Purpose
The optimal treatment strategy for pediatric atypical teratoid rhabdoid tumor (ATRT) is inconclusive. This study evaluated the prognostic value of early radiotherapy (RT) and high-dose ...chemotherapy with autologous stem cell rescue (HDC/ASCR) in pediatric ATRT.
Methods
This pooled analysis included ATRT patients treated at our institution and from other studies who were identified by a search of the PubMed electronic database. The effect of patient demographics and treatment profiles on progression-free survival (PFS) and overall survival (OS) were analyzed using Cox regression.
Results
Overall, 34 patients from our institution and 436 patients from 35 published studies were included. In multivariable analysis, patients with gross total resection (GTR), early RT (time to RT interval < 2 months), and HDC/ASCR had both better PFS hazard ratio (HR) 0.46,
p
<
0.001; HR 0.64,
p
= 0.011; and HR 0.51,
p
= 0.005, respectively and OS (HR 0.55,
p
= 0.002; HR 0.48,
p
= 0.004; and HR 0.42,
p
< 0.001, respectively). For patients aged < 3 years, both RT and HDC/ASCR were significant favorable factors for PFS (HR 0.32 and 0.46, respectively) and OS (HR 0.40 and 0.36, respectively), while early RT was not prognostic. For patients aged ≥ 3 years, early RT was significantly associated with better PFS (HR 0.51) and HDC/ASCR did not affect PFS, and neither was related to OS.
Conclusion
Both early RT initiation and HDC/ASCR were important components in the treatment of pediatric ATRT. However, the optimal treatment strategies might differ by age.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Commensal microbes are involved in intestinal homeostasis, and the dysregulation of host-microbe interactions may lead to the development of local and systemic disorders. Recent evidence indicated ...that microbiota dysbiosis plays a key role in the pathogenesis of inflammatory bowel disease and metabolism-related disorders. The circadian clock system originally identified in the brain was later found in the gastrointestinal tract. Although the light-controlled central clock in the brain is responsible for the synchronization of peripheral clocks, the timing of meal consumption serves as another cue for the rhythmic setting of gastrointestinal digestion, absorption, and epithelial renewal and barrier functions. Multiple lines of evidence have indicated that in addition to daylight and food intake, microbiota (as an environmental factor) are involved in the circadian control of gut homeostasis. Recent studies demonstrated that microbial metabolites and innate signaling orchestrate the host circadian rhythm, revealing unforeseen molecular mechanisms underlying the regulatory role of microbiota in intestinal physiology and systemic metabolism. In this review, we discuss the host-microbe interplay that contributes to the regulation of intestinal clock signals and physiological functions and explore how microbiota dysbiosis may cause misalignment of circadian systems leading to the development of chronic inflammatory and metabolic diseases.
This study evaluated the association between estrogen levels, emotion regulation, depression, anxiety, and stress of women with premenstrual dysphoric disorder (PMDD). We also evaluated the ...moderating effect of estrogen receptor (ESR) α-Xbal polymorphism on the aforementioned association.
A total of 100 women were diagnosed with PMDD based on psychiatric interviews and a prospective investigation of 3 menstrual cycles. A total of 96 normal individuals were recruited as controls. Their estrogen levels, depression, anxiety, stress, and ESR α-Xbal polymorphism in both premenstrual and follicular phases were assessed, and these data were included in the final analysis.
The PMDD group had high depression, anxiety, and stress and low emotional adjusting and tolerating in the premenstrual phase. Emotional adjustment was negatively associated with depression, anxiety and stress. No association was observed between PMDD and estrogen level. However, premenstrual estrogen level was negatively correlated with anxiety and stress in women with PMDD. The association was only significant in G carriers of ESR α-Xbal, as was the difference in premenstrual emotion regulation between the PMDD and control groups.
The results demonstrate the association between estrogen and anxiety in PMDD, supporting the claim that women with PMDD differ in their responses to normal estrogen levels. Furthermore, this association and dysfunctional emotional regulation in PMDD existed only among the G carriers of ESR α-Xbal polymorphism. Future studies should investigate the effect of estrogen on brain functions involving emotional regulation in women with PMDD, stratified by ESR α-Xbal polymorphism.
•Women with PMDD decreased emotional adjusting more in the premenstrual phase than controls did.•Emotional adjusting was negatively associated with depression, anxiety, and stress.•The premenstrual estrogen negatively correlated with anxiety and stress in women with PMDD.•The association between estrogen and stress was significant only in G carriers of ESR α-Xbal.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Background:
Exercise stress testing using a ramp protocol has been favored for cardiopulmonary exercise testing (CPX) in patients with heart failure (HF). However, the stepwise protocol for CPX was ...preferred for its possible combination with exercise stress echocardiography (ESE). We, therefore, investigated the feasibility and safety of using a stepwise protocol for CPX-ESE in patients with HF.
Methods:
Ambulatory outpatients with chronic HF were enrolled for a symptom-limited stepwise bicycle exercise test in the semi-supine position on a cycle ergometer. The test was started at a workload of 30 W and increased by 15 W every 3 minutes until maximal exertion. The echocardiographic and respiratory variables and any complications during the exercise were recorded.
Results:
Among a total of 36 participants (age 61.2 ± 12.4 years; 69.4% men), all subjects achieved anerobic threshold during CPX-ESE and reached 72.3% of the age-predicted peak heart rate. The peak oxygen consumption was 14.7 mL/kg/min, and the peak RER was 1.25. There were no severe adverse complications, and only two minor rhythmic events were reported: nonsustained supraventricular tachycardia and isolated ventricular premature beats. The echocardiographic images acquired at each stage were of good quality in 92.6% of all acquisitions, and the intra-observer and interobserver repeatability was >80%.
Conclusion:
The stepwise protocol, with an initial workload of 30 W, followed by 15 W increments every 3 minutes, was feasible and provided an adequate stress load for patients with HF. This exercise stress modality was safe and well-tolerated.
This paper describes an easy-to-prepare, robust bioanode constructed on a polyester-supported screen-printed carbon paste electrode (SPCE) for glucose biofuel cells. To prepare the bioanode, ...carboxylated multi-walled carbon nanotubes (MWCNTs) were drop-coated on the SPCE first, and then a crosslinked matrix composed of glucose oxidase (GOx), 2,5-dihydroxybenzaldehyde (DHB), bovine serum albumin (BSA) and glutaraldehyde was coated atop the MWCNTs. It was found that the MWCNTs assisted the immobilization of the crosslinked matrix, enhanced the electron-shuttling process, and showed electrocatalytic effect to gluconic acid, which allowed squeeze more electrons out of a glucose molecule. Inside the matrix, DHB mediators could couple to GOx and BSA via the Schiff base reaction, and GOx and BSA could crosslink to each other with glutaraldehyde. From cyclic voltammetry, it was estimated that 3.63
nmol
cm
−2 of DHB was anchored on the bioanode, and no mediator leaching was observed. The bioanode also attained reproducible flow-injection analysis (FIA) signals for glucose sensing (RSD
=
4.99%) and retained 84% of the initial response after keeping in a buffer at 4
°C for a week. In addition, the bioanode obeyed the Michaelis–Menten kinetics. Finally, we demonstrated that a glucose biofuel cell assembled with an optimal bioanode and a laccase/ABTS cathode generated an electric power of 45
μW
cm
−2 from 1
M glucose at 37
°C.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Chromogranin A (CgA) is a non-specific biomarker excreted by neuroendocrine tumor (NET) cells. Elevation of circulating CgA level can be detected in gastroenteropancreatic (GEP)-NET patients and has ...been shown to correlate with tumor burden. The prognostic and predictive roles of CgA level and the change of CgA level are controversial. In this study, we retrospectively analyzed 102 grade 1/2 GEP-NET patients with available baseline or serial follow-up CgA levels from the National Cheng Kung University Hospital to evaluate the association between circulating CgA level and the tumor extent, overall survival (OS), and tumor response prediction. The baseline characteristics, baseline CgA level, and change of CgA level during follow-up and their association was analyzed. Sixty cases had baseline CgA levels available prior to any treatment and ninety-four cases had serial follow-up CgA levels available during treatment or surveillance. Baseline CgA levels were associated with stage and sex. Higher baseline CgA levels were associated with worse OS after adjusting for sex, stage, grade, primary site, and functionality (hazard ratio=13.52, 95% confidence interval (CI), 1.06-172.47,
P
=0.045). The cross-sectional analysis for the change of CgA level during follow-up showed that a ≥ 40% increase of CgA meant a higher probability of developing tumor progression or recurrence than those with a < 40% increase of CgA level (odds ratio=5.04, 95% CI, 1.31-19.4,
P
=0.019) after adjusting for sex, age, grade, stage, and functionality. Our study results suggest that CgA may be a predictive marker for tumor burden, OS, and tumor progression in GEP-NET patients.
To develop 6-O-palmitoyl-ascorbic acid-based niosomes targeted to transferrin receptor for intravenous administration of tocotrienols (T3) in breast cancer.
Niosomes were prepared using film ...hydration and ultrasonication methods. Transferrin was coupled to the surface of niosomes via chemical linker. Nanovesicles were characterized for size, zeta potential, morphology, stability and biological efficacy.
When evaluated in MDA-MB-231 cells, entrapment of T3 in niosomes caused 1.5-fold reduction in IC
value compared with nonformulated T3. In vivo, the average tumor volume of mice treated with tumor-targeted niosomes was 12-fold lower than that of untreated group, accompanied by marked downregulation of three genes involved in metastasis.
Findings suggested that tumor-targeted niosomes served as promising delivery system for T3 in cancer therapy.
Cannibalism is a major problem in lobster and crab aquaculture. Reducing the aggressive characteristics of lobsters and crabs can improve survival during the culturing process. In this study, ...juvenile scalloped spiny lobsters (
) and crucifix crabs (
) were both cultured under different shelter and live prey conditions. Groups with shelter (seaweed and cotton filter) showed a better survival rate than the control group (no shelter;
< 0.05) for both
and
. Co-culturing with live prey (
) significantly benefited the juveniles of
and visibly increased the survival of juvenile
. Although providing shelter is currently the main method for reducing agonistic behavior, it must be continually altered as the lobsters and crabs grow. Live prey can grow and attract lobsters and crabs to hunt them, and live prey can be supplemented at any time. They can also be used as an additional source of income during the harvest season.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Introduction In medical education, the clerkship phase is a demanding period during which medical students learn to navigate the responsibilities of medical school and clinical medicine. Grit, a ...personal quality regarded as a non-cognitive trait, refers to perseverance and passion; specifically, it represents the ability to endure hardship and work industriously toward a goal. Most studies analysed grit as a single concept and few studies have investigated the effect of grit on the well-being of medical students through the whole-specialty training (i.e. surgical and non-surgical specialty rotations) required in clinical clerkships. Therefore, this study investigated whether associations exist between medical students’ grit, measured by the two subconstructs of perseverance and passion, and their well-being during clerkships in surgical and non-surgical specialty units. Methods This one-year prospective web-based questionnaire study enrolled fifth-year medical students at a tertiary medical centre in central Taiwan between September 2017 and July 2018 in their first-year clerkship. The students’ sex, age, and grit were measured at the start of their clerkship. Routine surveys were conducted over one year to assess burnout and compassion satisfaction for students’ well-being, and the training specialty characteristics of the surgical and non-surgical specialty departments were recorded. This study included 92 medical students and 1,055 survey responses from individual specialty rotations. Descriptive, univariate and multivariate analyses were performed. Results Our results revealed that medical students’ perseverance, as part of grit, was related to lower burnout and higher compassion satisfaction during clerkships, but not the subconstruct of passion. Moreover, the positive trait of perseverance measured in our study had greater explanatory power for compassion satisfaction than for burnout. Furthermore, the results revealed that older medical students suffered from less burnout than their younger counterparts, and that male medical students expressed higher compassion satisfaction than their female counterparts. Discussion Perseverance, as a subconstruct of grit, is a positive personal quality for medical students’ clerkships, and methods driving the cultivation of perseverance in medical education should be considered. In addition, even though positive traits such as perseverance equipped medical students for compassion satisfaction, additional factors attributed to medical students’ burnout must be identified.
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