0.01). In aggregate, WBC counts were highest following SPL, followed by EMB and OBS (p<0.01). Similar trends were noted in neutrophil and monocyte counts (p<0.01), but not in lymphocyte counts (p=n/s). This study describes important trends and patterns among fundamental hematologic parameters following traumatic splenic injuries managed with SPL, EMB, or OBS. As expected, observed WBC counts were highest following SPL, then EMB, and finally OBS. No differences were noted in RBC count between the three groups, but RDW was significantly greater following SPL compared to EMB and OBS. We also found that MCV was highest following OBS, when compared to EMB or SPL. Finally, our data indicate that platelet counts are similarly elevated for both SPL and EMB, when compared to the OBS group. These results provide an important foundation for further research in this still relatively unexplored area.

Abstract 248: Substance Abuse is Associated with Observation Status of Patients with Heart Failure at an Urban Academic Medical Center

Background: More than 80% of patients presenting to the emergency department (ED) with acute decompensated heart failure (ADHF) are admitted and categorized as either observation (OBS) or inpatient (IP) post discharge using Interqual criteria (severity of illness and intensity of service). Identifying patient characteristics upon admission to determine OBS or IP status may optimize hospital resource utilization. Purpose: To determine patient characteristics upon admission that are associated with the categorization (OBS vs IP) for patients with ADHF presenting to the ED of an urban academic medical center. Methods: Retrospective medical record review of 172 randomly selected adult patients from 2013 who presented to the ED with ADHF. Patients had been categorized as OBS vs IP after discharge based on Interqual Criteria. Based on the literature, we identified variables traditionally associated with an admitting diagnosis for heart failure (HF) including: symptoms (shortness of breath, paroxysmal nocturnal dyspnea, orthopnea, and lower extremity edema), physiologic measures (B-type natriuretic peptide and blood pressure), and patient characteristics (number of co-morbidities, type of HF- HF with reduced ejection fraction vs HF with preserved ejection fraction, 30 day readmission rate, gender, ethnicity, and history of substance abuse within the past 12 months). Chi square tests and student t-tests were used to compare variables between groups. Results: Of the 172 ADHF patients, 76% (n=131) were categorized as IP and 24% (n=41) were OBS. The majority of patients were African American (n = 130, 75.6%), female (n = 101, 58.7%) and had HF with a reduced ejection fraction (n = 99, 57.6%). There were no significant differences between the OBS and IP groups in terms of symptoms, B-type natriuretic peptide levels, blood pressure, number of co-morbidities, type of HF, 30 day readmission rate, gender, ethnicity, or socio-demographic characteristics. A history of substance abuse was more common among the OBS group versus the IP group ( p = 0.013). Conclusions: In this single center retrospective medical record review comparing the categorization of patients presenting to the ED with ADHF as OBS vs IP, we found no difference in the traditional clinical variables between groups. However, a history of substance abuse was associated with the patient being categorized as OBS. Substance abuse may be an important non-traditional variable to consider in resource utilization.

Combination of adjuvant chemotherapy and radiotherapy is associated with improved survival at early stage type II endometrial cancer and carcinosarcoma.

The aim of this study was to describe the impact of postoperative adjuvant treatment modalities and identify risk factors associated with recurrence and survival rates in women diagnosed with early stage type II endometrial cancer and carcinosarcoma. In this retrospective study, patients diagnosed with early stage (stages I-II) carcinosarcoma and type II endometrial cancer were reviewed. All women underwent comprehensive surgical staging. Postoperative treatment options of chemotherapy (CT), radiotherapy (RT), observation (OBS) and chemotherapy-radiotherapy (CT-RT) combination were compared in terms of recurrence and survival outcome. In CT-RT treatment arm, recurrence rate was found as 12.5% and this result is significantly lower than the other treatment approaches (P = 0.01 CT alone: 33.3%, RT alone: 26.7%, OBS: 62.5%). Three-year disease free survival(DFS) rate and overall survival (OS) rate were statistically higher for the group of women treated with combination of CT-RT (92-95%) compared to the women treated with RT alone (65-72%), treated with CT alone (67-74%) and women who received no adjuvant therapy (38-45%). The multivariate analysis revealed that carcinosarcoma histology was associated with shortened DFS and OS (P = 0.001, P = 0.002). On the other hand, being at stage Ia (P = 0.01, P = 0.04) and receiving adjuvant treatment of CT-RT combination (P = 0.005, P = 0.002) appeared to lead to increased DFS and OS rates. We identified that a combination treatment of chemotherapy and radiotherapy is superior compared to other postoperative adjuvant treatment approaches concerning PFS, OS and recurrence rates in stages I-II of type II endometrial cancers and uterine carcinosarcoma.

Prognostic and Predictive Effect of TP53 Mutations in Patients with Non–Small Cell Lung Cancer from Adjuvant Cisplatin–Based Therapy Randomized Trials: A LACE-Bio Pooled Analysis

IntroductionTumor protein p53 gene (TP53) mutations are common in stage I through III non–small cell lung cancer, but clinical trials have shown inconsistent results regarding their relationship to the effects of adjuvant therapy. The objective is to clarify their putative prognostic and predictive effects. MethodsA pooled analysis of TP53 mutations (exons 5–8) was conducted in four randomized trials (the International Adjuvant Lung Cancer Trial, J BRonchus 10, Cancer and Leukemia Group B-9633, and Adjuvant Navelbine International Trialist Association trial) of platinum-based adjuvant chemotherapy (ACT) versus observation (OBS). Hazard ratios (HRs) and 95% confidence intervals (CIs) of mutant versus wild-type (WT) TP53 for overall survival (OS) and disease-free survival (DFS) were estimated using a multivariable Cox model stratified on trial and adjusted on sex, age, and clinicopathological variables. Predictive value was evaluated with an interaction between treatment and TP53. ResultsA total of 1209 patients (median follow-up 5.5 years) were included. There were 573 deaths (47%) and 653 DFS events (54%). Mutations (434 [36%]) had no prognostic effect (OBS HROS = 0.99, 95% CI: 0.77–1.28, p = 0.95; HRDFS = 0.99, 95% CI: 0.78–1.25, p = 0.92) but were marginally predictive of benefit from ACT for OS (test for interaction: OS, p = 0.06; DFS, p = 0.11). Patients with WT TP53 had a tendency toward better outcomes with ACT than did those in the OBS group (HROS = 0.77, 95% CI: 0.62–0.95, p = 0.02; HRDFS = 0.75, 95% CI: 0.62–0.92, p = 0.005). In the ACT arm, a deleterious effect of mutant versus WT TP53 was observed (HROS = 1.40, 95% CI: 1.10–1.78, p = 0.006; HRDFS = 1.31, 95% CI: 1.04–1.64, p = 0.02). ConclusionsTP53 mutation had no prognostic effect but was marginally predictive for survival from ACT. In patients who received ACT, TP53 mutation tended to be associated with shorter survival than wild-type TP53.

The ‘minute rhythm’ incidence in the ovine abomasal antrum and small intestine

Summary R omanski, K. W., 2016. The ‘minute rhythm’ incidence in the ovine abomasal antrum and small intestine. Bulg. J. Vet. Med ., 19 , No 3, 200 – 208 . To characterise further the ‘minute rhythm’, six healthy rams were equipped with serosal electrodes sewn onto the abomasal antrum and the small bowel. The experiments were performed before and after feeding. Food was o f fered during phase 2a or 2b of the migrating motility complex. The ‘minute rhythm’ incidence and coordination were assessed during four 5 - minute observ ation periods. In the duodenal bulb and duodenum, the pattern was observed more frequently than in other segments e x a mined. During phase 2b, the ‘minute rhythm’ incidence was often more frequent than during phase 2a of the migrating motility complex. Feed ing increased significantly the ‘minute rhythm’ incidence, but these alter a tions were more evident during first two observation periods. In the jejunum, duration of one ‘minute rhythm’ episode was longer than in more proximal segments. In the more distal j ejunal recording site the ‘minute rhythm’ was often absent. The pattern was well coordinated mostly in the antroduodenum and its propagation velocity was the highest also in the upper small bowel. It is co ncluded that the ‘minute rhythm’ incidence, form, a nd coordination depend ed upon the feeding cond itions, intensity of intestinal motility and the gastrointe s tinal segment.

Additional Two Cycles of Rituximab Improves the Prognosis of Low-Risk NCCN-IPI Diffuse Large B-Cell Lymphoma Patients Responded to R-CHOP Regimen

Introduction: Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous group of aggressive lymphomas with a relapse/refractory rate of 30-40% under the current standard Rituximab plus cyclophophamide, adrimycin, vincristine and prednisone (R-CHOP21) treatment. As mechanism of action, Rituximab can target the B-cell receptor (BCR) and NF-ĸB signaling pathways, of which activating gene mutations are most frequently identified in activated B-cell-like (ABC) subtype of DLBCL and associated with increased disease relapse of the patients. The aim of our study was to investigate the clinical efficacy of additional two cycles of Rituximab maintenance (RM) in DLBCL and its relation with mutational status involved in BCR/NF-ĸB cascade.Methods: We retrospectively analyzed a total of 534 de novo DLBCL patients after 6 cycles of R-CHOP21 regimen in our institution from December 1998 to December 2012. Among 413 patients achieved complete response (CR), 211 patients received additional 2 cycles of RM in a intent-to-treat manner and 202 patients underwent observation (OBS). The remaining 121 patients were primarly refractory to R-CHOP regimen. All the patients were classified according to IPI and NCCN-IPI as previously described. Immunohistochemistry for germinal center B-cell (GCB) or non-GCB subgroups were determined by Hans classification. The mutational status of BCR/NF-ĸB-associated genes (mainly as CD79A, CD79B, MYD88, and CARD11) were detected in tumor samples of 124 patients (48 cases, 43 cases and 33 cases in the RM, OBS and Refractory group, respectively).Results: No significant difference of clincial and biological characteristics were found between the RM and OBS group, including age, gender, Ann Arbor stage, ECOG score, number of extranodal involvements, serum lactic dehydrogenase level, B symptoms, IPI and NCCN-IPI risk group, and GCB/non-GCB ratio. With a median follow-up of 36.5 months, the 3-year progrssion free survival (PFS) was 79.9% and 73.6% (P=0.123), and the 3-year overall survival (OS) was 91.0% and 87.4% (P=0.149) in RM and OBS group, respectively. According to NCCN-IPI, remarkable improvement of 3-year PFS and OS was observed in low-risk patients of the RM group (100% and 100%), comparing with those of the OBS group (82.5% and 88.2%, P=0.003 and 0.027 respectively, Figure 1). Similarly, male patients with low-risk IPI could also benefit from additional 2 cycles of Rituximab with a 3-year PFS of 100% in RM vs 84.4% in OBS (P=0.006).Overall, BCR/NF-ĸB mutations were detected in 46/124 patients (37.1%), including 20/48 (41.7%), 13/43(30.2%) and 13/33 (39.4%) patients in RM, OBS and Refractory group, respectively. However, MYD88 mutations were more frequently observed in the Refractory group than in the RM/OBS group (18/33 vs 6/91, P<0.001, Table 1). Mutations are not prognostic indicators for PFS or OS in general, but interestingly, those mutation-bearing patients showed a tendency of improved disease prognosis in the RM group compared with that of the OBS group (3-year PFS 85.5% vs 70.0%, P=0.091, 3-year OS 94.7% vs 71.6%, P=0.059, Figure 2).Conclusion: Low-risk NCCI-IPI patients with DLBCL responded to R-CHOP regimen benefit from additional two cycles of RM. As a potential target of Rituximab, BCR/NF-ĸB-associated mutations reflected disease resistance to Rituximab. Whether prolonged administration of Rituximab could improve the prognosis of the patients with these mutations warrants further investigation.Table 1The distribution of BCR/NF-κB-associated mutations in patients with DLBCLMutated geneRefractory (N=33)CR (N=91)Additional 2R (N=48)Observation (N=43)P valueCD79a1 (3.0%)0 (0%)0 (0%)0.595aCD79b5 (15.1%)10 (20.8%)6 (13.9%)0.750aMYD8818 (54.5%)3 (6.0%)3 (6.9%)<0.001bCARD111 (3.0%)7 (14.0%)4 (9.3%)0.244aa: No significantly difference was found between Refractory group and CR group.b: Significantly difference was found between Refractory group and CR group (p<0.05). [Display omitted] [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Paper #7 Complications and Radiographic Outcomes of Posterior Spinal Fusion (PSF) and Observation (OB) in Patients Who Have Undergone Distraction-Based Treatment for Early Onset Scoliosis (EOS)

Paper #7 Complications and Radiographic Outcomes of Posterior Spinal Fusion (PSF) and Observation (OB) in Patients Who Have Undergone Distraction-Based Treatment for Early Onset Scoliosis (EOS)

Structure and reflection spectra of In3–x S4(111)/mono-Si and In3–x S4(111)/SiO2/mono-Si films

Singlephase, textured In 3- x S 4 (111)/Si(100), In 3- x S 4 (111)/Si(111), and In 3- x S 4 (111)/SiO 2 /Si(100) films have been grown by spray pyrolysis. The texture of the films has been shown to be independent of the orientation of the silicon substrate and the deposition temperature (450-500°C). From the reflection spectra of the In 3- xS4 deposits, their band gap has been determined to be 1.55 eV for an indirect allowed transition. The energy of direct v-c transitions has been estimated at 1.61 eV. It has been pointed out that the observa� tion of interference in specular reflection spectra allows one to determine the instant when a continuous film has been formed and assess the kinetics of its growth.

A multi-institutional study of outcomes in stage I–III uterine carcinosarcoma

ObjectiveTo evaluate the use of adjuvant therapy after primary surgery for stage I–III uterine carcinosarcoma (CS). MethodsA multi-institutional retrospective study of women with stage I–III CS was conducted. Analyses were stratified by stage (I/II and III). Patients were categorized according to adjuvant therapy: observation (OBS), radiation (RT), chemotherapy (CT) or multimodal therapy (CT+RT). Overall survival (OS) and progression-free survival (PFS) were analyzed using log-rank tests and Cox proportional hazards models. Results303 patients were identified across four institutions: 195 with stage I/II and 108 with stage III disease. In stage I/II disease, 75 (39.9%) received OBS, 33 (17.6%) CT, 37 (19.7%) RT, and 43 (22.9%) CT+RT. OBS was associated with a fourfold increased risk of death compared to CT (adjusted hazard ratio (aHR)=4.48, p=0.003). Patients receiving CT+RT had significantly improved PFS compared to those receiving CT alone (aHR=0.43, p=0.04), but no difference in OS. In the stage III cohort, 16 (15.0%) received OBS, 34 (31.8%) CT, 20 (18.7%) RT, and 37 (34.6%) CT+RT. OBS was associated with worse OS and PFS compared to CT (OS: aHR=2.46, p=0.04; PFS: aHR=2.39, p=0.03, respectively). A potential improvement in PFS was seen for those treated with CT+RT compared to CT alone, however it was not statistically significant (aHR=0.53, p=0.09). ConclusionsObservation after surgery was associated with poor outcomes in uterine CS compared to CT and RT alone. Multimodality therapy for women with stage I/II disease was associated with improved PFS compared to chemotherapy alone. Novel treatment options are needed to improve outcomes in this aggressive disease.