In this trial, the addition of six cycles of docetaxel to androgen-deprivation therapy resulted in longer median progression-free and overall survival than that with ADT alone in patients with ...metastatic prostate cancer.
Regressions of metastatic prostate cancer were first documented in the 1940s and were achieved with surgical castration; subsequently, androgen-deprivation therapy (ADT) became the mainstay of therapy.
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Attempts to improve the efficacy or decrease the treatment burden of ADT have included the use of antiandrogens alone, intermittent dosing of ADT, and the use of an antiandrogen combined with medical or surgical castration.
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–
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A meta-analysis revealed an increase in survival of 3 percentage points at 5 years with concurrent use of a nonsteroidal antiandrogen at the time of initiation of ADT.
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However, resistance to ADT occurs in most patients, with the . . .
Abstract
Time crystals are many-body states that spontaneously break translation symmetry in time the way that ordinary crystals do in space. While experimental observations have confirmed the ...existence of discrete or continuous time crystals, these realizations have relied on the utilization of periodic forces or effective modulation through cavity feedback. The original proposal for time crystals is that they would represent self-sustained motions without any external periodicity, but realizing such purely self-generated behavior has not yet been achieved. Here, we provide theoretical and experimental evidence that many-body interactions can give rise to an inherent time crystalline phase. Following a calculation that shows an ensemble of pumped four-level atoms can spontaneously break continuous time translation symmetry, we observe periodic motions in an erbium-doped solid. The inherent time crystal produced by our experiment is self-protected by many-body interactions and has a measured coherence time beyond that of individual erbium ions.
Purpose - Online trust is one of the key obstacles to vendors succeeding on the internet medium; a lack of trust is likely to discourage online consumers from participating in e-commerce. This ...research aims to investigate how online consumers develop their initial trust and purchase intentions. The research in conducted in the context of Taiwanese online bookstores.Design methodology approach - The research examines consumers' online initial trust by using four major categories of determinants: perceived technology, perceived risk, company competency, and trust propensity. It also investigates the impacts of both online initial trust and familiarity with online purchasing on purchase intention. The research model is statistically tested using the web sites of four online bookstores in Taiwan. The web site selected by each respondent is unfamiliar.Findings - It is found that perceived usefulness, perceived security, perceived privacy, perceived good reputation, and willingness to customise are the important antecedents to online initial trust. It is also discovered that different levels of trust propensity moderate perceptions toward the web site and online with respect to online initial trust, including perceived usefulness, perceived security, perceived privacy, perceived good reputation, and willingness to customise. Both online initial trust and familiarity with online purchasing have a positive impact on purchase intention.Originality value - The research provides insight into the development of online initial trust by consumers, and the relationships between online initial trust and purchase intention. The research model was created and then tested in the context of online bookshops in Taiwan.
We conducted a multi-institutional study in Taiwan and a systematic review of the literature for reports of Guillain-Barré syndrome after coronavirus disease vaccination. This condition, mostly the ...classic form and the acute inflammatory demyelinating polyneuropathy subtype, has been reported in 39 cases and has occurred within 2 weeks of vaccine administration.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, ODKLJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract Soft photonic liquid crystals with electrically responsive properties are among the most promising intelligent materials for optoelectronic applications. This work demonstrates an ultra‐fast ...electrically tunable dual‐mode laser by introducing dye‐doped chiral liquid crystals. Due to the strong chirality of the chiral liquid crystal, two self‐assembled structures form depending on the temperatures. One is the chiral nematic phase (N*) with a 1D helical structure; the other is the blue phases (BPs) with 3D cubic structures. By tuning the strength of an electric field, the dye‐doped chiral liquid crystals are operated in two different modes: a band‐edge laser and a random laser. In the band‐edge mode, due to the electrostriction effect of the BPs, the electric‐tuning range of the laser emission is from 537 to 645 nm, and the switching times are less than 20 ms. When the electric field goes beyond a threshold value to force the occurrence of the BPs‐chiral‐nematic transition, the band‐edge laser with elliptical polarization emission is switched to a random laser with an immediate unpolarization emission (0.9 ms). Furthermore, the reversibility of the effects mentioned above points out the potential applications of self‐assembled soft photonic materials, spanning from solid‐state lighting to bio‐imaging.
Purpose Docetaxel added to androgen-deprivation therapy (ADT) significantly increases the longevity of some patients with metastatic hormone-sensitive prostate cancer. Herein, we present the outcomes ...of the CHAARTED (Chemohormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer) trial with more mature follow-up and focus on tumor volume. Patients and Methods In this phase III study, 790 patients with metastatic hormone-sensitive prostate cancer were equally randomly assigned to receive either ADT in combination with docetaxel 75 mg/m
for up to six cycles or ADT alone. The primary end point of the study was overall survival (OS). Additional analyses of the prospectively defined low- and high-volume disease subgroups were performed. High-volume disease was defined as presence of visceral metastases and/or ≥ four bone metastases with at least one outside of the vertebral column and pelvis. Results At a median follow-up of 53.7 months, the median OS was 57.6 months for the chemohormonal therapy arm versus 47.2 months for ADT alone (hazard ratio HR, 0.72; 95% CI, 0.59 to 0.89; P = .0018). For patients with high-volume disease (n = 513), the median OS was 51.2 months with chemohormonal therapy versus 34.4 months with ADT alone (HR, 0.63; 95% CI, 0.50 to 0.79; P < .001). For those with low-volume disease (n = 277), no OS benefit was observed (HR, 1.04; 95% CI, 0.70 to 1.55; P = .86). Conclusion The clinical benefit from chemohormonal therapy in prolonging OS was confirmed for patients with high-volume disease; however, for patients with low-volume disease, no OS benefit was discerned.
Background
Stereotactic body radiotherapy (SBRT) is gaining wider adoption for prostate cancer management but there remain significant toxicity risks when delivering prostate SBRT with standard ...techniques. Magnetic resonance‐guided daily adaptive SBRT (MRg‐A‐SBRT) offers technological advantages in precision of radiation dose delivery, but the toxicity profile associated with MRg‐A‐SBRT compared to more standardly used fiducial or computed tomography‐guided non‐adaptive prostate SBRT (CT‐SBRT) remains unknown.
Methods
A meta‐analysis to compare acute toxicity rates associated with MRg‐A‐SBRT and CT‐SBRT for prostate cancer was performed in compliance with PRISMA guidelines. MEDLINE (PubMed) and Google Scholar were searched for prospective studies of prostate SBRT that were published between January 1, 2018 and August 31, 2022. Random effects and fixed effects models were used to estimate pooled toxicity rates, and meta‐regression was performed to compare toxicity between MRg‐A‐SBRT and CT‐SBRT study groups.
Results
Twenty‐nine prospective studies were identified that met the inclusion criteria and included a total of 2547 patients. The pooled estimates for acute grade 2 or higher (G2+) genitourinary (GU) and gastrointestinal (GI) toxicity for MRg‐A‐SBRT were 16% (95% confidence interval CI, 10%–24%) and 4% (95% CI, 2%–7%) and for CT‐SBRT they were 28% (95% CI, 23%‐33%) and 9% (95% CI, 6%‐12%), respectively. On meta‐regression, the odds ratios for acute G2+ GU and GI toxicities comparing MRg‐A‐SBRT and CT‐SBRT were 0.56 (95% CI, 0.33–0.97, p = .04) and 0.40 (95% CI, 0.17–0.96, p = .04), respectively.
Conclusion
MRg‐A‐SBRT is associated with a significantly reduced risk of acute G2+ GU or GI toxicity compared to CT‐SBRT. Longer follow‐up will be needed to evaluate late toxicity and disease control outcomes.
Plain language summary
Magnetic resonance imaging‐guided daily adaptive prostate stereotactic radiation (MRg‐A‐SBRT) is a treatment that may allow for delivery of prostate radiation more precisely than other radiotherapy techniques, but it is unknown whether this reduces side effects compared to standardly used computed tomography‐guided SBRT (CT‐SBRT).
In this systematic review and meta‐analysis combining data from 29 clinical trials including 2547 patients, it was found that the risk of short‐term urinary side effects was reduced by 44% and the risk of short‐term bowel side effects was reduced by 60% with MRg‐A‐SBRT compared to CT‐SBRT.
This meta‐analysis of 29 prostate stereotactic body radiotherapy (SBRT) studies including 2547 patients found a reduction in the risk of acute urinary and gastrointestinal side effects with magnetic resonance‐guided adaptive SBRT compared to standard computed tomography‐guided SBRT.
Increasing nitrogen use efficiency (NUE) is critical to improve crop yield, reduce N fertilizer demand and alleviate environmental pollution. N remobilization is a key component of NUE. The nitrate ...transporter NRT1.7 is responsible for loading excess nitrate stored in source leaves into phloem and facilitates nitrate allocation to sink leaves. Under N starvation, the nrt1.7 mutant exhibits growth retardation, indicating that NRT1.7-mediated source-to-sink remobilization of stored nitrate is important for sustaining growth in plants. To energize NRT1.7-mediated nitrate recycling, we introduced a hyperactive chimeric nitrate transporter NC4N driven by the NRT1.7 promoter into the nrt1.7 mutant. NRT1.7p::NC4N::3' transgenic plants accumulated more nitrate in younger leaves, and
NO
tracing analysis revealed that more
N was remobilized into sink tissues. Consistently, transgenic Arabidopsis, tobacco and rice plants showed improved growth or yield. Our study suggests that enhancing source-to-sink nitrate remobilization represents a new strategy for enhancing NUE and crop production.
Abstract
Bandgap control is of central importance for semiconductor technologies. The traditional means of control is to dope the lattice chemically, electrically or optically with charge carriers. ...Here, we demonstrate a widely tunable bandgap (renormalisation up to 550 meV at room-temperature) in two-dimensional (2D) semiconductors by coherently doping the lattice with plasmonic hot electrons. In particular, we integrate tungsten-disulfide (WS
2
) monolayers into a self-assembled plasmonic crystal, which enables coherent coupling between semiconductor excitons and plasmon resonances. Accompanying this process, the plasmon-induced hot electrons can repeatedly fill the WS
2
conduction band, leading to population inversion and a significant reconstruction in band structures and exciton relaxations. Our findings provide an effective measure to engineer optical responses of 2D semiconductors, allowing flexibilities in design and optimisation of photonic and optoelectronic devices.
AbstractObjectiveTo investigate the associations between exposure to antenatal corticosteroids and serious infection in children during the first three, six, and 12 months of life.DesignNationwide ...cohort study.SettingNational Health Insurance Research Database, Birth Reporting Database, and Maternal and Child Health Database, 1 January 2008 to 31 December 2019, to identify all pregnant individuals and their offspring in Taiwan.Participants1 960 545 pairs of pregnant individuals and their singleton offspring. 45 232 children were exposed and 1 915 313 were not exposed to antenatal corticosteroids.Main outcome measuresIncidence rates were estimated for overall serious infection, sepsis, pneumonia, acute gastroenteritis, pyelonephritis, meningitis or encephalitis, cellulitis or soft tissue infection, septic arthritis or osteomyelitis, and endocarditis during the first three, six, and 12 months of life in children exposed versus those not exposed to antenatal corticosteroids. Cox proportional hazards models were performed to quantify adjusted hazard ratios with 95% confidence intervals for each study outcome.ResultsThe study cohort was 1 960 545 singleton children: 45 232 children were exposed to one course of antenatal corticosteroids and 1 915 313 children were not exposed to antenatal corticosteroids. The adjusted hazard ratios for overall serious infection, sepsis, pneumonia, and acute gastroenteritis among children exposed to antenatal corticosteroids were significantly higher than those not exposed to antenatal corticosteroids during the first six months of life (adjusted hazard ratio 1.32, 95% confidence interval 1.18 to 1.47, P<0.001, for overall serious infection; 1.74, 1.16 to 2.61, P=0.01, for sepsis; 1.39, 1.17 to 1.65, P<0.001, for pneumonia; and 1.35, 1.10 to 1.65, P<0.001, for acute gastroenteritis).Similarly, the adjusted hazard ratios for overall serious infection (P<0.001), sepsis (P=0.02), pneumonia (P<0.001), and acute gastroenteritis (P<0.001) were significantly higher from birth to 12 months of life. In the sibling matched cohort, the results were comparable with those observed in the whole cohort, with a significantly increased risk of sepsis in the first six (P=0.01) and 12 (P=0.04) months of life.ConclusionsThis nationwide cohort study found that children exposed to one course of antenatal corticosteroids were significantly more likely to have an increased risk of serious infection during the first 12 months of life. These findings suggest that before starting treatment, the long term risks of rare but serious infection associated with antenatal corticosteroids should be carefully weighed against the benefits in the perinatal period.
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