UNASSIGNED: We administered a new breast cancer (BC) adjuvant therapy sequence that delivered postoperative radiotherapy (PORT) before chemotherapy (CT). Our aim was to assess the gain in time to start PORT and the G2-G3 acute-subacute toxicity rate of whole breast adjuvant hypofractionated radiotherapy (AH-RT) administered up-front to the third-generation adjuvant CT (A-CT) in high-risk nodal positive BC in a preliminary report at 2 years.
UNASSIGNED: This retrospective study analysed the duration of treatment and safety of AH-RT administered up-front to A-CT in high-risk nodal positive BC patients (pts). Data on 45 pts treated between 2022-2023 were collected. All pts underwent the third-generation A-CT after AH-RT 15-5 fractions with or without a boost. Acute toxicity was scored according to CTCAE v5.0 for skin, pulmonary, and cardiac adverse events. Univariate and multivariate analyses were conducted to assess significant prognosticators for skin/lung/heart acute toxicities in the AH-RT 5-15 fractions arms and CT (p < 0.005).
UNASSIGNED: A reduction in the time to PORT initiation and overall adjuvant treatment time was recorded. RT was initiated 5 median weeks after surgery, and A-CT was performed 9 median weeks after surgery. The median duration of the entire adjuvant treatment was 35 weeks after surgery. At 6 months mean follow-up, no significant differences in G2-G3 toxicity were noted between the different hypofractionated RT arms, irrespective of the CT schedules, irradiated volumes, or boost (SIB or sequential) in univariate and multivariate analyses. In the multivariate analysis, no significant effects in CT schedules and AH-RT 5-15 arms for skin/lung acute toxicities (p = 0.077 and p = 0.68; 0.67 and 0.87, respectively) were recorded.
UNASSIGNED: As a new PORT approach in BC, AH-RT up-front to the third-generation A-CT appeared safe with a low acute toxicity profile, providing an advantage in shortening the time from surgery to PORT initiation and the overall adjuvant treatment time.

Polycyclic aromatic hydrocarbons (PAHs) constitute important organic contaminants that have been degrading coastal ecosystems over the years. Evaluating PAH status in port ecosystems aligns with societal goals of maintaining clean habitats and sustainability. This comprehensive review systematically analyzed 123 articles, exploring the global distribution, sources, and ecological risks linked to PAH contamination in ports, focusing on water, sediment, and biota. The mean concentrations of 16 PAHs in water, sediment, and biota across worldwide ports were 175.63 ± 178.37 ng/L, 1592.65 ± 1836.5 μg/kg, and 268.47 ± 235.84 μg/kg, respectively. In line with PAH emissions and use in Asia, Asian ports had the highest PAH concentrations for water and biota, while African ports had the highest PAH concentrations for sediment. The temporal trend in PAH accumulation in sediments globally suggests stability. However, PAH concentrations in water and biota of global ports exhibit increasing trends, signaling aggravating PAH contamination within port aquatic ecosystems. Some ports exhibited elevated PAH levels, particularly in sediments with 4.5 %, 9.5 %, and 21 % of the ports categorized as very poor, poor, and moderate quality. Some PAH isomers exceeded guidelines, including the carcinogenic Benzo(a)pyrene (BaP). Coal, biomass, and petroleum combustion were major sources for PAHs. The structure of ports significantly influences the concentrations of PAHs. PAH concentrations in sediments of semi-enclosed ports were 3.5 times higher than those in open ports, while PAH concentrations in water and biota of semi-enclosed ports were lower than those in open ports. Finally, risk analyses conducted through Monte Carlo simulation indicated moderate to high risks to aquatic species, with probabilities of 74.8 % in water and 34.4 % in sediments of ports worldwide. This review underscores the imperative to delve deeper into the accumulation of PAHs and similar pollutants in ports for effective management and environmental protection.

UNASSIGNED: We explored the differences in deep venous catheterization-associated complications between patients with hematological malignancies after peripherally inserted central catheter placement and such patients after implantable venous access port catheterization.
UNASSIGNED: peripherally inserted central catheters and implantable venous access ports are the most popular devices used for chemotherapy. However, no study has revealed differences between peripherally inserted central catheters and implantable venous access ports in Chinese patients with hematological malignancies.
UNASSIGNED: The clinical data of 322 patients with hematological malignancies who were treated from January 1, 2020 to December 30, 2021 were included in a retrospective cohort study. Postoperative color Doppler ultrasonography and follow-up results were used to compare the incidence rates of deep venous catheterization -associated complications after peripherally inserted central catheters and implantable venous access ports catheterization.
UNASSIGNED: The relative risk of catheter-related complications considering the type of device was 8.3 (95% CI = 3.0-22.8). In addition, chi-square segmentation analysis revealed a significant difference in the complication rate between the internal jugular vein and the basilic vein (χ2 = 22.002, p < 0.0001) and between the subclavian vein and the basilic vein (χ2 = 28.940, p < 0.0001).
UNASSIGNED: Implantable venous access ports are safer than peripherally inserted central catheters for Chinese patients with hematological malignancies. The implantation of implantable venous access ports could be firstly considered for systematic anti-cancer treatment.

UNASSIGNED: The aim of this meta-analysis is to evaluate the potential benefits of postoperative radiotherapy (PORT) in patients with pN1 oral cavity squamous cell carcinoma.
UNASSIGNED: A literature search through major databases was conducted until January 2023. The adjusted hazard ratio (aHR) or risk ratio (RR) with 95% confidence intervals (CIs) of different survival outcomes were extracted and pooled.
UNASSIGNED: Ten studies published between 2005 and 2022, with a pooled patient population of 2888, were included in this meta-analysis. Due to differences in study design and reported outcomes, the studies were categorized into distinct groups. In pN1 patients without extranodal extension (ENE), PORT was associated with a significant improvement in overall survival (OS) (aHR 0.76, 95% CI: 0.61-0.94). In pN1 patients without ENE and positive margins, PORT improved OS (aHR 0.71, 95% CI: 0.56-0.89) and was associated with a lower regional recurrence rate (RR 0.35, 95% CI: 0.15-0.83). However, in pN1 patients without ENE, positive margins, perineural invasion, and lymphovascular invasion, there were no significant differences observed between the PORT and observation groups in either 5-year OS (RR 0.48, 95% CI: 0.07-3.41) or 5-year disease-free survival (RR 0.37, 95% CI: 0.07-2.06).
UNASSIGNED: The current study demonstrated that PORT has the potential to improve OS in pN1 disease. However, the decision of whether to administer PORT still hinges on diverse clinical scenarios, and additional research is necessary to furnish a more conclusive resolution.
UNASSIGNED: 2.

UNASSIGNED: Femoral ports are used in patients with indication to a totally implanted venous access device but with contraindication to chest-ports and brachial ports because of obstruction of the superior vena cava. In the last three decades, femoral ports have been implanted almost exclusively by cannulation of the common femoral vein at the groin, while the position of the tip has been assessed by X-ray.
UNASSIGNED: We report our experience with a new approach to femoral ports, which includes recent methods and techniques developed in the last few years. These novel femoral ports, which we call \"FICC-ports,\" are characterized by (a) long femoral 5 Fr polyurethane catheter inserted by ultrasound-guided puncture of the superficial femoral vein at mid-thigh; (b) intraprocedural location of the tip in the sub-diaphragmatic inferior vena cava, using ultrasound visualization by the transhepatic and/or the subcostal view; (c) low-profile or very low-profile reservoir implanted above the quadriceps muscle, at mid-thigh.
UNASSIGNED: In the last 3 years, we have implanted 47 FICC-ports in young adults with mediastinal lymphoma compressing the superior vena cava. We had no immediate/early complication, and only three late complications (one kinking of the catheter in the subcutaneous tissue; one tip migration with secondary venous thrombosis; one persistent withdrawal occlusion due to fibroblastic sleeve).
UNASSIGNED: If there is indication to a femoral port, the implantation of a \"FICC-port\"-as described above-is to be strongly considered in terms of safety, effectiveness, and cost-effectiveness: no immediate-early complications, minimal late complications, no X-ray exposure, low invasiveness, low cost.

COVID-19 remains a communicable disease with the capacity to cause substantial damage to health and health systems. Enhanced health screening at points of entry (POEs) is a public health measure implemented to support early detection, prevention and response to communicable diseases, such as COVID-19. The purpose of this study was to review the available evidence on the effectiveness of POE health screening in the detection and containment of the COVID-19 pandemic. This study was registered under PROSPERO and followed PRISMA guidelines in which the literature between 2019 and 2022 was retrieved from Scopus, PubMed, Web of Science, Global Health, CINAHL, Embase, Google Scholar and international organizations. A total of 33,744 articles were screened for eligibility, from which 43 met the inclusion criteria. The modeling studies predicted POE screening able to detect COVID-19 in a range of 8.8% to 99.6%, while observational studies indicated a detection rate of 2% to 77.9%, including variants of concern depending on the screening method employed. The literature also indicated these measures can delay onset of the epidemic by 7 to 32 days. Based on our review findings, if POE screening measures are implemented in combination with other public health interventions such as rapid tests, they may help detect and reduce the spread of COVID-19.

The rapid onset of the COVID-19 pandemic in March 2020 marked a challenging time for the US and its freight industry. Manufacturing slowed, consumer purchasing patterns changed, and for many, shopping moved online. The freight industry suffered a sharp decline in shipments, followed by a surprisingly quick rebound. The industry had to adapt quickly to meet fast-changing demand and supply patterns upended by global supply chain disruptions. This paper uses U.S. intermodal activity data, supported by in-depth interviews with leaders of railroads, intermodal carriers, equipment manufacturers, car leasing companies, shippers, and e-commerce players to characterize and assess how the rail industry met the challenge of this demand whiplash and other performance impediments. What emerges is a rich picture of the multi-actor intermodal supply chain, the impacts of COVID-19 on it, the performance of the logistics system in general, and railroads in particular during the pandemic. Industry interviews revealed that a handful of choke points, many of which were outside the rail industry, complicated supply chain responses to COVID-19. The paper shows how the rail industry was an essential component of pandemic resilience, demonstrating a high level of adaptability to meet consumer and business demands. Through the use of depth interviews it reveals the complexity of the intermodal supply chain, and it accurately foretells the subsequent disruptions that continued to plague that supply chain long after the initial impacts of the pandemic.

In this study, multiple molecular markers [polycyclic aromatic hydrocarbons (PAHs), linear and branched alkanes, unresolved complex mixture (UCM), hopanes, and steranes] were applied to explore petroleum-related inputs in complex coastal systems influenced by various human-induced pressures. To investigate anthropogenic impacts related to petrogenic emissions, we analysed surface sediments from coastal areas of southern Baltic, including harbour/shipyard channels, offshore dumping sites, shipping routes, and major sinks for particulate matter discharged by large rivers. This study indicates a large spatial variability in the contamination degree of examined sites by petroleum-derived chemicals. Hopanes and steranes along with UCM appeared to have the highest potential to identify petroleum sources in studied locations, whereas investigations based on alkanes and PAHs seemed to be considerably affected by inputs of modern biogenic and combustion-derived materials, respectively. However, the combined use of all these markers provides deeper insight into the complexity of sedimentary organic matter in human-impacted environments.

Port implantation can be associated with an array of serious vascular complications, typically involving the subclavian artery. We report a case in which implantation of a port resulted in iatrogenic perforation of the aortic arch at the level of the left subclavian artery, which was sealed off using a percutaneous vascular closure device.

BACKGROUND: Currently, skinfold thickness in studies on arm venous access ports and the effect of venous access port application are unknown.
METHODS: A total of 256 cancer patients who underwent primary venous access port placement in the Fourth Hospital of Hebei Medical University from September 2022 to March 2023 were selected as the study subjects. Two hundred fifty-six patients were divided into normal skinfold thickness group and high skinfold thickness group according to skinfold thickness. The success rate of primary catheterization of arm venous port catheterization, catheterization operation time, catheterization length and incidence rate of adverse reactions were compared.
RESULTS: There was no significant difference in the basic data between the two groups. There was no significant difference in the success rate of primary catheterization between the two groups (p > 0.05), the catheterization operation time in the normal skinfold thickness group was significantly lower than that in the high skinfold thickness group (p < 0.05), the total length of the implanted catheter in the normal skinfold thickness group was significantly lower than that in the high skinfold thickness group (p < 0.05), and the incidence of adverse reactions in the normal skinfold thickness group was significantly lower than that in the high skinfold thickness group (p < 0.05).
CONCLUSIONS: In cancer patients, skinfold thickness can significantly affect the application effect of arm venous port, and normal skinfold thickness for arm venous port has shorter operation time, total length of implanted catheter and lower incidence of adverse reactions.