Neutrophil-to-Lymphocyte Ratio (NLR) Predicts PD-1 Inhibitor Survival in Patients with Metastatic Gastric Cancer

Background and Aims. Biomarkers for systemic inflammation have been introduced into clinical practice for risk-rating in cancer patients’ treatment. This study is aimed at confirming the prognostic role of the neutrophil-to-lymphocyte ratio (NLR) as an effective biomarker for patients with metastatic gastric cancer (MGC) receiving anti-PD-1 agents. Method. Patients with MGC who received anti-PD-1 treatment at the Chinese PLA General Hospital between January 2016 and November 2020 were reviewed. The study analyzed the association of NLR and overall survival (OS) or progression-free survival (PFS) and antitumor response rate with PD-1 inhibitors. Results. 137 patients were included in the final analysis. The area under the curve value of NLR for 6-month OS was 0.71. The best cut-off value for NLR was 3.23. NLR < 3.23 was associated with longer OS ( HR = 0.38 , 95% CI, 0.26-0.57, p < 0.001 ) and PFS ( HR = 0.42 , 95% CI, 0.29-0.62, p < 0.001 ) in patients with MGC. No significant difference was observed in the objective response rate (ORR) (35.8% vs. 28.6%, p = 0.377 ) and disease control rate (DCR) (86.4% vs. 78.6%, p = 0.229 ) in the NLR < 3.23 group and in the NLR ≥ 3.23 group, respectively. Univariate analysis and multivariate analysis found that NLR was an independent prognosis biomarker for PFS and OS. Conclusions. Pretreatment elevated NLR was significantly associated with inferior PFS and OS in patients with MGC who received anti-PD-1 inhibitors. Clinicians need to consider patients with elevated NLR for decisions on immunotherapy strategy.

Morse theory and the calculus of variations

We prove for the first time that classical Morse theory applies to functionals of the form 𝒥 ⁢ ( u ) = 1 2 ⁢ ∫ Ω A α ⁢ β i ⁢ j ⁢ ( x ) ⁢ ∂ ⁡ u i ∂ ⁡ x α ⁢ ∂ ⁡ u j ∂ ⁡ x β ⁢ 𝑑 x + ∫ Ω G ⁢ ( x , u ) ⁢ 𝑑 x \displaystyle\mathcal{J}(u)=\frac{1}{2}\int_{\Omega}A^{ij}_{\alpha\beta}(x)% \frac{\partial u^{i}}{\partial x^{\alpha}}\frac{\partial u^{j}}{\partial x^{% \beta}}\,dx+\int_{\Omega}G(x,u)\,dx where u : Ω → ℝ N {u:\Omega\to\mathbb{R}^{N}} , Ω ⊂ ℝ n {\Omega\subset\mathbb{R}^{n}} compact with C ∞ {C^{\infty}} boundary ∂ ⁡ Ω {\partial\Omega} , u | ∂ ⁡ Ω = φ {u|_{\partial\Omega}=\varphi} , and we argue that this is the largest class to which Morse theory applies.

Effects of Ozone on Hippocampus BDNF and Fos Expressions in Rats with Chronic Compression of Dorsal Root Ganglia

The effects of ozone on hippocampal expression levels of brain-derived neurotrophic factor (BDNF) and c-fos protein (Fos) were evaluated in rats with chronic compression of dorsal root ganglia (CCD). Forty-eight adult female Sprague-Dawley rats were randomly divided into the following 4 groups ( n = 12 ): sham operation (sham group), CCD group, CCD with 20 μg/ml of ozone ( CCD + A O 3 group), and CCD with 40 μg/ml of ozone ( CCD + B O 3 group). Except the sham group, unilateral L5 dorsal root ganglion (DRG) compression was performed on all other groups. On days 1, 2, and 4 after the operation, the CCD + A O 3 and CCD + B O 3 groups were injected with 100 μl of ozone with concentrations of 20 and 40 μg/ml, respectively. Thermal withdrawal latencies (TWLs) and mechanical withdrawal thresholds (MWTs) were measured at various time points before and after the operation. BDNF and Fos expressions were examined in the extracted hippocampi using immunohistochemistry. The TWLs and MWTs of CCD model rats that received ozone were lower with decreased BDNF and increased Fos expression levels, on day 21 after the operation, compared to those of the sham group ( P < 0.05 ). The TWLs and MWTs of the CCD + A O 3 and CCD + B O 3 groups were higher with increased BDNF and decreased Fos expression levels, on day 21 after the operation, compared to those of the CCD group ( P < 0.05 ). The TWLs were longer and the MWTs were higher in the CCD + B O 3 group at each time point with increased BDNF and decreased Fos expression levels, on day 21 after the operation, compared to those of the CCD + A O 3 group ( P < 0.05 ). Our results revealed that ozone can relieve the neuropathic pain caused by the pathological neuralgia resulting from DRG compression in rats. The mechanism of action for ozone is likely associated with changes in BDNF and Fos expression levels in the hippocampus.

Bounded complexes of permutation modules

Let k k be a field of characteristic p > 0 p > 0 . For G G an elementary abelian p p -group, there exist collections of permutation modules such that if C ∗ C^* is any exact bounded complex whose terms are sums of copies of modules from the collection, then C ∗ C^* is contractible. A consequence is that if G G is any finite group whose Sylow p p -subgroups are not cyclic or quaternion, and if C ∗ C^* is a bounded exact complex such that each C i C^i is a direct sum of one dimensional modules and projective modules, then C ∗ C^* is contractible.

Relationship between the Quantitative Indicators of Cranial MRI and the Early Neurodevelopment of Preterm Infants

Aim. To explore the relationship between the quantitative indicators (biparietal width, interhemispheric distance) of the cranial MRI for preterm infants at 37 weeks of postmenstrual age (PMA) and neurodevelopment at 6 months of corrected age. Methods. A total of 113 preterm infants (gestational age < 37 weeks) delivered in the Obstetrics Department of the First People’s Hospital of Lianyungang from September 2018 to February 2020 and directly transferred to the Neonatology Department for treatment were enrolled in this study. Based on their development quotient (DQ), the patients were divided into the normal ( DQ ≥ 85 , n = 76 ) group and the abnormal ( DQ < 85 , n = 37 ) group. Routine cranial MRI (cMRI) was performed at 37 weeks of PMA to measure the biparietal width (BPW) and interhemispheric distance (IHD). At the corrected age of 6 months, Development Screening Test (for children under six) was used to assess the participants’ neurodevelopment. Results. Univariate analysis showed statistically significant differences in BPW, IHD, and the incidence of bronchopulmonary dysplasia between the normal and the abnormal groups ( P < 0.05 ), while no statistically significant differences were found in maternal complications and other clinical conditions between the two groups ( P > 0.05 ). Binary logistic regression analysis demonstrated statistically significant differences in IHD and BPW between the normal and the abnormal groups (95% CI: 1.629-12.651 and 0.570-0.805, respectively; P = 0.004 and P < 0.001 , respectively), while no significant differences were found in the incidence of bronchopulmonary dysplasia between the two groups (95% CI: 0.669-77.227, P = 0.104 ). Receiver operating characteristic curve revealed that the area under the curve of BPW, IHD, and the joint predictor (BPW + IHD) were 0.867, 0.805, and 0.881, respectively (95% CI: 0.800-0.933, 0.710-0.900, and 0.819-0.943, respectively; all P values < 0.001). Conclusion. BPW and IHD, the two quantitative indicators acquired by cMRI, could predict the neurodevelopmental outcome of preterm infants at the corrected age of 6 months. The combination of the two indicators showed an even higher predictive value.

Evaluation of the Effect of Hydroxyzine on Preoperative Anxiety and Anesthetic Adequacy in Children: Double Blind Randomized Clinical Trial

Surgical procedures can generate significant preoperative anxiety (POA) in as much as 70% of the paediatric population. The role of hydroxyzine and distractive techniques such as clowns in the management of anxiety is controversial. Our main objective was to evaluate the effect of hydroxyzine on the control of POA. The secondary objective was to assess the potential additive effect of hydroxyzine and distracting techniques. We performed a randomized double-blind, controlled clinical trial in children aged 2–16 years undergoing outpatient surgery ( n = 165 ). Subjects were randomized to hydroxyzine (group 1) or placebo (group 2). For the secondary objective, two further groups were made by allocation by chance to hydroxyzine plus accompaniment with clowns (group 3) and placebo plus clowns (group 4). All patients were accompanied by their parents as the standard procedure. POA was determined by a modified Yale scale of POA (m-YPAS). Compliance of children during induction of anesthesia (Induction Compliance Checklist (ICC)) was also assessed. No differences ( p = 0.788 ) were found in POA control at the time of induction measured by m-YPAS (group 1: 39.2 ± 27.9 ; group 2: 37.0 ± 26.1 ; group 3: 34.7 ± 25.5 ; group 4: 32.4 ± 20.5 ). No differences were found in the level of ICC between the different treatment arms (group 1: 1.8 ± 3.4 ; group 2: 1.5 ± 3.0 ; group 3: 1.2 ± 2.4 ; group 4: 1.5 ± 2.7 ). The combination of all treatments (group 3) was the only effective strategy to contain the progression of anxiety. In conclusion, hydroxyzine was not effective to control POA in children. The combination of hydroxyzine and clowns avoided the progression of POA in our patients. This trial is registered with ClinicalTrials.gov identifier: NCT03324828 (registered 21 September 2017, subject recruitment started on 12th January 2018).

Generalization of prime ideals in $$M_n(N)$$-group $$N^{n}$$

The notion of a matrix nearring over an arbitrary nearring was introduced by (Meldrum and Walt Arch. Math. 47(4): 312–319, 1986). In this paper, we define the notions such as weakly $$\tau$$ τ -prime $$(\tau =0,c,3,e)$$ ( τ = 0 , c , 3 , e ) ideals of an N-group G, which are the generalization of the classes of $$\tau$$ τ -prime ideals of G, and provide suitable examples to distinguish between the two classes. We extend the concept to obtain the one-one correspondence between weakly $$\tau$$ τ -prime ideals $$(\tau =0,c,3,e)$$ ( τ = 0 , c , 3 , e ) of N-group (over itself) and those of $$M_n(N)$$ M n ( N ) -group $$N^{n}$$ N n , where $$M_n(N)$$ M n ( N ) is the matrix nearring over the nearring N. Further, we prove the correspondence between weakly 2-absorbing ideals of these classes.

Effects of Early Weight Gain Velocity, Diet Quality, and Snack Food Access on Toddler Weight Status at 1.5 Years: Follow-Up of a Randomized Controlled Infant Formula Trial

This study followed children who participated in a feeding trial in which the type of randomized infant formula fed from 2 weeks significantly affected weight gain velocity during the first 4 months and weight-for-length Z (WLZ) scores up to 11.5 months. We focused on measures of anthropometry, dietary intakes, and parenting related to the provision of snack foods that were collected at the end of the trial (1 year) and the 1.5 years follow-up visit. We not only describe what toddlers are eating, but we also determined the independent and/or interactive effects of randomized formula group, early weight gain velocity, the nutrient content of the post-formula diet, and maternal snack food practices, on toddlers’ weight status. Diet quality underwent drastic changes during this 6-month period. As infant formula disappeared from the diet, fruit and 100% fruit juice intake increased slightly, while intake of “What We Eat in America” food categories sweetened beverages and snacks and sweets more than doubled. Added sugars accounted for 5% of energy needs at 1 year and 9% at 1.5 years. Generalized linear mixed models revealed that, independent of the randomized formula group, greater velocities of weight gain during early infancy and lower access to snacks as toddlers predicted higher WLZ and a greater proportion of toddlers with overweight at 1.5 years. Energy and added sugar intake had no significant effects. These findings add to the growing body of evidence that unhealthy dietary habits are formed even before formula weaning and that, along with improving early diet, transient rapid weight gain and parental feeding practices are modifiable determinants that may reduce risks for obesity.

Peptide-based enteral formula vs a whole protein enteral formula after major intestinal surgeries in children

Background Malnutrition is a common finding after major abdominal surgeries especially after prolonged period of fasting in children. Enteral feeding is the commonest support way postoperatively for stimulating gut hormones, modulating immunity, and maintaining the barrier function of the intestinal mucosa. Our aim was to compare the results and outcome regarding tolerance, nutritional status, and hospital stay following a postoperative diet of peptide-based enteral formula against a whole protein enteral formula after major intestinal surgeries in pediatric patients who had resection and re-anastomosis after intussusception. Results This is a prospective cohort study on two groups of patients with a total of 30 patients during the period between January 2019 and June 2020. All patients in both groups underwent major intestinal surgeries (resection and re-anastomosis after intussusception). The first group received postoperative whole protein formula exclusively on the 3rd postoperative day while the other group received peptide-based formula exclusively on the same day. Postoperative mean serum albumin and pre-albumin levels were significantly higher in peptide-based formula group compared to those who had protein-based formula as their initial feeds (P value < 0.05). The average hospital stay was also significantly shorter in the peptide group (P value < 0.05). Peptide formula was easily tolerated than protein formula in postoperative children who had major intestinal surgeries. Conclusion Peptide-based enteral formulas are better tolerated and more useful as regards nutritional status than whole-protein formulas in post-operative course of pediatric patients regarding clinical outcome and better economically with shorter hospital stay.

CENTRE OF BANACH ALGEBRA VALUED BEURLING ALGEBRAS

We prove that for a Banach algebra A having a bounded $\mathcal {Z}(A)$ -approximate identity and for every $\mathbf {[IN]}$ group G with a weight w which is either constant on conjugacy classes or satisfies $w \geq 1$ , $\mathcal {Z}(L^{1}_{w}(G) \otimes ^{\gamma } A) \cong \mathcal {Z}(L^{1}_{w}(G)) \otimes ^{\gamma } \mathcal {Z}(A)$ . As an application, we discuss the conditions under which $\mathcal {Z}(L^{1}_{\omega }(G,A))$ enjoys certain Banach algebraic properties, such as weak amenability or semisimplicity.