Stage IV Research Articles

Effect of elemental sulfur on anaerobic ammonia oxidation: Performance and mechanism

Biological nitrogen removal processes provide effective means to mitigate nitrogen-related issues in wastewater treatment. Previous studies have highlighted the collaborative efficiency between sulfur autotrophic denitrification and Anammox processes. However, the trigger point induced the combination of nitrogen and sulfur metabolism is unclear. In this study, elemental sulfur (S0) was introduced to Anammox system to figure out the performance and mechanism of S0-mediated autotrophic denitrification and Anammox (S0SAD-A) systems. The results showed that the nitrogen removal performance of the Anammox reactor decreased with the increasing concentrations of NH4+-N and NO2−-N in influent, denitrification occurred when NH4+-N concentration reached 100 mg/L. At stage ⅳ (150 mg/L NH4+-N), the total nitrogen removal efficiency in S0SAD-A system (95.99%) was significantly higher than that in the Anammox system (77.22%). Throughout a hydraulic retention time, the consumption rate of NH4+-N in S0SAD-A was faster than that in Anammox reactor. And there existed a nitrate-concentration peak in S0SAD-A system. Metagenomic sequencing was performed to reveal functional microbes as well as key genes involved in sulfur and nitrogen metabolism. The results showed that the introduction of S0 elevated the abundance of Ca. Brocadia. Moreover, the relative abundance of Anammox genes, such as hao, hzsA and hzsC were also stimulated by sulfur. Notably, unclassified members in Rhodocyclaceae acted as the primary contributor to key genes involved in the sulfur metabolism. Overall, the interactions between Anammox and denitrification were stimulated by sulfur metabolism. Our study shed light on the potential significance of Rhodocyclaceae members in the S0SAD-A process and disclosed the relationship between anammox and denitrification.

Results of Cementless Total Hip Arthroplasty in Patients Below 50 Years for Ficat and Arlet Stage Iii and Iv Avascular Necrosis of The Femoral Head

Results of Cementless Total Hip Arthroplasty in Patients Below 50 Years for Ficat and Arlet Stage Iii and Iv Avascular Necrosis of The Femoral Head

Impact of type 2 diabetes mellitus on short-term and long-term outcomes of stage iv colorectal cancer patients after primary surgery: a propensity score matching analysis.

This study aims to investigate the influence of type 2 diabetes mellitus (T2DM) on stage IV colorectal cancer (CRC) patients performed primary surgery in terms of short-term and long-term outcomes. Patients diagnosed with stage IV CRC and received primary CRC surgery at a single clinical center from Jan, 2013 to Jan, 2020 were included in this study. Baseline characteristics, short-term and long-term outcomes were compared between the T2DM group and the Non-T2DM group. Univariate and multivariate analysis were used to find risk factors for overall survival (OS). Propensity score matching (PSM) using a 1:1 ratio was used to minimize selective bias between the two groups. Statistical analysis was performed using SPSS (version 22.0) software. A total of 302 eligible patients were enrolled, and there were 54 (17.9%) patients with T2DM, and 248 (82.1%) patients without T2DM. The T2DM group had more older patients (P < 0.01), higher body mass index (BMI) (P < 0.01), and a higher proportion of hypertension (P < 0.01) than the Non-T2DM group. After PSM, there were 48 patients in each group. There were no significant differences in short-term outcomes or OS between the two groups, either before or after PSM (P > 0.05). In multivariate analysis, older age (P < 0.01, HR = 1.032, 95% CI = 1.014-1.051) and larger tumor size (P < 0.01, HR = 1.760, 95% CI = 1.179-2.626) were independent factors for OS. Although T2DM did not influence short-term outcomes or OS in stage IV CRC patients after primary surgery, age and tumor size might have predictive value for OS.

Carboplatin and Paclitaxel as an Initial Treatment in Patients with Stage IV A &amp; IVb Cervical Cancer: A Report of 16 Cases and a Review of the Literature

Objective: Ca Cervix in 2nd most common malignancy in India and worldwide. NACT is not standard treatment in Advanced Ca Cervix. In this study we try to see the response rate of P+C NACT and to see if patients are able to complete definitive RT in advanced CA Cervix pt. Stage IVA and IV B post NACT. Methods: Am bidirectional study to see the demographic profile and treatment response when patients receive P+C NACT. We reviewed the demographic data and treatment details of patients who has received NACT for advanced Ca Cervix from our prospectively maintained database from 2019 till 2022.&#x0D; Results: Out of 386 number of registered pt. Of ca cervix , 156 number of patients were of advanced ca cervix malignancy registered in this time period 17number of pt. Received NACT with P+C , median age of these patients was 52.2( 39-71yrs ) 16% of patients who were planned for NACT received 3.number of cycles. Overall, the treatment of PC was well tolerated. The overall response rate was 75%.(2 complete response, 10 partial response). Although grade 3-4 hematologic toxicities were observed in 4 out of 16 patients (25%), 3 patients experienced grade 3-4 non-hematologic toxicities,2 neurotoxity ,1 nephrotoxicity. Out of 14 ,who completed NACT and underwent definitive CRT , 8 (57.14 %) achieved complete response&#x0D; Conclusion: PC is having response and efficacy and well tolerated in patients FIGO stage IVa &amp; IVb cervical cancer. This combination can be considered as an initial treatment regimen in locally advanced cervical cancer patient population.&#x0D; Key Words: Cervical cancer, Neoadjuvant chemotherapy (NACT), Paclitaxel (P) and cisplatin (C)

Clinical characteristics and treatment outcome of patients with advanced non-small-cell lung cancer (NSCLC) and FGFR fusions.

e21139 Background: Activating FGFR fusions are targetable genetic alterations in several solid tumours and hematologic malignancies, but little is known about their frequency in advanced NSCLC patients (pts). Furthermore, clinical characteristics and treatment outcome in NSCLC have not been sufficiently identified yet. Methods: Within Network Genomic Medicine (NGM), we screened advanced NSCLC pts without targetable mutations for genetic fusions using RNA-NGS (ArcherDx FusionPlex) and analysed fusion frequencies, patient characteristics and clinical courses. Results: From 01/2019 to 09/2022, we screened a total of 3309 NSCLC pts. We found 37 pts (1.1%) with FGFR activating fusions. Of these patients, 26 cases had squamous cell carcinoma (70.3%), 10 cases adenocarcinoma (27%), one patient had sarcomatoid differentiation (2.7%). The most common FGFR fusion was FGFR3-TACC3 with 21 cases (56.8%). All patients had UICC stage IIIB or IV at time of diagnosis: 13 were females (35.1%), 24 were males (64.9%); median age at first diagnosis was 69 years (range 36-91), 27 pts were former smokers (72.9%), 8 pts were current smokers (21.6%) and only one patient was a never smoker (2.7%). Co-occurring mutations were identified in 30 pts (81.1%): TP53 co-mutations were the most frequent co-mutation with 27 cases (72.9%), two cases had KEAP1 (5.4%), one case harboured either PTEN (2.7%), PIK3CA (2.7%) or MAP2K1 (2.7%). One patient harboured FGFR2 S587C co-mutation (2.7%). From 37 identified patients, 34 were available for follow-up. The median overall survival (mOS) was 24.87 months (95% confidence interval [CI]: 11.57–38.17). We counted 26 pts who received immunotherapy (either as monotherapy or chemoimmunotherapy) with a mOS of 26.44 months (95% CI: 20.23–32.66) comparing to the median OS of 9.5 months for patients (n = 8) with no immunotherapy (95% CI: 0.0–22.58) (p = 0.037). For three patients there was no information regarding therapy regimen obtainable. Six pts (16.21%) received targeted therapy (Erdafitinib/Rogaratinib) with no improved mOS compared to standard therapy (p = 0.026). Patients with TP53 mutation had longer mOS than pts with TP53 wild type (WT) (mOS 26.45 months [95% CI: 20.06–32.83] vs 9.24 months [95% CI: 1.43–17.06] [p = 0.031]). Conclusions: Activating FGFR fusions in NSCLC are rare events. The majority of patients are elder males with smoking history and predominantly squamous histology. The most frequent co-mutation is TP53 with prolonged OS comparing to TP53 WT patients. In contrast to other NSCLC with targebatle driver mutations, patients with FGFR fusion seem to benefit from immunotherapy, if added to their treatment. Targeted therapy is beneficial, but sufficient long-term data are currently missing.

Diagnóstico de desnutrición y su relación con el pronóstico en el paciente hospitalizado con enfermedad oncológica

IntroductionMedical oncology inpatients are at a very high risk of malnutrition, and the presence of complications associated with malnutrition is significant in their evolution. It is necessary to have adequate tools in the diagnosis of malnutrition. ObjectivesThis study is aimed to assess the nutritional status of cancer inpatients and compare the incidence of complications based on the nutritional diagnosis with different tools. Material and methodsAn observational, longitudinal, and retrospective study was designed on 149 patients admitted to the Oncology Service who were requested nutritional and medical treatment between January 2014 and June 2017. Epidemiological, clinical, anthropometric, and nutritional data were collected. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), the Malnutrition Universal Screening Tool (MUST), and the Global Leadership Initiative on Malnutrition (GLIM) criteria. ResultsThe age of the patients was 61.61 (15.96) years and 67.8% of the patients were men. Most of the patients were in advanced tumor stages (stage iii, 15.3%; stage iv,77.1%). The median of the MUST was 2 (0-3) (high risk: 83, 55.7%). The median MNA was 17 (14-20) (poor nutritional status: 65, 43.6%; risk of malnutrition: 71, 47.7%). According to the GLIM criteria, 115 (77.2%) had malnutrition, and 97 (65.1%) had severe malnutrition. According to MNA, an increase in mortality was observed (<17: 24.6% vs. >17: 7.9%; P<0.01). Multivariate analysis showed that poor nutritional status measured with MNA is related to an increased probability of mortality regardless of the stage of the disease and the patient's age (OR: 4.19, 95%CI: 1.41-12.47, P=0.02). ConclusionsMalnutrition among cancer patients in whom a nutritional assessment is requested during admission is very high. In hospitalized patients with oncological pathology, it was observed that malnutrition measured by MNA acts as a mortality risk factor.

Responses of maize hybrids to water stress conditions at different developmental stages: accumulation of reactive oxygen species, activity of enzymatic antioxidants and degradation in kernel quality traits.

Sustainable maize production under changing climatic conditions, especially heat and water stress conditions is one of the key challenges that need to be addressed immediately. The current field study was designed to evaluate the impact of water stress on morpho-physiological, biochemical, reactive oxygen species, antioxidant activity and kernel quality traits at different plant growth stages in maize hybrids. Four indigenous i.e., YH-5427, YH-5482, YH-5395, JPL-1908, and one multinational maize hybrid i.e., NK-8441 (Syngenta Seeds) were used for the study. Four stress treatments (i) Control (ii) 3-week water stress at pre-flowering stage (iii) 3-week water stress at anthesis stage (iv) 3-week water stress at grain filling/post-anthesis stage. The presence of significant oxidative stress was revealed by the overproduction of reactive oxygen species (ROXs) i.e., H2O2 (1.9 to 5.8 µmole g-1 FW) and malondialdehyde (120.5 to 169.0 nmole g-1 FW) leading to severe negative impacts on kernel yield. Moreover, a severe reduction in photosynthetic ability (50.6%, from 34.0 to 16.8 µmole m-2 s-1), lower transpirational rate (31.3%, from 3.2 to 2.2 mmol m-2 s-1), alterations in plant anatomy, reduced pigments stability, and deterioration of kernel quality was attributed to water stress. Water stress affected all the three studied growth stages, the pre-flowering stage being the most vulnerable while the post-anthesis stage was the least affected stage to drought stress. Antioxidant activity was observed to increase under all stress conditions in all maize hybrids, however, the highest antioxidant activity was recorded at the anthesis stage and in maize hybrids YH-5427 i.e., T-SOD activity was increased by 61.3% from 37.5 U mg-1 pro to 60.5 U mg-1 pro while CAT activity was maximum under water stress conditions 8.3 U mg-1 pro as compared to 10.3 U mg-1 pro under control (19.3%). The overall performance of maize hybrid YH-5427 was much more promising than other hybrids, attributed to its higher photosynthetic activity, and better antioxidant defense mechanism. Therefore, this hybrid could be recommended for cultivation in drought-prone areas.

A Krukenberg tumor removed in an emergency setting (bowel obstruc-tion) from a patient with a stage iv colon cancer diagnosis: differential diagnosis challenges with an ovarian adenocarcinoma

A Krukenberg tumor removed in an emergency setting (bowel obstruc-tion) from a patient with a stage iv colon cancer diagnosis: differential diagnosis challenges with an ovarian adenocarcinoma

Influence of varying soil moisture on growth and yield of Chia (Salvia hispanica l.) in Meru county, Kenya.

moisture content at different growth stages is unknown. A field experiment was conducted in March-June and June-October 2021 to determine the influence of different soil moisture regimes on the growth and yield of Chia. A randomized complete block design with three replications was used. Chia plants were subjected to four soil moisture regimes; (i)watering to the seedling stage (seedling), (ii) watering to the vegetative stage (vegetative), and (iii) watering to the flowering stage (flowering) (iv) continuous watering (control). High soil moisture of 89-93 %, significantly increased (p≤0.05) the vegetative growth of Chia plants. Plant height, stem diameter and number of leaves increased by 65-180%, 100-109% and 92-565%, respectively. 20-40% reduction in the available soil water to the plant decreased growth of Chia. Low soil moisture of 30-32 % caused plants to produce 172-220% less seed yield than control plants. Seasonal variation was noted, with increased vegetative growth and seed yield reported in the March-June 2021 season compared to the June-October 2021 season. Decreased vegetative growth and yields was a result from inhibition of cell enlargement or cell division under reduced soil moisture. The study recommends watering to the flowering stage as the best practice for water saving and increasing Chia production in Kenya.&#x0D;

Overexpression of INSM1, NOTCH1, NEUROD1, and YAP1 genes is associated with adverse clinical outcome in pediatric neuroblastoma.

Pediatric neuroblastoma is responsible for approximately 8-10% of pediatric tumors, and it is one of the leading causes of tumor-related deaths in children. Although significant progress has been made in the characterization of neuroblastoma in recent years, the mechanisms influencing the prognosis of neuroblastoma patients remain largely unknown. Our aim was to investigate if the major neuroendocrine-associated transcriptional drivers, including ASCL1, NEUROD1, DLL3, NOTCH1, INSM1, MYCL1, POU2F3 and YAP1 are correlated with specific clinical and pathological characteristics. We selected a retrospective series of 46 primary pediatric neuroblastoma, composed of 30 treatment-naïve and 16 post-chemotherapy cases. Gene expression levels were explored by means of quantitative real-time PCR. An increased expression of NOTCH1 (p = 0.005), NEUROD1 (p = 0.0059), and YAP1 (p = 0.0008) was found in stage IV tumors, while the highest levels of MYCL1 and ASCL1 were seen in stages IVS and III, respectively (p = 0.0182 and p = 0.0134). A higher level of NOTCH1 (p = 0.0079) and YAP1 (p = 0.0026) was found in cases with differentiating morphology, while high mitosis-karyorrhexis index cases demonstrated significantly lower levels of POU2F3 (p = 0.0277). High expression of NOTCH1 (p = 0.008), NEUROD1 (p = 0.026), INSM1 (p = 0.010), and YAP1 (p = 0.005) together with stage IV (p = 0.043) was associated with shorter disease-free survival. In summary, our data indicate that the assessment of gene expression levels of neuroendocrine-lineage transcription factors might help to identify neuroblastoma patients with the risk of relapse.

Concordance between the tumor mutational status and circulating tumor DNA in patients with colorectal cancer

Background. Circulating tumor DnA (ctDnA) may act as a potential biomarker for predicting disease progression in patients with colorectal cancer (CRC), which are radically cured or receiving chemotherapy.Objective: to evaluate the sensitivity of the investigated ctDnA detection assay and quantify the concordance of genomic alterations between ctDnA and matched primary tumor tissue of patients with CRC.Materials and methods. we included patients with histologically confirmed stage I–Iv CRC treated in n.n. Blokhin Cancer Research Center from 2016 to 2021. DnA was purified from tissue samples using QIAamp DnA formalin-fixed paraffin-embedded (ffPE) Tissue Kit (QIAgEn, germany). next-generation sequencing (ngS) technique was used to detect genetic mutations in primary tumor. ctDnA mutations were detected by droplet digital PCR.Results. The sensitivity of platform (assay) for detecting genetic alterations in tissue samples was 97.82 %; in ctDnA – 51.20 % for all stages and 64.5 % for stage Iv CRC. Across eight genes (KRAS, TP53, APC, PIK3CA, BRAF, FBXW7, MB21D2, and SMAD4) concordance between primary tumor and ctDnA was 69.4 % (95 % CI 62.2–76.0). Sensitivity for all stages is 51.2 % (95 % CI 45.8–56.6), for metastatic CRC 64.5 % (95 % CI 53.3–74.5). The concordance across all genes was 65.4 % (95 % CI 57.1–73.1) and 83.8 % (95 % CI 69.6–92.9) for stage I–III and stage Iv CRC, respectively. The concordance rate between ctDnA and primary tumor tissue for KRAS alterations across all stages and stage Iv CRC was 78.3 % (95 % CI 66.7–87.3) and 90.9 % (95 % CI 64.7–99.0), respectively. with increasing tumor stage (T), the number of matches raised across all genes with the highest number observed in nx category.Conclusion. The study indicates high concordance between tumor tissue and ctDnA, especially for KRAS and BRAF genes in patients with metastatic CRC, suggesting the clinical utility of ctDnA testing as a minimally invasive method and alternative to tissue biopsy.

RNA Drugs

RNA Drugs

Internal audit of oncological results in gastric cancer surgery

IntroductionNational information on the oncological results of gastric cancer surgery is scarce, so foreign figures are used, which may completely differ from local ones. The aim of our study is to analyse these results in the patients operated on in our centre. MethodsSurvival results of 134 patients that underwent gastric cancer surgery with curative intent from 2004 to June 2016 were analysed. ResultsA percentage of 76.8 of the patients (103/134) presented in advanced clinical stages (≥ii). Staging laparoscopy was performed in 67% of them (69/103), an extensive lymphadenectomy (≥LD1+) was carried out in 89.3% of patients (92/103), and 76.7% (79/103) received perioperative chemotherapy. The distribution by pathological stage 0, i, ii, iii and iv was 8.2, 20.2, 26.1, 37.3, and 8.2%, respectively. Median follow-up was 87 months. Median OS was 68 months and one-, 3- and 5-year OS were 81.2, 62, and 53.8%, respectively. The 5-year OS according to pathological staging was 100% for stage 0, 88.4% for stage i, 62.5% for stage ii, 23.6% for stage iii and 17% for stage iv. ConclusionsOur survival rates are in the high ranges of western literature. These results could not be compared with national ones due to the lack of information regarding oncological outcomes in gastric cancer surgery in our closest environment.

Understanding the mechanism of selective catalytic reduction on spinel TiMn2O4(001) surface

Manganese based spinel oxides is one of the most promising catalysts for low temperature selective catalytic reduction (SCR) process due to its high activity and tunable composition. Understanding the molecular-level reaction mechanism of SCR on Mn-containing spinel oxides is of great importance for design and development of appropriate catalyst for low temperature SCR process. In this paper, density functional theory calculations were performed to address the detail SCR reaction pathways between NH3 and NO on spinel TiMn2O4(001) surface. The full SCR process was found to be divided into four sequential stages, including the NH3 chemisorption (stage i), NH2NO formation (stage ii), H migration (stage iii), and products desorption (stage iv). Notably, we found that water molecules could serve as a hydrogen exchanger and play a positive role in promoting the hydrogen migration during stage i and stage iii of the SCR process. Thermodynamically, the overall SCR process is highly exothermic with the reaction energy of -3.054 eV. Kinetically, the formation of NH2NO intermediate was identified as the rate determining step with a moderate activation barrier of 1.064 eV. Our results suggest that the spinel TiMn2O4 is a promising catalyst for low temperature SCR. Moreover, the promoting effect of water on hydrogen diffusion should be also applicable to other chemical reactions involving hydrogen transfer.

P8‐127: A case of stage iv lung adenocarcinoma with long‐term survival for over 18 years, finally found to be positive for EGFR gene mutations

P8‐127: A case of stage iv lung adenocarcinoma with long‐term survival for over 18 years, finally found to be positive for EGFR gene mutations

561 Metastasectomy for Stage IV Melanoma in the Effective Systemic Treatment Era

Abstract Aim Historically, a diagnosis of Stage IV melanoma was a dire one, with low survival rates and ineffective treatment. The only beneficial treatment option was metastasectomy in very selected cases. The recent introduction of the effective systemic therapy agents (EST) (immunotherapy and BRAF inhibitors) dramatically changed this. This research’s aim is to determine if EST + Metastectomy significantly improves OS. And if so, should be considered as the main therapeutic approach to stage IV melanoma patients. Method Single-centre retrospective cohort study from the Melanoma Unit at Calvary Mater Hospital in Australia was conducted, approved by the ethics committee. Inclusion criteria was Stage IV Melanoma patients who received EST from 2009-2019. OS of those who received EST alone are compared to EST + Metastasectomy. The 2 groups were compared retrospectively based on their disease characteristics, using probability score weighting analysis and survival curve. Results This is a preliminary analysis for the first 200 patients, data collection is ongoing. Mean OS is 2 years. Several combinations of immunotherapy treatments were identified. Of the 200 patients, 35% underwent metastasectomy. Mean survival for those who had surgery is 3 years, as oppose to 2 years for those who had EST alone. OS in the Metastasectomy group was higher than those who had EST alone, of 47.1% and 42.3% respectively. The Kaplan Meier curve also shows increase survival in the metastasectomy group, up to year 6 post diagnosis. Conclusions Metastasectomy for stage iv melanoma in the EST era appears to offer a survival benefit in selected patients

Epidemiological, Clinical Profile, and Treatment Outcome of Stage IV Nonsquamous Nonsmall Cell Lung Cancer Patients Presenting to Tertiary Care Hospital in North India

Background: Better planning of limited resources in oncology is possible with more real-world data of lung cancer, one of the most common causes of cancer related mortality in India and Globe. Aim: This study aimed to evaluate the clinical profile and treatment outcomes in patients with Stage IV adenocarcinoma of lung at our center. Materials and Methods: One hundred and eighty-two patients with Stage IV adenocarcinoma of lung were prospectively screened and analyzed, of which 107 patients who met the inclusion criteria were included in the final analysis. Patients with epidermal growth factor receptor (EGFR) and echinodermal microtubule-associated protein-like 4-anaplastic lymphoma kinase (EML4-ALK) genomic alterations were treated with tyrosine kinase inhibitors and others were treated as per standard chemotherapy regimens. Response rates (RRs), progression-free survival (PFS), and overall survival (OS) were measured. Results: Median age of patients was 55.6 years (range, 26–82) with a male-to-female ratio of 1.23:1. Analyses for EGFR and EML4-ALK alterations were possible for 104 (96.3%) patients and were detected in 31.7% and 8.7% patients, respectively. The overall RR for the entire cohort was 51.4%, while median PFS and median OS were 6.9 and 13.7 months, respectively. Median PFS for the EGFR-mutated and ALK-rearranged group was 9.6 and 10.2 months, respectively, which was higher than non-EGFR non-ALK patients. Median OS for the whole cohort was 13.7 months, while median OS was not reached for EGFR and ALK altered groups. Conclusions: As patients with driver mutations like EGFR and ALK have better prognosis than those who do not, every patient diagnosed with advanced nonsmall cell lung cancer should be offered mutational analysis.

Euclid Preparation. XIV. The Complete Calibration of the Color–Redshift Relation (C3R2) Survey: Data Release 3

Abstract The Complete Calibration of the Color–Redshift Relation (C3R2) survey is obtaining spectroscopic redshifts in order to map the relation between galaxy color and redshift to a depth of i ∼ 24.5 (AB). The primary goal is to enable sufficiently accurate photometric redshifts for Stage iv dark energy projects, particularly Euclid and the Nancy Grace Roman Space Telescope (Roman), which are designed to constrain cosmological parameters through weak lensing. We present 676 new high-confidence spectroscopic redshifts obtained by the C3R2 survey in the 2017B–2019B semesters using the DEIMOS, LRIS, and MOSFIRE multiobject spectrographs on the Keck telescopes. Combined with the 4454 redshifts previously published by this project, the C3R2 survey has now obtained and published 5130 high-quality galaxy spectra and redshifts. If we restrict consideration to only the 0.2 &lt; z p &lt; 2.6 range of interest for the Euclid cosmological goals, then with the current data release, C3R2 has increased the spectroscopic redshift coverage of the Euclid color space from 51% (as reported by Masters et al.) to the current 91%. Once completed and combined with extensive data collected by other spectroscopic surveys, C3R2 should provide the spectroscopic calibration set needed to enable photometric redshifts to meet the cosmology requirements for Euclid, and make significant headway toward solving the problem for Roman.

PRELIMINARY EVALUATION OF THE EFFECTIVENESS OF HIFU-THERAPY IN PATIENTS WITH PANCREATIC CANCER

Purpose: to conduct a preliminary analysis of the safety and effectiveness of hifu-therapy with a lowenergy hifu-2001 device (shenzhen Huikang Medical apparatus Co., ltd) performed concurrently with chemotherapy in pancreatic cancer patients who are not suitable for surgery or chemoradiotherapy.Material and Method. The study included 24 pancreatic cancer patients who were treated at the Hertsen Moscow Oncology Research institute in the period from 2016 to 2019. There were 17 (71 %) women and 7 (29 %) men. The percentage of patients in the elderly group was 79 %. Stage iia pancreatic cancer was diagnosed in 3 (12.5 %) patients, stage ii in 5 (21 %) patients, stage iii in 9 (37.5 %) patients, and stage iv in 7 (29 %) patients. All patients received combination therapy, including systemic chemotherapy and hifu-therapy. Results. The most frequent adverse events of treatment were skin burns (n=6), with third-degree burns occurring in 2 (8.3 %) patients. Local sclerosis of subcutaneous adipose tissue was observed in 4 (17 %) patients; development of asymptomatic pancreatic pseudocysts in the area of hifu exposure was observed in 1 (4 %) patient. Pain control was achieved in 17 (85 %) patients, and local tumor control was achieved in 19 (79.2 %) patients. The follow-up time ranged from 5 to 30 months with a median time of 14.5 months. The median total life expectancy of patients was 16 months, and the median time to progression was 9 months. The overall 6-month survival rate was 100 %. The 1- and 1.5-year survival rates were 75.0 % and 41.7 %, respectively. The 2-year survival rate was 17.2 %. The 6-month and 1-year disease-free survival rates were 62.5 % and 12.5 %, respectively. Conclusion. The short- and long-term outcomes were consistent with those described in other studies, which indicated that a combination of systemic drug therapy and hifu-therapy is an appropriate approach for the treatment of patients with pancreatic cancer.

Effect of e-module stage iv childbirth care with blended learning model on skills improvement of midwifery students

Objective: This study aims to determine the effect of education on improving midwifery students' skills in improving management skills for stage IV labor. Methods: This study used a Quasi Experiment (Pre-test post-test design). The population of all students who program the subject of childbirth care is 90 students. The sampling technique was total sampling, then analyzed using the Chisquare and Mann withney. Results: The results of this study indicate that there is a significant effect; the value (p = 0.000, p &lt;0.05) improves the skills of D-III midwifery students regarding stage IV delivery care in the Module group and the demonstration method compared to the Module group. Conclusions: Based on the results, the Android-based application of learning mag guru for childbirth improves Midwifery Diploma students' skills in managing stage IV childbirth care.