Interior Sound Field Subjective Evaluation Based on the 3D Distribution of Sound Quality Objective Parameters and Sound Source Localization

Controlling low frequency noise in an interior sound field is always a challenge in engineering, because it is hard to accurately localize the sound source. Spherical acoustic holography can reconstruct the 3D distributions of acoustic quantities in the interior sound field, and identify low-frequency sound sources, but the ultimate goal of controlling the interior noise is to improve the sound quality in the interior sound field. It is essential to know the contributions of sound sources to the sound quality objective parameters. This paper presents the mapping methodology from sound pressure to sound quality objective parameters, where sound quality objective parameters are calculated from sound pressure at each specific point. The 3D distributions of the loudness and sharpness are obtained by calculating each point in the entire interior sound field. The reconstruction errors of those quantities varying with reconstruction distance, sound frequency, and intersection angle are analyzed in numerical simulation for one- and two-monopole source sound fields. Verification experiments have been conducted in an anechoic chamber. Simulation and experimental results demonstrate that the sound source localization results based on 3D distributions of sound quality objective parameters are different from those based on sound pressure.     

R语言多目标优化养阴通脑颗粒组方中3种黄酮类指标成分提取工艺

目的 多目标优化养阴通脑颗粒组方中3种黄酮类指标成分的提取工艺.方法 以养阴通脑颗粒组方中葛根素、毛蕊异黄酮和芒柄花素的提取率为检测指标,采用4因素3水平的正交试验设计方法进行提取工艺考察.通过R语言结合熵权法赋予权值,建立BP神经网络模型,再利用遗传算法对网络进行目标寻优,从而得到养阴通脑颗粒组方中葛根素、毛蕊异黄酮和芒柄花素的最佳提取工艺.结果 养阴通脑颗粒组方中葛根素、毛蕊异黄酮和芒柄花素的最优工艺条件为乙醇体积分数85%、提取时间1.5 h、提取温度80 ℃、乙醇用量25倍,模型综合评价预测值为0.389,而实验所得的平均综合评价值为0.394,相对误差为1.27%,表明具有良好的网络预测性.结论 结合所得3个指标成分的提取率和提取工艺的可操作性、可重复性,建立的数学模型可用于对养阴通脑颗粒组方中葛根素、毛蕊异黄酮和芒柄花素的提取工艺进行分析和预测,为实现中药有效成分多目标寻优提供了新的参考.     

Global and caregiving mastery as moderators in the caregiving stress process

Objectives: The study tests the circumstances under which global mastery and caregiving mastery moderate the impact of objective and subjective stressors on depressive and anxious symptoms among Alzheimer's caregivers.

Methods: Data from a sample of 200 spousal caregivers to people with Alzheimer's disease were examined. Sixteen separate models were tested with depression and anxiety regressed on two measures of objective demand (activities of daily living and problem behaviors) and two measures of subjective demand (role overload and role captivity) matched with each of the two mastery measures and their relevant interaction terms.

Results: Caregiving mastery functions as a moderator in the relationship between subjective demands and depression and anxiety, that is, at higher levels of caregiving mastery, the positive association between role overload and role captivity on depression and anxiety was weaker. Although there is a strong main effect of global mastery on mental health, it was not found to act as a moderator in this study.

Conclusion: The findings demonstrate the importance of evaluating role-specific measures, such as caregiving mastery, as well as assessing a variety of stressful demands, in order to explicate the pathways through which psychosocial resources exert their protective effects.     

Response as a predictor of survival in patients with recurrent glioblastoma treated with bevacizumab

Development of effective therapies for recurrent glioblastoma multiforme (GBM) and reliable, timely evaluation of their benefit are needed. Understanding the relationship between objective response (OR) and survival is important for determining whether OR can provide an early signal of treatment activity in clinical trials. We performed a landmark analysis to evaluate the association between OR and survival at 9, 18, and 26 weeks for 167 patients with recurrent GBM who participated in BRAIN, a phase II trial that evaluated efficacy of bevacizumab alone or in combination with irinotecan, using the Cox regression models adjusted for age, baseline Karnofsky performance score, first vs second relapse, and treatment arm. Hazard ratios (HRs) and P-values for survival between responders and nonresponders were calculated. Additional analyses were performed to test robustness, validity, fit, and accuracy of the models. The relationships between progression-free survival (PFS) and survival and between OR and PFS were also explored. There were 55 responders and 112 nonresponders across the 2 treatment arms in BRAIN. OR status at 9, 18, and 26 weeks was a statistically significant predictor of survival (HR ≤ 0.52, P < .01). PFS was also a statistically significant predictor of survival at each landmark (HR ≤ 0.25, P < .0001). The association between OR and PFS was not statistically significant, likely due to inadequate statistical power for the analysis. Clarifying the relationship of OR and survival is important for determining whether OR can be a reliable predictor of the benefit of a therapeutic agent in patients with recurrent GBM.     

两种口腔矫治器治疗阻塞性睡眠呼吸暂停低通气综合征的疗效比较

目的在下颌前伸程度相同的情况下,比较两种不同设计类（分体式与整体式）口腔矫治器治疗阻塞性睡眠呼吸暂停低通气综合征（obstructivesleepapnea／hypOpneasyndrome,OSAHS）成年男性患者的主客观疗效。方法采用随机交叉实验设计,16例OSAHS患者先后戴用分体式和整体式两种口腔矫治器,每副矫治器戴用3个月,患者戴用两种矫治器之间需停戴2周。在治疗前及戴用两种矫治器3个月时分别获取患者的主观疗效、多导睡眠监测（polysomnography,PSG）及上气道大小参数。采用单因素方差分析比较两者主客观疗效及上气道形态变化。结果两种口腔矫治器治疗OSAHS的主客观疗效显著（P〈O．05）。在呼吸指标方面,戴用分体式口腔矫治器的有效率为56．3％,整体式口腔矫治器的有效率为68．9％,两者无显著性差异（P〉0．05）。分体式在改善睡眠效率和深睡眠的比例方面不及整体式（P〈O．05）。两种口腔矫治器显著增大上气道各水平的前后径（P〈O．05）,两者间无明显差别（P〉0．05）。结论两种口腔矫治器对OSAHS患者的主客观疗效大致相似,但整体式口腔矫治器在改善睡眠效率和主观依从性方面占优势。     

Prognostic role of modified Glasgow Prognostic score in elderly non-small cell lung cancer patients treated with anti-PD-1 antibodies

BackgroundThis study aimed to investigate whether the immunosenescence-related score is a critical prognostic predictor of anti-programmed cell death protein 1 (PD-1) axis inhibitors in elderly patients with advanced non-small cell lung cancer (NSCLC).MethodsWe reviewed 51 patients with advanced NSCLC aged ≥75 years, who were treated with nivolumab or pembrolizumab at the National Cancer Center Hospital between December 2015 and April 2019. Factors such as modified Glasgow prognostic score (mGPS), Neutrophil-to-lymphocyte ratio (NLR), and Charlson comorbidity index (CCI) were used to assess immunosenescence.ResultsThe objective response rate (ORR) and disease control rate (DCR) of all patients were 25.4% (95% confidence interval [CI]: 14.3–39.6) and 52.9% (95% CI: 38.5–67.1), respectively. High mGPS (score of 2) was associated with low DCR compared to low mGPS (score of 0–1) (26.0% vs. 54.0%, p = 0.03). However, none of these scores were significantly related to the ORR. High mGPS was significantly linked to shorter median progression-free survival (mPFS) (4.2 mos. vs. 12.7 mos, p < 0.01), and median overall survival (mOS) (4.8 mos. vs. 28.1 mos, p = 0.03). However, neither CCI nor NLR was associated with prognosis. Multivariate regression analysis identified high mGPS as a significant prognostic factor for mOS (hazard ratio, HR: 0.31 [95% CI: 0.13–0.71], p < 0.01).ConclusionsHigh mGPS scores significantly impaired DCR, mPFS, and mOS in patients with advanced NSCLC treated with anti-PD-1 antibodies.     

Ipilimumab with atezolizumab-bevacizumab in patients with advanced hepatocellular carcinoma: The PRODIGE 81-FFCD 2101-TRIPLET-HCC trial

A substantial proportion of patients with hepatocellular carcinoma have to face up, sooner or later, to systemic therapy. The current standards as first line systemic therapies are either atezolizumab (anti-PD-L1) plus bevacizumab (anti-VEGF), or durvalumab (anti-PD-L1) plus tremelimumab (anti-CTLA-4). However, the median overall survival remains below 20 months, and a minority of patients become long-term survivors. Of interest in immune-oncology strategies for hepatocellular carcinoma, the objective response seems to be the most reliable surrogate marker of better overall survival.TRIPLET-HCC (NCT05665348) is a multicentre, randomised, open-label phase II-III trial designed to evaluate efficacy and safety of the triple combination by the addition of ipilimumab (anti-CTLA-4) to atezolizumab/bevacizumab, versus the double atezolizumab/bevacizumab combination. The main inclusion criteria are histologically proven BCLC-B/C HCC without previous systemic therapy. The primary objective of the phase II is the objective response rate in the triple arm, and OS in the triple versus double arms in the phase III. Secondary endpoints common to the phases II and III are the comparisons of progression-free survival, objective response rates, tolerance and quality of life. In addition, genetic and epigenetic studies from tissue and circulating DNA/RNA will be conducted to assess their prognostic or predictive value.     

An Exploration of Trifluridine/Tipiracil Monotherapy and in Combination With Bevacizumab or Immune Checkpoint Inhibitors for Patients With Metastatic Colorectal Cancer: A Real-World Study

BackgroundTrifluridine/tipiracil (TAS-102) has achieved modest efficacy in the late-line treatment of metastatic colorectal cancer. The present study aimed to explore the clinical efficacy and drug toxicities of TAS-102 for patients with metastatic colorectal cancer in real-world clinical setting.MethodsFrom October 2020 to February 2022, patients with metastatic colorectal cancer who failed from 2 or more lines of prior therapy and treated with TAS-102 monotherapy, in combination with bevacizumab or immune checkpoint inhibitors (ICIs) were analyzed. The evaluation indicators were progression free survival (PFS), objective response rate , disease control rate (DCR), overall survival (OS) and drug toxicities.ResultsA total of 70 patients were enrolled. The objective response rate and DCR were 1.4% and 68.6%. The median PFS and OS were 6.0 (95% CI: 4.1-7.9) and 10.0 (95% CI: 8.3-11.7) months. Compared with TAS-102 monotherapy and TAS-102 plus ICIs, TAS-102 plus bevacizumab obtained superior DCR (75.9% vs. 50% vs. 40%, P = .047), PFS (6.3m vs. 3.0 m vs. 3.0 m, P = .041) and OS (12.0 m vs. 6.5 m vs. 6.0m, P = .013). Patients without prior regorafenib or fruquintinib therapy obtained better median PFS (6.3 vs. 4.3 m, P = .031) and OS (NR vs. 9.0 m, P = .036). Other indicators, including age, tumor site, KRAS status and use of fluoropyrimidine as last regimen before TAS-102, did not affect the clinical efficacy of TAS-102. The most frequent adverse events were leukopenia, neutropenia, anemia, fatigue, nausea, and vomiting.ConclusionIn real-world clinical setting, TAS-102 showed consistent clinical efficacy and manageable safety with previous prospective clinical studies. Compared with monotherapy and TAS-102 plus ICIs, TAS-102 plus bevacizumab demonstrated better clinical efficacy for metastatic colorectal cancer.