BACKGROUND Lateral pelvic lymph node(LLN)metastasis(LLNM)occur in up to 28%of patients with low rectal tumours.While prophylactic lateral pelvic lymph node dissection(LLND)has been abandoned by most western institutio...BACKGROUND Lateral pelvic lymph node(LLN)metastasis(LLNM)occur in up to 28%of patients with low rectal tumours.While prophylactic lateral pelvic lymph node dissection(LLND)has been abandoned by most western institutions in the era of neoadjuvant chemoradiation therapy(CRT),the role of selective LLND in patients with enlarged LLN on pre-CRT imaging remains unclear.Some studies have shown improved survival and recurrence outcomes when LLNs show"response"to CRT.However,no management algorithm exists to differentiate treatment for"responders"vs"non-responders".AIM To determine if selective LLND in patients with enlarged LLNs results in improved survival and recurrence outcomes.METHODS A systemic search of Pub Med and Embase databases for studies reporting on patients with synchronous radiologically suspicious LLNM(s-LLNM)in rectal cancer receiving preoperative-CRT was performed.RESULTS Fifteen retrospective,single-centre studies were included.793 patients with sLLNM were evaluated:456 underwent TME while 337 underwent TME with7,LLND post-CRT.In the TME group,local recurrence(LR)rates range from 12.5%to 36%.Five-year disease free survival(DFS)was 42%to 75%.In the TME with LLND group,LR rates were 0%to 6%.Five years DFS was 41.2%to 100%.Radiological response was seen in 58%.Pathologically positive LLN was found in up to 94%of non-responders vs 0%to 20%in responders.Young age,low tumour location and radiological non-response were associated with final positive LLNM and lowered DFS.CONCLUSION LLND is associated with local control in patients with s-LLNM.It can be performed in radiological non-responders given a large majority represent true LLNM.Its role in radiological responders should be considered in selected high risk patients.展开更多
Military aviation demands cognitive performance,emotional stability,and resilience under pressure.Portuguese Airforce pilots face additional challenges:maintaining fitness and readiness independently,without structure...Military aviation demands cognitive performance,emotional stability,and resilience under pressure.Portuguese Airforce pilots face additional challenges:maintaining fitness and readiness independently,without structured exercise regimens.Yoga’s capacity to enhance mindfulness makes it a promising intervention.Despite potential benefits,research on yoga’s impact in military aviation remains limited.This study investigates incorporation of yoga into the training regimen of Portuguese Airforce to verify decision-making effectiveness and performance.A randomized controlled trial was conducted with 18 Portuguese Air Force pilots:Control Group(n=8)followed standard military training,and Intervention Group(n=10)received aditional yoga training twice a week,for 12 weeks.Assessments included Five Facet Mindfulness Questionnaire(FFMQ),Multidimensional Assessment of Interoceptive Awareness(MAIA),Aviation Safety Attitude Scale(ASAS),Risk Perception To Self(RPTS),Trail Making Test(TMT)and aviation simulator performance.Data analysis used Jamovi v2.6.13.The yoga group showed significant improvements in mindfulness(FFMQ),interoceptive awareness(MAIA),self-confidence and safety attitudes(ASAS),cognitive flexibility(TMT-B),and simulator performance(fewer flight errors).En-hancements in attention regulation,body awareness,and emotional self-regulation reflect greater readiness for stress management.Improvements in decision-making,calculated risk-taking,and operational safety suggest yoga’s potential to reinforce psychophysiological resilience in high-demand environments.Yoga contributes meaningfully to enhanced performance and safety in high-pressure aviation environments.These findings may inform policy-level decisions toward integrating mandatory mind-body training programs that are cost-effective and time-efficient.The benefits observed may be applicable to Air Force teams globally,as well as commercial aviation,civil aviation,and other high-stress,high-performance domains,including elite sports.展开更多
By optimizing pump power ratio between 1st order backward pump and 2nd order forward pump on discrete Raman amplifier, we demonstrated over 2dB noise figure improvement without excessive non-linearity degradation.
We designed and evaluated a fluoride-based high concentration erbium/ cerium co-doped fiber amplifier. It is suitable for Metropolitan Area Networks due to faster transient, flatter (unfiltered) gain, smaller footprin...We designed and evaluated a fluoride-based high concentration erbium/ cerium co-doped fiber amplifier. It is suitable for Metropolitan Area Networks due to faster transient, flatter (unfiltered) gain, smaller footprint and gain excursion than its silica-based counterpart.展开更多
文摘BACKGROUND Lateral pelvic lymph node(LLN)metastasis(LLNM)occur in up to 28%of patients with low rectal tumours.While prophylactic lateral pelvic lymph node dissection(LLND)has been abandoned by most western institutions in the era of neoadjuvant chemoradiation therapy(CRT),the role of selective LLND in patients with enlarged LLN on pre-CRT imaging remains unclear.Some studies have shown improved survival and recurrence outcomes when LLNs show"response"to CRT.However,no management algorithm exists to differentiate treatment for"responders"vs"non-responders".AIM To determine if selective LLND in patients with enlarged LLNs results in improved survival and recurrence outcomes.METHODS A systemic search of Pub Med and Embase databases for studies reporting on patients with synchronous radiologically suspicious LLNM(s-LLNM)in rectal cancer receiving preoperative-CRT was performed.RESULTS Fifteen retrospective,single-centre studies were included.793 patients with sLLNM were evaluated:456 underwent TME while 337 underwent TME with7,LLND post-CRT.In the TME group,local recurrence(LR)rates range from 12.5%to 36%.Five-year disease free survival(DFS)was 42%to 75%.In the TME with LLND group,LR rates were 0%to 6%.Five years DFS was 41.2%to 100%.Radiological response was seen in 58%.Pathologically positive LLN was found in up to 94%of non-responders vs 0%to 20%in responders.Young age,low tumour location and radiological non-response were associated with final positive LLNM and lowered DFS.CONCLUSION LLND is associated with local control in patients with s-LLNM.It can be performed in radiological non-responders given a large majority represent true LLNM.Its role in radiological responders should be considered in selected high risk patients.
文摘Military aviation demands cognitive performance,emotional stability,and resilience under pressure.Portuguese Airforce pilots face additional challenges:maintaining fitness and readiness independently,without structured exercise regimens.Yoga’s capacity to enhance mindfulness makes it a promising intervention.Despite potential benefits,research on yoga’s impact in military aviation remains limited.This study investigates incorporation of yoga into the training regimen of Portuguese Airforce to verify decision-making effectiveness and performance.A randomized controlled trial was conducted with 18 Portuguese Air Force pilots:Control Group(n=8)followed standard military training,and Intervention Group(n=10)received aditional yoga training twice a week,for 12 weeks.Assessments included Five Facet Mindfulness Questionnaire(FFMQ),Multidimensional Assessment of Interoceptive Awareness(MAIA),Aviation Safety Attitude Scale(ASAS),Risk Perception To Self(RPTS),Trail Making Test(TMT)and aviation simulator performance.Data analysis used Jamovi v2.6.13.The yoga group showed significant improvements in mindfulness(FFMQ),interoceptive awareness(MAIA),self-confidence and safety attitudes(ASAS),cognitive flexibility(TMT-B),and simulator performance(fewer flight errors).En-hancements in attention regulation,body awareness,and emotional self-regulation reflect greater readiness for stress management.Improvements in decision-making,calculated risk-taking,and operational safety suggest yoga’s potential to reinforce psychophysiological resilience in high-demand environments.Yoga contributes meaningfully to enhanced performance and safety in high-pressure aviation environments.These findings may inform policy-level decisions toward integrating mandatory mind-body training programs that are cost-effective and time-efficient.The benefits observed may be applicable to Air Force teams globally,as well as commercial aviation,civil aviation,and other high-stress,high-performance domains,including elite sports.
文摘By optimizing pump power ratio between 1st order backward pump and 2nd order forward pump on discrete Raman amplifier, we demonstrated over 2dB noise figure improvement without excessive non-linearity degradation.
文摘We designed and evaluated a fluoride-based high concentration erbium/ cerium co-doped fiber amplifier. It is suitable for Metropolitan Area Networks due to faster transient, flatter (unfiltered) gain, smaller footprint and gain excursion than its silica-based counterpart.
