The consensus molecular subtype (CMS) classification of colorectal cancer is based on bulk transcriptomics. The underlying epithelial cell diversity remains unclear. We analyzed 373,058 single-cell transcriptomes from 63 patients, focusing on 49,155 epithelial cells. We identified a pervasive genetic and transcriptomic dichotomy of malignant cells, based on distinct gene expression, DNA copy number and gene regulatory network. We recapitulated these subtypes in bulk transcriptomes from 3,614 patients. The two intrinsic subtypes, iCMS2 and iCMS3, refine CMS. iCMS3 comprises microsatellite unstable (MSI-H) cancers and one-third of microsatellite-stable (MSS) tumors. iCMS3 MSS cancers are transcriptomically more similar to MSI-H cancers than to other MSS cancers. CMS4 cancers had either iCMS2 or iCMS3 epithelium; the latter had the worst prognosis. We defined the intrinsic epithelial axis of colorectal cancer and propose a refined ‘IMF’ classification with five subtypes, combining intrinsic epithelial subtype (I), microsatellite instability status (M) and fibrosis (F).

With the aging population, the incidence rate of osteoporosis has been rapidly increasing. [1] These fractures are predicted to reach 2.6 million in 2025 and 4.5 million in 2050 worldwide. [2] The incidence of these fractures, which frequently occur due to falls, is two-three times higher in females than in males. [3] Intertrochanteric fractures, which are usually unstable, can only be treated surgically. [4] The key point of the surgical treatment is stable fixation and early mobilization with full-weight bearing. However, this is not always as easy as it seems. Most of the patients are elderly, osteoporotic, with additional morbidity and limited mobilization, and prone to complications. [5,6] Therefore, there is no consensus regarding the treatment of Objectives: This study aims to compare the clinical and functional results of intertrochanteric femoral fractures treated with bipolar hemiarthroplasty (BHA) or proximal femoral nailing (PFN) in elderly patients. Patients and methods: This multicenter, prospectively followed-up, retrospectively compared cohort-type study included 308 patients (81 males, 227 females; mean age 78.4±7.2 years; range, 65 to 95 years) who were treated with BHA or PFN for intertrochanteric fractures by five orthopedic surgeons in four provinces and seven clinics between January 2014 and May 2018. Clinical follow-up was performed at third week, third and sixth months, and at the end of the first and second years. The American Society of Anesthesiologists for preoperative status, Singh index for bone quality, and Harris Hip Score (HHS) for functional outcomes were evaluated. Results: While 156 patients (38 males, 118 females; mean age 77.7±5.9) were treated with BHA, 152 patients (43 males, 109 females; mean age 79±6.1) were treated with PFN. While there was no significant difference between the two groups in terms of total HHS, a significant difference was found in the sub-parameters (p<0.001). Good and excellent results were found in 78.2% of BHA and 86.2% of PFN patients. Mortality rates were similar at the end of two years (14% and 13.6%, respectively). Conclusion: In general, clinical and functional outcomes of BHA and PFN are similar. The rates of pulmonary embolism and deep vein thrombosis are significantly higher in BHA. However, BHA is advantageous in terms of operation time and early weight bearing compared to PFN.

In many plastic applications, improvement of the flame retardancy is a very significant topic. Polypropylene (PP) is used in many applications such as housing industry due to its cost performance efficiency. Enhancement of flame retardancy properties of PP is necessary in many applications. In this study, the investigation focuses on the synergistic effect of mica mineral and IFR in enhancing the flame retardancy properties of PP in order to achieve cost competitive solution, so as to provide that different/various ratios of IFR and mica mineral were added into PP to compose 30 wt% of the total mass of the polymeric compounds. The synergistic effect of mica mineral with IFR in PP was investigated by limiting oxygen index (LOI), glow wire test (GWT), UL-94 test, thermal gravimetric analyses (TGA), and mechanical tests. The results from LOI, UL 94, and GWT tests indicated that mica added to PP/IFR compound has a synergistic flame retardancy effects with the IFR system. When the content of mica was 6 wt%, LOI value of PP compound reaches to 34.9% and becomes V-0 rating (3.2 mm) in UL 94 flammability tests and compounds pass GWT tests both at 750 and 850°C.

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