Academic literature on the topic 'Proportional scoring'
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Journal articles on the topic "Proportional scoring"
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Senesh, Merav R., and David J. Reinkensmeyer. "Breaking Proportional Recovery After Stroke." Neurorehabilitation and Neural Repair 33, no. 11 (2019): 888–901. http://dx.doi.org/10.1177/1545968319868718.
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People with hemiparesis after stroke appear to recover 70% to 80% of the difference between their baseline and the maximum upper extremity Fugl-Meyer (UEFM) score, a phenomenon called proportional recovery (PR). Two recent commentaries explained that PR should be expected because of mathematical coupling between the baseline and change score. Here we ask, If mathematical coupling encourages PR, why do a fraction of stroke patients (the “nonfitters”) not exhibit PR? At the neuroanatomical level of analysis, this question was answered by Byblow et al—nonfitters lack corticospinal tract (CST) integrity at baseline—but here we address the mathematical and behavioral causes. We first derive a new interpretation of the slope of PR: It is the average probability of scoring across remaining scale items at follow-up. PR therefore breaks when enough test items are discretely more difficult for a patient at follow-up, flattening the slope of recovery. For the UEFM, we show that nonfitters are most unlikely to recover the ability to score on the test items related to wrist/hand dexterity, shoulder flexion without bending the elbow, and finger-to-nose movement, supporting the finding that nonfitters lack CST integrity. However, we also show that a subset of nonfitters respond better to robotic movement training in the chronic phase of stroke. These persons are just able to move the arm out of the flexion synergy and pick up small blocks, both markers of CST integrity. Nonfitters therefore raise interesting questions about CST function and the basis for response to intensive movement training.
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Lapp, William M., and R. Lorraine Collins. "Relative/Proportional Scoring of the Ways of Coping Checklist: Is it Advantageous or Artificial." Multivariate Behavioral Research 28, no. 4 (1993): 483–512. http://dx.doi.org/10.1207/s15327906mbr2804_5.
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G., Vignesh, and Tumbanatham . "Epicardial fat thickness and severity of coronary artery disease: a review." International Journal of Advances in Medicine 7, no. 5 (2020): 856. http://dx.doi.org/10.18203/2349-3933.ijam20201626.
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People with diabetes are at high risk of coronary artery disease (CAD,) duration of diabetes is directly proportional to macro vascular complications. Epicardial fat through its various mechanism and anatomical closeness to the myocardium it has the direct impact on the severity of CAD. Aim of the study was to determine the correlation between epicardial fat thickness and severity of coronary artery disease in diabetic patients using syntax scoring system. The references used in this review were identified through PubMed and Google Schlor searches of articles published for the last 20 years. Search terms included CAD, correlation of EFT in CAD, syntax scoring system , Gensini scoring system, 2D-ECHO, diabetes in CAD. We reviewed 50 articles done on only humans. We reviewed relevant review articles also. It can be concluded that Epicardial fat thickness has significant correlation with severity of coronary artery disease.
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Jeruss, Jacqueline S., Elizabeth A. Mittendorf, Susan L. Tucker, et al. "Combined Use of Clinical and Pathologic Staging Variables to Define Outcomes for Breast Cancer Patients Treated With Neoadjuvant Therapy." Journal of Clinical Oncology 26, no. 2 (2008): 246–52. http://dx.doi.org/10.1200/jco.2007.11.5352.
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Purpose Neoadjuvant chemotherapy is being used with increasing frequency for operable breast cancer. We hypothesized that by using clinical and pathologic staging parameters, in conjunction with biologic tumor markers, a novel means of determining prognosis for patients treated with neoadjuvant chemotherapy could be facilitated. Patients and Methods A prospective database of patients treated with neoadjuvant chemotherapy from 1997 to 2003 was reviewed, and 932 patients meeting inclusion criteria were identified. Clinical and pathologic tumor characteristics, treatment regimens, and patient outcomes were recorded. Cox proportional hazards models were used to create two prognostic scoring systems. American Joint Committee on Cancer (AJCC) clinical and pathologic staging parameters and biologic tumor markers were investigated to devise the scoring systems. Results Median follow-up time was 5 years (range, 0.4 to 9.4 years). Five-year disease-specific survival rate was 96% for patients who experienced a pathologic complete response (pCR; n = 130) compared with 87% for patients who did not have a pCR (n = 802; P = .001). Two scoring systems, based on summing binary indicators for clinical substages ≥ IIB and ≥ IIIB, pathologic substages ≥ ypIIA and ≥ ypIIIC, negative estrogen receptor status, and grade 3 pathology, were devised to predict 5-year patient outcomes. These scoring systems facilitated separation of the study population into more refined subgroups by outcome than the current AJCC staging system. Conclusion The scoring systems derived in this work provide a novel means for evaluating prognosis after neoadjuvant therapy. Future work will focus on prospective validation of these scoring systems and refinement of the scoring systems through addition of new biologic markers.
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Kim, Yong Chan, Je Eun Song, Eun Jin Kim, et al. "A Simple Scoring System Using the Red Blood Cell Distribution Width, Delta Neutrophil Index, and Platelet Count to Predict Mortality in Patients With Severe Sepsis and Septic Shock." Journal of Intensive Care Medicine 34, no. 2 (2018): 133–39. http://dx.doi.org/10.1177/0885066618787448.
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Purpose: The purpose of our study was to investigate whether a simple scoring system based on the red blood cell distribution width (RDW), delta neutrophil index (DNI), and platelet count was associated with the prognosis of patients with sepsis, and whether this scoring system was more useful than each individual parameter. Materials and Methods: We conducted a retrospective cohort study involving adult patients who received intensive therapy due to severe sepsis and septic shock from January 2010 to December 2015 at a tertiary teaching hospital in South Korea. Results: A total of 730 patients were included in this study. Each patient was rated on a scale of 0 to 3 according to the new scoring system using the platelet count, RDW, and DNI. Point values were assigned based on the following definitions: RDW > 14.5%, DNI > 5.0%, and platelet count < 150 000/mm3. The 28-day mortality rate was 12.6% (92/730). The nonsurvivors had higher scores than the survivors (2.05 ± 0.80 vs 1.06 ± 0.87, P < .001). In the multivariate Cox proportional hazard analysis, the scoring system was an independent predictor of the 28-day mortality. The scoring system was well calibrated ( P = .81 for the goodness-of-fit test) and discriminated (area under the receiver operating characteristic curve = 0.785). Conclusion: Our new scoring system using the RDW, DNI, and platelet count was useful for predicting the mortality in patients with severe sepsis and septic shock.
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Teo, KW, NK Yuan, WB Tan, and R. Parameswaran. "Comparison of prognostic scoring systems in follicular thyroid cancer." Annals of The Royal College of Surgeons of England 99, no. 6 (2017): 479–84. http://dx.doi.org/10.1308/rcsann.2017.0072.
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INTRODUCTION Many studies have addressed the accuracy of prognostic scoring systems in the treatment of differentiated thyroid cancers as a whole but few have addressed this issue in patients with follicular thyroid cancer (FTC) alone. The aim of this study was to establish the accuracy of the various scoring systems in determining the overall and disease free survival of FTC patients in Singapore. METHODS Retrospective review was undertaken of 82 patients with FTC treated at a single tertiary institution between January 2000 and December 2014. Demographic, clinical, pathological and treatment outcomes were analysed. Prognostic scoring systems evaluated for the cohort included TNM (Tumour, Nodes, Metastases), AGES (Age, Grade, Extent, Size), MACIS (Metastases, Age, Completeness of resection, Invasion, Size), AMES (Age, Metastases, Extent, Sex) and EORTC (European Organisation for Research and Treatment of Cancer). Statistical analysis was performed by plotting Kaplan–Meier survival curves and using the Cox proportional hazards model. RESULTS There were 29 male and 53 female patients with a mean age of 48 years. The mean follow-up duration was 88 months and there were 7 deaths (9%). The ten-year overall survival rate was 90%. Factors predictive of survival on univariate analysis were age, size of tumour, invasiveness, completeness of resection, metastasis, external beam radiotherapy, and risk scores using the AGES and MACIS scoring systems (p<0.05). On multivariate analysis, AGES and MACIS provided the best prognostic information. CONCLUSIONS MACIS is the best prognostic scoring system currently available for FTC and it is superior to other scoring systems in term of guiding management. The scoring systems require further development to accommodate variations in clinical practice globally and to improve the prognostic accuracy.
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Thornton, S., M. Troop, A. P. Burgess, et al. "The relationship of psychological variables and disease progression among long-term HIV-infected men." International Journal of STD & AIDS 11, no. 11 (2000): 734–42. http://dx.doi.org/10.1258/0956462001915165.
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This study investigated the contribution of psychological factors to disease progression among long-term HIV-1 infected gay men. Participants completed self-report measures including coping strategies, life events, social support, personality and psychological morbidity and were followed clinically for up to 30 months. Cox proportional hazards survival analyses were carried out to CD4 < 200 × 106/l and AIDS-related complex (ARC) or AIDS diagnosis controlling for viral load, antiretroviral drug use and CD4 count. Only acceptance coping was a significant predictor of time to ARC or AIDS diagnosis: the risk of ARC or AIDS was almost 5 times greater for those scoring within the lowest tertile compared with those scoring in the highest tertile (HR = 4.7, 95% CI 1.8-12.3).
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Chen, Shengsen, Chao Wang, An Cui, et al. "Development of a Genetic and Clinical Data-Based (GC) Risk Score for Predicting Survival of Hepatocellular Carcinoma Patients After Tumor Resection." Cellular Physiology and Biochemistry 48, no. 2 (2018): 491–502. http://dx.doi.org/10.1159/000491779.
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Background/Aims: Carnitine palmitoyltransferase 1A (CPT1A) is a rate-limiting enzyme in the transport of long-chain fatty acids for β-oxidation. Increasing evidence has indicated that CPT1A plays an important role in carcinogenesis. However, the expression and prognostic value of CPT1A in hepatocellular carcinoma (HCC) have not been extensively studied. Methods: Here, we collected 66 post-operative liver cancer tissue samples. Gene profile expression was tested by RT-PCR. Receiver operating characteristic (ROC) analysis was performed and multivariate analysis with Cox’s Proportional Hazard Model was used for confirming the selected markers’ predictive efficiency for HCC patients’ survival. A simple risk scoring system was created based on Cox’s regression modeling and bootstrap internal validation. Results: Cox multivariate regression analysis demonstrated that CPT1A, tumor size, intrahepatic metastasis, TNM stage and histological grade were independent risk factors for the prognosis of HCC patients after surgery. Our genetic and clinical data-based (GC) risk scoring system revealed that HCC patients whose total score≥3 are more likely to relapse and die than patients whose total score < 3. Finally, the good discriminatory power of our risk scoring model was validated by bootstrap internal validation. Conclusions: The genetic and clinical data-based risk scoring model can be a promising predictive tool for liver cancer patients’ prognosis after operation.
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Kaiser, Gernot M., Andreas Paul, George Sgourakis, et al. "Novel Prognostic Scoring System after Surgery for Klatskin Tumor." American Surgeon 79, no. 1 (2013): 90–95. http://dx.doi.org/10.1177/000313481307900136.
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Klatskin tumor is a rare hepatobiliary malignancy whose outcome and prognostic factors are not clearly documented. Between April 1998 and January 2007, 96 patients with hilar cholangiocarcinoma underwent resection. Data were collected prospectively. Thirty-one variables were evaluated for prognostic significance. There were 40 trisectionectomies, 40 hemihepatectomies, five central hepatectomies, and 11 biliary hilar resections. Thirty-seven (n = 37) patients required vascular reconstruction. There were 68 R0, 26 R1, and two R2 resections. Age ( P = 0.048), pT status ( P = 0.046), R class ( P = 0.034), and adjuvant chemoradiation ( P = 0.045) showed predictive significance by multivariate Cox proportional hazard regression analysis. A point scoring system was determined as follows: age younger than 62 years:age 62 years or older = 1:2 points; pT1:pT2 to 4 = 1:2 points; R0:R1/2 = 1:2 points; and chemoradiation yes:no = 1:2 points. The only model that reached statistical significance ( P = 0.0332) described the following three groups: score 6 or less; score = 7; and score = 8. Median survival for score 6 or less, score = 7, and score = 8 was 26.5, 12, and 2.2 months, respectively ( P = 0.032). The corresponding 1- and 3-year survival rates were 73 to 56 per cent, 52 to 38 per cent, and 17 to 0 per cent, respectively. We propose a scoring system predictive of long-term surgical outcome that could potentially improve patient selection for further postoperative oncologic treatment for Klatskin tumors.
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Walker, David, and Michael Davis. "Quantifying fear potentiated startle using absolute versus proportional increase scoring methods: implications for the neurocircuitry of fear and anxiety." Psychopharmacology 164, no. 3 (2002): 318–28. http://dx.doi.org/10.1007/s00213-002-1213-0.
Full textDissertations / Theses on the topic "Proportional scoring"
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Dahlin, Sam, and Mathias Åström. "En beslutsanalytisk granskning av offentlig upphandling inom IT-system : Tillämpning av känslighets- och robusthetsanalys." Thesis, Mittuniversitetet, Institutionen för informationssystem och –teknologi, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:miun:diva-39931.
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Research in the area of public procurement has gained increasing attention with increasing interest in researching different evaluation methods for incoming tenders in procurement. The study analyzed the structure for procurement with a multi-criteria model for observation of changes in ranking and studied the importance of correct scoring. A sensitivity and robustness analysis were used as a tool to study the stability and the strength of a contracting entity's priorities. The purpose of this thesis was a study to determine if the ranking of tenders became more sensitive to the structure of the model or for each tender's evaluation, where it was found that the ability to correctly score points was more crucial than being critical of weights assigned to the criteria in the procurement, respectively. Relationship between price and quality turned out to be unknown to some extent, the connection could be determined after all tenders were submitted and accumulated points were available.<br>Forskning inom området offentlig upphandling har fått allt mer uppmärksamhet när intresset hamnat på undersökning av olika utvärderingsmetoder för inkommande anbud vid en upphandling. I studien analyserades uppbyggnaden för upphandlingar med en multikriteriemodell för observation över förändringar hos rangordning samt studerandet av vikten för en korrekt poängsättning. En känslighets- och robusthetsanalys tillämpades som verktyg för att studera stabiliteten och styrkan hos en upphandlande entitets prioriteringar. Syftet med uppsatsen var en undersökning för en bedömning om rangordningen av upphandlingars anbud blev känsligast mot strukturen på modellen eller för varje anbuds värdering, där det visade sig att förmågan för korrekt poängtilldelning var mer avgörande än att vara kritisk till vikterna som tilldelades respektive kriterier inom upphandlingen. Relationen mellan pris och kvalitet visade sig vara okänd till viss del, sambandet kunde avgöras efter att alla anbud var inskickade och samlade poäng fanns att tillhandahålla.
Book chapters on the topic "Proportional scoring"
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Kang, Yuxin, Hansheng Li, Xin Han, et al. "Automated Tumor Proportion Scoring for Assessment of PD-L1 Expression Based on Multi-Stage Ensemble Strategy." In Machine Learning in Medical Imaging. Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-59861-7_8.
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Seddon, Mike, and Nick Curzen. "Cutting balloons and AngioSculpt®." In Oxford Textbook of Interventional Cardiology. Oxford University Press, 2010. http://dx.doi.org/10.1093/med/9780199569083.003.035.
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Although percutaneous coronary intervention has revolutionized the treatment of coronary artery disease, it has been limited by acute ischaemic complications and restenosis. It is well recognized that elastic recoil, negative remodelling, and neointimal hyperplasia are the underlying mechanisms of restenosis, with a clear association between the extent of vascular injury sustained and subsequent intimal hyperplasia. The search for a method to dilate an obstructive coronary lesion without invoking this proportional injury response led to the development of a variety of devices designed to excise or modify plaque in order to limit intimal injury. In 1991, Barath and colleagues developed a noncompliant cutting balloon with three or four microblades fixed radially to it. It was hypothesized that the discrete longitudinal incisions created during balloon inflation might improve the success of conventional balloon angioplasty by reducing elastic recoil and minimizing intimal injury, thereby minimizing the subsequent neointimal proliferative response. Theoretically, this effect would allow cutting balloon angioplasty to achieve and maintain a larger lumen diameter using lower balloon inflation pressures and durations than conventional balloon angioplasty. Technology has since progressed rapidly through several stages, with the introduction of intracoronary stents, advances in adjunctive antiplatelet therapies, and the advent of drug-eluting stents. However, the Cutting Balloon®, and the recently approved AngioSculpt® scoring balloon, remain in the armamentarium of the interventional cardiologist today. This chapter summarizes the clinical experience with these devices to date and their place in the current era.
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Diaz, Gustavo Adolfo, Olga Marina García Norato, Alvaro Andrés Vernazza Páez, and Oscar A. Arcos Palma. "Tool for the Financial Inclusion of Informal Retailers in Colombia." In Emerging Tools and Strategies for Financial Management. IGI Global, 2020. http://dx.doi.org/10.4018/978-1-7998-2440-4.ch010.
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One of the structural problems in Colombia is the informality of economic activities. Indeed, there is a high proportion of informal retailers in large cities of the country. This chapter propounds a tool, Credit Scoring, for the financial inclusion of this population. The tool is designed for obtaining resources at lower financial costs, and it aims at improving the commercial activities of these agents. In this way, informal financing, which increases poverty, is avoided. Also, in connection with this subject, surveys conducted among a thousand informal retailers in five Colombian cities—Bogotá, Cúcuta, Ibagué, Villavicencio and Arauca—were taken into account.
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Frase, Richard S., and Julian V. Roberts. "Introduction." In Paying for the Past. Oxford University Press, 2019. http://dx.doi.org/10.1093/oso/9780190254001.003.0001.
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This chapter provides an overview of the book, including the following major topics: why this neglected topic is so important; the ubiquity of prior record enhancement in modern sentencing systems, and their particularly powerful roles in U.S. jurisdictions with sentencing guidelines; the wide variations in the criminal history scoring formulas used in guidelines, with respect to matters such as which prior crimes and other factors are included, the weight each receives, and the degree to which a high score increases recommended sentence severity; the unclear punishment rationales for such enhancements; and the numerous negative consequences of these enhancements— increasing the size and expense of prison populations, undermining the important goal of punishment in proportion to offense severity, increasing the need for prison beds to house property and other nonviolent offenders, generating large numbers of aging prison inmates, contributing to racial disproportionality in prison populations, and undermining offenders’ efforts to reintegrate into society.
Conference papers on the topic "Proportional scoring"
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Schönnenbeck, G. "A Few Aspects on Lubricant Selection for Stepless Chain Coverters: Efficiency and Service Life." In ASME 1992 Design Technical Conferences. American Society of Mechanical Engineers, 1992. http://dx.doi.org/10.1115/detc1992-0079.
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Abstract Stepless vehicle drives will assume their place next to automatic switching units throughout the world if they meet their expected fuel-saving potential. This necessitates optimizing the individual components of the CVT as regards their efficiency. The main source of losses are the hydraulic supply units and the losses which result specifically from non-positive transmission. In the case of stepless chain conveners, these result mainly from friction disk deformation. These losses account for 50 to 70 % of total CVT losses. Both loss components are influenced by the lubricant to a significantly greater extent than it would appear at first sight: In the case of fully-hydraulic clamping and control systems, the viscosity and its long-term stability determines the degree of leakage losses and therefore the size of the pump or pump combinations. This applies to pressure levels between 20 and 40 bar. This in turn is directly proportional to the hydraulic losses on the CVT. The friction coefficient of the lubricant determines the level of the necessary clamping forces. These are responsible for friction-disk deformation. Also of importance as far as the selection of lubricant is concerned is its influence on the CVT service life. The critical service life limits for chain converters are chain breakage (not the subject of this report) and evidence of wear, i.e. grey staining, sheave-grooving, pitting, scoring and rocker pin wear. Standardized test methods exist at P.I.V. for both wear manifestations and for the friction coefficient, these tests allowing a targeted selection of lubricants.
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Moake, J. L., M. A. Harris, C. E. Whitley, and C. P. Alfrey. "RAPID, SENSITIVE N0N-RADI0ACTIVE QUANTIFICATION AND ANALYSIS OF PLASMA VON WILLEBRAND FACTOR (vWF) MULTIMERS." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644085.
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Assessment of plasma vWF abnormalities by clinical coagulation laboratories is difficult because the available test systems for vWF antigen quantification and multimer analysis are expensive, laborious, and require days, radioactive anti-vWF antibodies and autoradiographic methods. We have devised simple, rapid, sensitive alternative techniques for vWF quantification and multimer analysis that can be readily installed in clinical laboratories. Plasma vWF antigen quantification is by a 2 hour enzyme immunoassay that accurately detects levels as low as 0.23% of normal. Plasma vWF to be quantified is bound to polyclonal monospecific antihuman vWF attached to small glass beads, and anti-human vWF conjugated with alkaline phosphatase is added to make an insoluble "sandwich." A substrate solution consisting of phenylphosphate and 4-amino-antipurine is added, followed by potassium ferricyanide. Optical density (at 490-510 nm) of the red color that develops is directly proportional to the plasma concentration of vWF antigen. Plasma vWF multimeric analysis is by a one-day electrophoretic immunobiot procedure. Plasma vWF multimer forms are solubilized in SDS-urea-Tris-EDTA, separated by horizontal 1% agarose gel electrophoresis, and transferred to a cationic membrane. Other protein binding sites on the membrane are blocked with milk proteins, and the membrane is overlaid with anti-vWF IgG linked to alkaline phosphatase. vWF multimers are then displayed as blue bands by soaking the membrane in an alkaline solution of the histochemical stain, fast blue RR (commonly used for leukocyte alkaline phosphatase scoring) dissolved in naphtol AS-MX phosphate. These simple, non-radioactive procedures performed together permit the rapid distinction of classical (Type I) von Willebrand's disease (vWD), characterized by low vWF antigen and normal multimers, from the Type II vWD syndromes, characterized by a relative deficiency of the largest plasma vWF forms. Unusually large vWF multimers, present in remission plasma of patients with chronic relapsing thrombotic thrombocytopenic purpura (TTP), are also easily detected using this rapid system of multimer analysis.
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Prasanna, Vikram, Amresh Raina, Jeffrey Arkles, et al. "Echo-Doppler Scoring System Identifies 'Proportionate' And 'Disproportionate' Pulmonary Hypertension In Patients With Chronic Left Heart Disease And Respiratory Disease." In American Thoracic Society 2011 International Conference, May 13-18, 2011 • Denver Colorado. American Thoracic Society, 2011. http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a2294.
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Smith, Mark E., and Yan Chen. "Thrombogenicity Testing Results for Control Legally Marketed Comparator Devices (LMCD): Comparison Between Traditional Non-Anticoagulated Venous Implant (NAVI) Assay and an In Vitro Ovine Blood Loop Test." In 2020 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2020. http://dx.doi.org/10.1115/dmd2020-9073.
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Abstract Legally marketed comparator devices (LMCD) are required by many regulatory bodies in as a control for thrombogenicity testing when evaluating new devices. It is assumed by both the medical device manufacturing industry and regulatory bodies that these LMCD’s have good clinical history and should perform with no to minimal thrombus accumulation and thereby serve as valid negative controls for the assay. APS regularly performs these assays for many medical device manufacturers, all of whom select a predicate comparator device (required by FDA to be an LMCD), for both the in vivo Non-Anticoagulated Venous Implant (NAVI) assay as well as a custom in vitro blood loop AVI. In this retrospective analysis, we have compiled thrombogenicity scores of control/predicate devices (limited to assays which used LMCD’s), both the discrete score from the classification standard scoring scheme and the continuous values obtained from the percent surface area associated with thrombus. We have compared results from 37 NAVI studies and 22 in vitro blood loop studies. These compiled results show ∼25% of LMCDs score ≥ 3 (&gt; 50% of the surface covered in thrombus) in the NAVI model while &lt; 5% of LMCDs score ≥ 3 (&gt; 50% thrombus) in the Blood-Loop assay. In addition, the median score and mean % thrombus for LMCD in the blood loop assay is substantially lower than the median and mean scores for LMCD in the NAVI assay. This retrospective assessment highlights a high proportion of false-positive scores for LMCD in a large number of NAVI assays.
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Das, Saikat. "Low dose radiation and chemotherapy significantly reduces hypoxic cell population in locally advanced cervix cancer-results of a phase II study." In 16th Annual International Conference RGCON. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0039-1685259.
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Introduction: Tumor hypoxia is one of the major causes of high incidence of treatment failures to chemoradiation which is the standard of care in locally advanced cervical cancer. The necessity of newer treatment options that can circumvent hypoxia is highly relevant in this group. Use of low dose radiation to enhance the efficacy of cell cycle specific chemotherapy by mechanism of chemopotentiation is one of the elegant approaches reported in the literature. We have already published the feasibility, efficacy and tolerance of low dose radiation and chemotherapy in neoadjuvant setting in cervical cancer. In this report we evaluated the role of this novel treatment regimen in reducing the hypoxic tumor cell population in cervical cancer. Methods: Total 24 patients with stage IIB-IIIB squamous cell carcinoma cervix were treated with initial 2 cycles of paclitaxel and carboplatin and concurrent low dose radiotherapy prior to standard chemoradiation. Response was assessed clinically, radiologically (by MRI) and pathologically (four quadrant representative punch biopsy from the cervix) after 3 weeks of neoadjuvant treatment prior to chemoradiation. Immunohistochemistry of HIF-1a was done in the biopsy samples to determine the proportion, intensity and scoring of hypoxic cells. Results: The proportion of positivity of base line HIF-1α was 42% (10 out of 24 patients). Low, moderate and high expressions were seen in 8%, 17% and 17% respectively. We observed nuclear positivity in 20%, and fine granular perinuclear cytoplasmic positivity in 80% cases. We failed to observe any association between expressions of HIF 1α in relation to the distance from blood vessels in tumor cord. The average age of patients in hypoxia positive and negative groups were 51.7 vs 48.36 yrs (p > 0.05). There was no difference of mean hemoglobin level (11.3 to 11.1, p > 0.05.) or MRI based tumor volume at baseline (57.1 vs. 52.4, p > 0.05) in HIF 1α positive and negative groups respectively. Low dose radiation and chemotherapy significantly reduced the tumor volume in bulky hypoxic tumors. The tumor volume reduction rate (TVRR) was significantly higher in hypoxic group (TVRR HIF_neg vs. TVRR HIF_pos 68.9 vs. 86.3, p = 0.02, t-test). There was significant improvement of diffusion MRI derived apparent diffusion coefficient (ADC) in hypoxic tumors with low dose radiation and chemotherapy (0.75 vs. 1.27, p = 0.12, Wilcoxon signed-rank test). Median score of percentage of hypoxic cells after neoadjuvant treatment were significantly higher in patients who developed subsequent local recurrence than the rest of the group (77% vs. 5% p = 0.009, Mann Whitney U test). Conclusion: Overall all HIF 1 positivity was 42% in the present study. A predominantly perinuclear pattern of HIF 1 staining was found in cervix cancer. Low dose radiation and chemotherapy significantly reduced the hypoxic tumor bulk in cervical cancer.
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Wu, Wei, Haijun Hu, Yuhai Lv, et al. "An Alternative Corrosion Risk Assessment Method for Industrial Pipelines in Natural Gas Purification Plant." In ASME 2020 Pressure Vessels & Piping Conference. American Society of Mechanical Engineers, 2020. http://dx.doi.org/10.1115/pvp2020-21376.
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Abstract Natural gas is a kind of high-quality and low-carbon energy and its demand is increasing rapidly year by year. The natural gas produced from the gas well contains some corrosive impurities like CO2, H2S, and H2O. Therefore, the gas needs to be purified in purification plants before it can be used. In the process of purification, the impurities in the natural gas will cause corrosion to the purification equipment, especially to the industrial pipeline, which will lead to perforation and leakage of the pipeline, and even cause poisoning, fire or explosion, and other serious safety accidents. In order to ensure the safe operation of the industrial pipeline in the purification plant, it is necessary to carry out effective inspection and maintenance measures for the pipelines. The traditional regular inspection method just inspects a certain proportion of the pipelines which are selected by on-site inspection personnel. But limited by technical level and work experience of the inspection personnel, some high-risk pipelines may be neglected. Therefore, some plants try to adopt risk-based inspection (RBI) to carry out a risk assessment and conduct a comprehensive inspection on high-risk pipelines, so as to improve inspection efficiency and reduce inspection cost. However, in practice, it was found that the pipeline risk levels are not in accordance with the actual inspection results. The reason is that the RBI method developed in the background of oil refining and chemical industry is not suitable for natural gas purification plants. In order to solve the problems, this paper analyzed the relationship between the influencing factors and pipeline corrosion behavior. The influencing factors include the impurity contents (CO2, H2S, H2O, and chlorides), pipeline materials (carbon steel and austenitic stainless steel), and service conditions (operating temperature, operating pressure and flow velocity). Meanwhile, the plant management status and maintenance factors were also considered as the influencing factors to pipelines. According to the analysis, a corrosion risk assessment method for the pipelines in the natural gas purification plant was developed based on fault tree and scoring method. Finally, the method was applied to the pipelines in purification plant to verify the accuracy of this method.