Steerable catheters are rapidly evolving and still require technological refinements to extend current capabilities.

BACKGROUND Adding radiotherapy (RT) to systemic therapy improves progression-free survival (PFS) and overall survival (OS) in oligometastatic non-small cell lung cancer (NSCLC). Whether these findings translate to EGFR-mutated NSCLC remains unknown. The SINDAS trial (NCT02893332) evaluated first-line tyrosine kinase inhibitor (TKI) therapy for EGFR-mutated synchronous oligometastatic NSCLC, and randomized to up-front RT vs. no RT; we now report the pre-specified interim analysis at 68% accrual. METHODS Inclusion criteria were biopsy-proven EGFR-mutated adenocarcinoma (per amplification refractory mutation system or next generation sequencing), with synchronous (newly-diagnosed, treatment-naïve) oligometastatic (≤5 metastases; ≤2 lesions in any one organ) NSCLC without brain metastases. All patients received a first-generation TKI (gefitinib, erlotinib, or icotinib), and randomization was between no RT vs. RT (25–40 Gy in 5 fractions depending on tumor size/location) to all metastases and the primary tumor/involved regional lymphatics. The primary endpoint (intention-to-treat) was PFS. Secondary endpoints included OS and toxicities. All statistical tests were 2-sided. RESULTS A total of 133 patients (n = 65 TKI only, n = 68 TKI+RT) were enrolled (2016–2019). The median follow-up was 23.6 months. The respective median PFS was 12.5 months vs. 20.2 months (p < .001), and the median OS was 17.4 months vs. 25.5 months (p < .001) for TKI only vs TKI+RT. Treatment yielded no grade 5 events and a 6% rate of symptomatic grade 3–4 pneumonitis in the TKI+RT arm. Based on the efficacy results of this pre-specified interim analysis, the ethics committee recommended premature cessation of this trial. CONCLUSIONS As compared to a first-line TKI alone, addition of up-front local therapy using RT statistically significantly improved PFS and OS for EGFR-mutated NSCLC.

When studying the pressure-relief effect of hard roof blasting and cutting, the roof-cutting position and angle obviously affect the stability of the rock surrounding the gob-side entry (GSE). In this paper, control of the large deformation of rock surrounding the GSE is evaluated on the basis of the overlying structure and pressure-relief principle caused by roof cutting. Moreover, a mechanics model of a three-hinged arch structure (THAS) and a universal distinct element code (UDEC) numerical model with regard to the overlying rock movement were established to study the relationship among the rotation angle of key blocks in the THAS, the width of the roadway and the wall force beside it, and the optimal cutting position and cutting angle to reveal the pressure-relief effect of roof blasting and cutting and its influence on the support stability of the roadway. The results show that the overlying rock can form a stable THAS after roof blasting and cutting and that the wall stress and the coal-wall displacement are small, which indicates that roof blasting and cutting results in obvious pressure relief. The wall force increases with an increase in the rotation angle of the key block and decreases with an increase in the roadway width. Moreover, the optimal roof-cutting position (5 m) and angle (15°) are obtained with the specific mining conditions. Finally, on-site monitoring of the anchor-cable force and support force in panel 5312 of the Jining no. 3 coal mine is used to verify the pressure-relief effect after roof blasting and cutting. The study results can provide a theoretical basis for reasonable technical means and optimization of supporting parameters in field observation and have important application value for roof cutting and pressure relief for GSE retaining (GSER) technology.

Pictures have become increasingly common and popular in mobile communications. However, due to the limitation of mobile devices, there is a need to develop new technologies to facilitate the browsing of large pictures on the small screen. In this paper, we propose a novel approach which is able to automate the scrolling and navigation of a large picture with a minimal amount of user interaction on mobile devices. An image attention model is employed to illustrate the information structure within an image. An optimal image browsing path is then calculated based on the image attention model to simulate the human browsing behaviors. Experimental evaluations of the proposed mechanism indicate that our approach is an effective way for viewing large images on small displays.

Objective: Lingzhihuang capsule (LZHC) is a natural product that consists of 10 commonly used medicinal plants, and it is used in traditional Chinese medicine to promote people's overall health. Previously, LZHC was successfully used as adjuvant therapy for treating patients with cancer. However, the chemical constituents of LZHC and their potential biological functions remain unclear. The aim of this study is to investigate the major bioactive compounds in LZHC and predict their pharmacological targets.Methods: The LZHC constituents were putatively identified by ultra-high performance liquid chromatography coupled with timeof-flight mass spectrometry combined with mass spectrometry-based molecular networking. The targets were predicted using SwissTargetPrediction software, and the associated gene ontology and Kyoto encyclopedia of genes and genomes pathways were analyzed using the Database for Annotation, Visualization, and Integrated Discovery. The mass spectrometry-based molecular network and compound-target-pathway network were constructed using Cytoscape 3.8.0 software. Results:We putatively identified 94 compounds of LZHC by mass spectrometry-based molecular networking, including triterpene (the main structural type) and other clusters (ie, flavonoids and organic acids). Our results suggested that multiple pivotal targets were regulated by LZHC, including tumor necrosis factor, nitric oxide synthase 2, glucocorticoid receptor, estrogen receptor, 3-oxo-5-alpha-steroid 4-dehydrogenase 2, prostaglandin e2 receptor ep4 subtype, estrogen receptor beta, phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit alpha isoform, mitogen-activated protein kinase 3, and racalpha serine, which are related to signal transduction, positive regulation of transcription from RNA polymerase II promoters, oxidation-reduction processes, inflammatory responses, and other biological processes. Functional annotation of those targets suggested that several signaling pathways may be regulated by LZHC, such as cancer-related proteoglycans, the PI3K-Aktsignaling pathway, and the cAMP-signaling pathway.Conclusions: Our findings reveal the chemical constituents of LZHC and provided scientific support for the efficacy of LZHC in terms of immune regulation, anti-aging, and tumor suppression.