The role of upfront primary tumor resection in asymptomatic patients with unresectable stage IV colorectal cancer: A systematic review and meta-analysis

BackgroundControversy exists over the role of upfront primary tumor resection (PTR) in asymptomatic patients with unresectable stage IV colorectal cancer (CRC). The purpose of this study was to evaluate the effect of upfront PTR on survival outcomes and adverse outcomes.MethodsSearches were conducted on PubMed, EMBASE, Web of Science, and Cochrane Library from inception to August 2021. Studies comparing survival outcomes with or without adverse outcomes between PTR and non-PTR treatments were included. Review Manager 5.3 was applied for meta-analyses with a random-effects model whenever possible.ResultsOverall, 20 studies with 3,088 patients were finally included in this systematic review. Compared with non-PTR, upfront PTR was associated with better 3-year (HR: 0.69, 95% CI, 0.57–0.83, P = 0.0001) and 5-year overall survival (OS) (HR: 0.77, 95% CI, 0.62–0.95, P = 0.01), while subgroup analysis indicated that there was no significant difference between upfront PTR and upfront chemotherapy (CT) group. In addition, grade 3 or higher adverse effects due to CT were more frequent in the PTR group with marginal significance (OR: 1.74, 95% CI, 0.99–3.06, P = 0.05), and other adverse outcomes were comparable.ConclusionsPTR might be related to improved OS for asymptomatic patients with unresectable stage IV CRC, whereas receiving upfront CT is a rational alternative without detrimental influence on survival or adverse outcomes compared with upfront PTR.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=27267

Stimulatory Effect of Aluminum in Root Development of Pogostemon cablin: Integration of ROS Homeostasis and Gene Expression Networks

On acid soils, aluminum (Al3+) is typically toxic to plants, though certain species like Pogostemon cablin (patchouli) show growth stimulation. This study reveals that Al functions as a root development stimulant in patchouli under acidic conditions. Treatment with 1.0 mM AlCl3 for 34 days significantly enhanced root architecture, increasing total root length by 172.12% and root dry weight by 161.75%, without affecting shoot biomass. Structural analysis showed Al accumulation in root tip meristems and lateral root primordia, triggering a 103.77% increase in meristem activity and a 111.9% promotion of cell elongation. Physiological assays showed that Al treatment reduced H2O2 and malondialdehyde (MDA) levels by 49.2% and 67.6%, respectively, while boosting glutathione (GSH) content by 187.5%, thereby mitigating oxidative membrane damage mainly through the non-enzymatic antioxidant system. Moreover, Al deprivation impaired lateral root elongation, highlighting its functional importance. Gene expression profiling further indicated that Al regulated pathways related to cell proliferation, cell wall remodeling, and lateral root development. Taken together, our findings uncover a novel mechanism by which Al, traditionally regarded as toxic, acts as a stimulator of root development in patchouli, providing new insights into the molecular networks underlying plant abiotic stress responses

Reinforcement learning-based fixed-time trajectory tracking control for uncertain robotic manipulators with input saturation

A fixed-time trajectory tracking control method for uncertain robotic manipulators with input saturation based on reinforcement learning (RL) is studied. The designed reinforcement learning control algorithm is implemented by radial basis function (RBF) neural network, in which the actor neural network is used to generate the control strategy and the critic neural network is used to evaluate the execution cost. A new non-singular fast terminal sliding mode technique is used to ensure the convergence of tracking error in fixed time, and the upper bound of convergence time is estimated. To solve the saturation problem of an actuator, a nonlinear anti-windup compensator is designed to compensate for the saturation effect of the joint torque actuator in real time. Finally, the stability of the closed-loop system based on Lyapunov candidate is analyzed, and the timing convergence of the closed-loop system is proved. Simulation and experimental results show the effectiveness and superiority of the proposed control law.</div