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  • Dalrymple Jennings posted an update 3 weeks ago

    Generic quality of life (QoL) is an important issue in decision making related to the primary treatment of localized prostate cancer (PC). This study assessed the dynamic changes of QoL in patients with localized PC under different treatment modalities. From 2013 to 2018, we prospectively assessed QoL scores in patients with localized PC under unitary treatment using the World Health Organization Quality of Life (WHOQOL) BREF version. The trajectories of the QoL scores after different treatments were estimated using a kernel-smoothing method. Dynamic changes in the major determinants were analyzed using a mixed effects model. The clinical features of the participants in our institute were compared with PC patients in Taiwan’s cancer registry. A total of 196 patients were enrolled with 491 repeated assessments. The participants shared similar clinical characteristics with the PC patients in Taiwan as a whole. Patients with lower household incomes showed statistically significant lower scores on all four domains and related facets, while PC survivors with comorbidities of anxiety and/or diabetes appeared to be affected on the physical domain and related facets. After controlling for these determinants, patients under active surveillance or observation demonstrated significantly higher QoL scores in the physical and social domains, as well as several facets belonging to these domains, in mixed models compared with patients undergoing radical prostatectomy or radiotherapy within the first year. The generic QoL scores were higher within the first year in patients receiving active surveillance or observation after controlling other significant factors. The difference diminished after one year of post management. More studies are needed to corroborate our findings.Sitting toilets are preferred globally because they afford a relatively comfortable posture. However, squat toilets are among the most common toilets in numerous public areas because of their advantages, including personal hygiene, easy cleaning, and health benefits. This study attempted to determine optimal toilet design parameters and recruited 50 Taiwanese and 50 Southeast Asian women and collected span between feet (SBF) data for participants squatting in their most comfortable posture, and also surveyed maximum outer width (MOW) data of 28 public squat toilets in Taipei. Finally, we compared the squatting stability levels of 40 female participants (20 Taiwanese and 20 Southeast Asians) who squatted for 2 min at comfortable SBF and MOW-based SBF values. The results revealed that the minimum and maximum SBFs of Taiwanese were 14.52 cm and 18.40 cm, and that of Southeast Asians were 15.64 cm and 20.40 cm, respectively. No significant difference was observed in the SBFs between the two groups was observed. The mean (range) MOW of the surveyed toilets was 27.7 (27-29) cm. Analysis of variance results showed no difference in stability between the two SBFs. This implies that the comfortable SBF (i.e., 16 cm between the participants’ heels) was narrower than the MOW, as commonly used, indicating that the comfortable SBF can be considered as an optimal toilet width parameter because of its constant stability.Blockchain technology has brought significant advantages for security and trustworthiness, in particular for Internet of Things (IoT) applications where there are multiple organisations that need to verify data and ensure security of shared smart contracts. Blockchain technology offers security features by means of consensus mechanisms; two key consensus mechanisms are, Proof of Work (PoW) and Practical Byzantine Fault Tolerance (PBFT). While the PoW based mechanism is computationally intensive, due to the puzzle solving, the PBFT consensus mechanism is communication intensive due to the all-to-all messages; thereby, both may result in high energy consumption and, hence, there is a trade-off between the computation and the communication energy costs. In this paper, we propose a hybrid-blockchain (H-chain) framework appropriate for scenarios where multiple organizations exist and where the framework enables private transaction verification and public transaction sharing and audit, according to application needs. In particular, we study the energy consumption of the hybrid consensus mechanisms in H-chain. Moreover, this paper proposes a reward plan to incentivize the blockchain agents so that they make contributions to the H-chain while also considering the energy consumption. While the work is generally applicable to IoT applications, the paper illustrates the framework in a scenario which secures an IoT application connected using a software defined network (SDN). The evaluation results first provide a method to balance the public and private parts of the H-chain deployment according to network conditions, computation capability, verification complexity, among other parameters. The simulation results demonstrate that the reward plan can incentivize the blockchain agents to contribute to the H-chain considering the energy consumption of the hybrid consensus mechanism, this enables the proposed H-chain to achieve optimal social welfare.KRAS is one of the most common human oncogenes, but concerted efforts to produce direct inhibitors have largely failed, earning KRAS the title of “undruggable”. Recent efforts to produce subtype specific inhibitors have been more successful, and several KRASG12C inhibitors have reached clinical trials, including adagrasib and sotorasib, which have shown early evidence of efficacy in patients. Lessons from other inhibitors of the RAS pathway suggest that the effect of these drugs will be limited in vivo by the development of drug resistance, and pre-clinical studies of G12C inhibitors have identified evidence of this. In this review we discuss the current evidence for G12C inhibitors, the mechanisms of resistance to G12C inhibitors and potential approaches to overcome them. Pelabresib mw We discuss possible targets of combination therapy, including SHP2, receptor tyrosine kinases, downstream effectors and PD1/PDL1, and review the ongoing clinical trials investigating these inhibitors.

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