Conventionally, acute myeloid leukemia (AML) patients are categorized into good-, intermediate- and poor-risk groups according to cytogenetic changes. However, patients with intermediate-risk ...cytogenetics represent a largely heterogeneous population regarding treatment response and clinical outcome. In this study, we integrated cytogenetics and molecular mutations in the analysis of 318 patients with de novo non-M3 AML who received standard chemotherapy. According to the mutation status of eight genes, including NPM1, CEBPA, IDH2, RUNX1, WT1, ASXL1, DNMT3A and FLT3, that had prognostic significance, 229 patients with intermediate-risk cytogenetics could be refinedly stratified into three groups with distinct prognosis (P<0.001); patients with good-risk genotypes had a favorable outcome (overall survival, OS, not reached) similar to those with good-risk cytogenetics, whereas those with poor-risk genotypes had an unfavorable prognosis (OS, 10 months) similar to those with poor-risk cytogenetics (OS, 13.5 months), and the remaining patients with other genotypes had an intermediate outcome (OS, 25 months). Integration of cytogenetic and molecular profiling could thus reduce the number of intermediate-risk AML patients from around three-fourth to one-fourth. In conclusion, integration of cytogenetic and molecular changes improves the prognostic stratification of AML patients, especially those with intermediate-risk cytogenetics, and may lead to better decision on therapeutic strategy.
Fluid availability during high‐grade metamorphism is a critical factor in dictating petrological, geochemical and isotopic reequilibration between metamorphic minerals, with fluid‐absent metamorphism ...commonly resulting in neither zircon growth/recrystallization for U‐Pb dating nor Sm‐Nd isotopic resetting for isochron dating. While peak ultra‐high pressure (UHP) metamorphism is characterized by fluid immobility, high‐pressure (HP) eclogite‐facies recrystallization during exhumation is expected to take place in the presence of fluid. A multichronological study of UHP eclogite from the Sulu orogen of China indicates zircon growth at 216 ± 3 Ma as well as mineral Sm‐Nd and Rb‐Sr reequilibration at 216 ± 5 Ma, which are uniformly younger than UHP metamorphic ages of 231 ± 4 to 227 ± 2 Ma as dated by the SHRIMP U‐Pb method for coesite‐bearing domains of zircon. O isotope reequilibration was achieved between the Sm‐Nd and Rb‐Sr isochron minerals, but Hf isotopes were not homogenized between different grains of zircon. The HP eclogite‐facies recrystallization is also evident from petrography. Thus this process occurred during exhumation with fluid availability from decompression dehydration of hydrous minerals and the exsolution of hydroxyl from nominally anhydrous minerals. This provides significant amounts of internally derived fluid for extensive retrogression within the UHP metamorphosed slabs. Based on available experimental diffusion data, the consistent reequilibration of U‐Pb, Sm‐Nd, Rb‐Sr and O isotope systems in the eclogite minerals demonstrates that time‐scale for the HP eclogite‐facies recrystallization is c. 1.9–9.3 Myr or less. This provides a maximum estimate for duration of the fluid‐facilitated process in the HP eclogite‐facies regime during the exhumation of deeply subducted continental crust.
As there is currently a lack of consensus on the most appropriate dose and duration of peginterferon alfa‐2a (PEG‐IFNα‐2a) therapy in hepatitis B e antigen (HBeAg)‐positive patients, the efficacy and ...safety of either 24 or 48 weeks' duration and 90 μg/week or 180 μg/week doses were compared. HBeAg‐positive patients (n = 544; 34% genotype B, 51% genotype C) were randomized to receive PEG‐IFNα‐2a (2 × 2 factorial design) for 24 or 48 weeks and at 90 μg/week or 180 μg/week and included in the per‐protocol population. The primary efficacy endpoint of the noninferiority study was HBeAg seroconversion 6 months posttreatment. The prespecified odds ratio (OR) noninferiority margin was 1.88 with a one‐sided significance level of 0.025. The highest rates of HBeAg seroconversion 6 months posttreatment were in the 180/48 arm (36.2% versus 14.1%‐25.8% in the other arms). When the dose and duration arms were pooled, the OR for noninferiority of 24 weeks versus 48 weeks was 2.17 (95% confidence interval CI 1.43, 3.31; P = 0.749) and for 90 μg versus 180 μg was 1.79 (95% CI 1.18, 2.72; P = 0.410). As the upper limit of the 95% CI of the ORs were >1.88, 24 weeks were inferior to 48 weeks and 90 μg/week was inferior to 180 μg/week. The highest rates of response in the 180/48 arm were achieved by patients with HBsAg <1,500 IU/mL at Week 12 (58%) or Week 24 (57%), whereas patients with HBsAg >20,000 IU/mL did not respond. Adverse events were typical of those associated with PEG‐IFNα‐2a. Conclusion: Compared with lower doses and shorter durations, the licensed PEG‐IFNα‐2a treatment regimen (180μg/48 weeks) was the most efficacious and beneficial for HBeAg‐positive patients predominantly infected with hepatitis B virus genotypes B or C. (HEPATOLOGY 2011;)
The associations between long-term risk of hepatocellular carcinoma (HCC) and spontaneous seroclearance of HBV e antigen (HBeAg), HBV DNA and HBV surface antigen (HBsAg) have never been examined by a ...prospective study using serially measured seromarkers. This study aimed to assess the importance of spontaneous HBeAg, HBV DNA and HBsAg seroclearance in the prediction of HCC risk.
This study included 2946 HBsAg seropositive individuals who were seronegative for antibodies against HCV and free of liver cirrhosis. Serial serum samples collected at study entry and follow-up health examinations were tested for HBeAg, HBV DNA and HBsAg. Cox proportional hazards models were used to calculate the HRs of developing HCC after seroclearance of HBV markers.
The HR (95% CI) of developing HCC after seroclearance of HBeAg, HBV DNA and HBsAg during follow-up was 0.63 (0.38 to 1.05), 0.24 (0.11 to 0.57) and 0.18 (0.09 to 0.38), respectively, after adjustment for age, gender and serum level of alanine aminotransferase at study entry. High HBV DNA levels at the seroclearance of HBeAg (mean±SD, 4.35±1.64 log10 IU/mL) may explain the non-significant association between HBeAg seroclearance and HCC risk. Among HBeAg seronegative participants with detectable serum HBV DNA at study entry, the lifetime (30-75-years-old) cumulative incidence of HCC was 4.0%, 6.6% and 14.2%, respectively, for those with seroclearance of both HBV DNA and HBsAg, seroclearance of HBV DNA only, and seroclearance of neither.
Spontaneous seroclearance of HBV DNA and HBsAg are important predictors of reduced HCC risk.
Summary
Background
Peptic ulcer bleeding remains a major healthcare problem despite decreasing prevalence of peptic ulcer disease. The role of chronic obstructive pulmonary disease (COPD) in the risk ...of peptic ulcer bleeding has not yet been established.
Aim
To determine if COPD patients have a higher risk of peptic ulcer bleeding than the general population and to identify the risk factors of peptic ulcer bleeding in COPD patients.
Methods
From Taiwan's National Health Insurance research database, 62 876 patients, including 32 682 COPD and 30 194 age‐gender‐matched non‐COPD controls, were recruited. Cox proportional hazard regression was performed to evaluate independent risk factors for ulcer bleeding in all patients and to identify risk factors in COPD patients.
Results
During the 8‐year follow‐up, COPD patients had a significant higher rate of peptic ulcer bleeding than the control group (P < 0.001, by log‐rank test). By Cox proportional hazard regression analysis, COPD hazard ratio (HR) 1.93, 95% CI 1.73–2.17 was an independent risk factor after adjusting for age, gender, underlying comorbidities and ulcerogenic medication. Age > 65 years, male, comorbidities of hypertension, diabetes, heart failure, history of peptic ulcer disease, and chronic renal disease and use of nonsteroidal anti‐inflammatory drugs were risk factors of ulcer bleeding in COPD patients.
Conclusion
Patients with chronic obstructive pulmonary disease have a higher risk of peptic ulcer bleeding after adjustments for possible confounding factors like underlying comorbidities and ulcerogenic medication.
We describe a microwave photon counter based on the current-biased Josephson junction. The junction is tuned to absorb single microwave photons from the incident field, after which it tunnels into a ...classically observable voltage state. Using two such detectors, we have performed a microwave version of the Hanbury Brown-Twiss experiment at 4 GHz and demonstrated a clear signature of photon bunching for a thermal source. The design is readily scalable to tens of parallelized junctions, a configuration that would allow number-resolved counting of microwave photons.
Several types of multiphase solid (MS) inclusions are identified in garnet from ultrahigh‐pressure (UHP) eclogite in the Dabie orogen. The mineralogy of MS inclusions ranges from pure K‐feldspar to ...pure quartz, with predominance of intermediate types consisting of K‐feldspar + quartz ± silicate (plagioclase or epidote) ± barite. The typical MS inclusions are usually surrounded with radial cracks in the host garnet, similar to where garnet contains relict coesite. Barite aggregates display significant heterogeneity in major element composition, with total contents of only 57–73% and highly variable SiO2 contents of 0.32–25.85% that are positively correlated with BaO and SO3 contents. The occurrence of MS inclusions provides petrographic evidence for partial melting in the UHP metamorphic rock. The occurrence of barite aggregates with variably high SiO2 contents suggests the coexistence of aqueous fluid with hydrous melt under HP eclogite facies conditions. Thus, local dehydration melting is inferred to take place inside the UHP metamorphic slice during continental collision. This is ascribed to phengite breakdown during ‘hot’ exhumation of the deeply subducted continental crust. As a consequence, the aqueous fluid is internally buffered in chemical composition and its local sink is a basic trigger to the partial melting during the continental subduction‐zone metamorphism.
The preparation of high-purity and -quality gallium nitride nanowires is accomplished by a catalytic growth using gallium and ammonium. A series of catalysts and different reaction parameters were ...applied to systematically optimize and control the vapor−liquid−solid (VLS) growth of the nanowires. The resulting nanowires show predominantly wurtzite phase; they were up to several micrometers in length, typically with diameters of 10−50 nm. A minimum nanowire diameter of 6 nm has been achieved. Temperature dependence of photoluminescence spectra of the nanowires revealed that the emission mainly comes from wurtzite GaN with little contribution from the cubic phase. Moreover, the thermal quenching of photoluminescence was much reduced in the GaN nanowires. The Raman spectra showed five first-order phonon modes. The frequencies of these peaks were close to those of the bulk GaN, but the modes were significantly broadened, which is indicative of the phonon confinement effects associated with the nanoscale dimensions of the system. Additional Raman modes, not observed in the bulk GaN, were found in the nanowires. The field emission study showing notable emission current with low turn-on field suggests potential of the GaN nanowires in field emission applications. This work opens a wide route toward detailed studies of the fundamental properties and potential applications of semiconductor nanowires.
Summary
Background
Few large population‐based studies have compared the occurrence of peptic ulcer bleeding (PUB) in cirrhotic and noncirrhotic patients.
Aims
To investigate if cirrhotic patients ...have higher risk of PUB than the general population and to identify possible risk factors of PUB in cirrhotic patients.
Methods
Using the National Health Insurance Research Database, a nationwide population‐based dataset in Taiwan and matching age, gender, comorbidities and ulcerogenic medication by propensity score, 4013 cirrhotic patients, 8013 chronic hepatitis patients and 7793 normal controls were compared. The log‐rank test was used to analyse differences in accumulated PUB‐free survival rates between the groups. Cox proportional hazard regressions were performed to evaluate independent risk factors for PUB in all patients and identified risk factors of PUB in cirrhotic patients.
Results
During the 7‐year follow‐up, cirrhotic patients had significantly higher incidences of PUB than chronic hepatitis patients and controls, respectively (P < 0.001 by log‐rank test). By Cox proportional hazard regression analysis, cirrhosis was independently associated with increased risk of PUB (hazard ratio: 4.22; 95% CI 3.37–5.29, P < 0.001) after adjusting for age, gender, economic status, underlying comorbidities and ulcerogenic medication. Age, male, diabetes, chronic renal disease, history of gastro‐oesophageal variceal bleeding and use of nonsteroidal anti‐inflammatory drugs were risk factors for PUB in cirrhotic patients.
Conclusion
Cirrhotic patients have a significantly higher risk of peptic ulcer bleeding after adjustments for possible confounding factors like age, gender, economic status, underlying comorbidities and ulcerogenic medication.
Optical reflection, or in other words the loss of reflection, from a surface becomes increasingly crucial in determining the extent of the light-matter interaction. The simplest example of using an ...anti-reflecting (AR) surface is possibly the solar cell that incorporates an AR coating to harvest sunlight more effectively. Researchers have now found ways to mimic biological structures, such as moth eyes or cicada wings, which have been used for the AR purpose by nature herself. These nanoscopic biomimetic structures lend valuable clues in fabricating and designing gradient refractive index materials that are efficient AR structures. The reflectance from a selected sub-wavelength or gradient index structures have come down to below 1% in the visible region of the spectrum and efforts are on to achieve broader bands of such enhanced AR regime. In addition to the challenge of broader bands, the performance of AR structures is also limited by factors such as omnidirectional properties and polarization of incident light. This review presents selected state-of-the-art AR techniques, reported over the last half a century, and their guiding principles to predict a logical trend for future research in this field.
PDF
