We report on a scalable wet deposition to simultaneously manipulate the self-assembly and orientation of zeolite Linde Type A (LTA) nanocrystals. This process, referred to as surfactant-mediated ...self-assembly (SMSA), creates zeolite LTA thin films with long-range ordered cylindrical patterns, wherein {100} faces of the crystals are preferably oriented parallel to the support surface. This approach makes it possible to control the diameter as well as the depth of the cylindrical patterns in zeolite thin films fabricated via scalable wet deposition. To elucidate the mechanism underlying the SMSA process, we applied in situ imaging to cast solutions subjected to a temperature swing. Our results indicate that the cylindrical patterns may be developed from micelles of the surfactant, which make up a thermodynamic phase in the cast solution. We also demonstrate that the apparent dielectric constant and optical haze of the zeolite LTA thin films can be engineered by altering the dimensions of the cylindrical patterns.
Recently we unexpectedly found that PI3K/akt, JAK/STAT and MEK/ERK pathway inhibitors enhanced retinal ganglion cell (RGC) survival after optic nerve (ON) axotomy in adult rat, a phenomenon ...contradictory to conventional belief that these pathways are pro‐survival. In this study we showed that: (i) the RGC protection was pathway inhibition‐dependent; (ii) inhibition of PI3K/akt and JAK/STAT, but not MEK/ERK, activated macrophages in the eye, (iii) macrophage removal from the eye using clodronate liposomes significantly impeded PI3K/akt and JAK/STAT inhibition‐induced RGC survival and axon regeneration whereas it only slightly affected MEK/ERK inhibition‐dependent protection; (iv) in the absence of recruited macrophages in the eye, inhibition of PI3K/akt or JAK/STAT did not influence RGC survival; and (v) strong PI3K/akt, JAK/STAT and MEK/ERK pathway activities were located in RGCs but not macrophages after ON injury. In retinal explants, in which supply of blood‐derived macrophages is absent, MEK/ERK inhibition promoted RGC survival whereas PI3K/akt or JAK/STAT inhibition had no effect on RGC viability. However, MEK/ERK inhibition exerted opposite effects on the viability of purified adult RGCs at different concentrations in vitro, suggesting that this pathway may be bifunctional depending on the level of pathway activity. Our data thus demonstrate that inhibition of the PI3K/akt or JAK/STAT pathway activated macrophages to facilitate RGC protection after ON injury whereas the two pathways per se did not modulate RGC viability under the injury conditions (in the absence of the pathway activators). In contrast, the MEK/ERK pathway inhibition protected RGCs via macrophage‐independent mechanism(s).
Purpose: Current immunomagnetic enrichment method can only detect general epithelial antigens of circulating tumor cells (CTC). Further
characterization of the CTCs to provide specific information on ...the tumor type is not possible. We attempted to overcome this
drawback by developing the methodology for using a gastrointestinal-specific anti-cytokeratin (CK) 20 antibody to detect CTCs
in colorectal cancer patients' blood.
Experimental Design: The protocol was validated using a colorectal cancer SW480 cell line. The clinical significance of findings in colorectal
cancer was investigated by detecting CK20-positive CTCs (pCTC) in patients with colorectal cancer, other common cancers, colorectal
adenoma, benign colorectal diseases, and normal subjects. Moreover, the malignant nature of CK20 pCTCs was examined by comparing
chromosome 17 aberration patterns with those from the corresponding primary tumors.
Results: The assay successfully showed CK20-positive SW480 cells. When applied in patient samples, the detection rates were 62% (132
colorectal cancer patients; median number = 11 CTCs), 0% (120 patients with other common cancers), 6% (50 colorectal adenoma
patients), 0% (120 patients with benign colorectal diseases), and 0% (40 normal subjects). Furthermore, statistical analysis
showed that CK20 pCTC numbers were associated with tumor-node-metastasis stage and lymph node status. Using the median CK20
pCTC numbers as the cutoff points, stratified groups of colorectal cancer patients had significant differences in their recurrence,
metastasis, and survival. Finally, chromosome 17 aneusomy in 90% of colorectal cancer patients with CK20 pCTCs matched with
those from the primary tumors.
Conclusions: Detection of CK20 pCTCs using the new protocol could generate clinically important information for colorectal cancer patients.
Objective While most geriatric patients with hip fracture benefit from definitive operative treatment, pre-operative pain management is often overlooked. Conventional oral analgesics may provide ...suboptimal pain control, resulting in poor morbidity outcomes. Fascia iliaca compartment block (FICB) provides a more consistent analgesic effect. This study aims to provide high level local evidence on the effect of FICB in pre-operative pain control for these patients in Hong Kong. Materials and Methods This study was a double-blinded randomized controlled trial. Mentally competent geriatric patients with acute fracture hip, admitted to United Christian Hospital, were recruited to receive pre-operative FICB. The procedure was carried out by landmark approach with addition of ultrasonography-guidance. They were randomized into intervention group (receiving 0.25% levobupivacaine), and control group (receiving normal saline as placebo). Numeric Rating Scale of pain score (at rest, and on gentle movement) at different time intervals, timing of injection, systemic analgesic use, complications, and demographics were compared. Results Total 80 patients were recruited from July 2019 to September 2021 and randomized into intervention and control groups. Two patients in intervention group and 1 in control group were withdrawn due to development of delirium. Demographics of both groups were comparable. Pain score at rest was significantly lower at 12 h after injection in intervention group (41.4% reduction, p = 0.03). Pain score upon gentle movement was significantly lower in intervention group at 1 h (p = 0.01), 12 h (28.9% reduction, p = 0.003) and 24 h after injection (p = 0.01). There was no complication from the procedure documented. Total systemic analgesic use was similar in both groups. Conclusion FICB is an effective choice of pre-operative analgesia for geriatric hip fracture patients with good safety profile, especially in controlling pain induced by movement. It shall be considered as a routine practice for suitable patients.
Asia will soon have the majority of demented patients in the world.
To assess dementia using a uniform data system to update the current status of dementia in Asia.
A uniformed data set was ...administered in Taiwan, China, Hong Kong, Korea, Japan, Philippines, Thailand, Singapore, and Indonesia to gather data with regard to Alzheimer's disease (AD) and its related issues for these countries.
In total, 2,370 AD patients and their caregivers were recruited from 2011 to 2014. The demographic characteristics of these patients and the relationships between patients and caregivers were different among individuals in these countries (p < 0.001). Of note, the family history for having dementia was 8.2% for females in contrast to 3.2% for males.
Our study highlighted the differences in dementia assessment and care in developing versus developed countries. Greater effort with regard to studying dementia, especially in developing countries, is necessary.
This study aimed to assess the psychometric properties of the Chinese version of the Revised Clinical Interview Schedule (C-CIS-R), and explore its applicability as a diagnostic instrument for common ...mental disorders (CMDs) in Hong Kong. Its psychometric properties were evaluated among 140 patients and 161 healthy controls. In comparison to the diagnoses made by the Structured Clinical Interview for the DSM-IV, the C-CIS-R showed good criterion validity in diagnosing CMDs. The correlation of the total score of C-CIS-R with the 12-item General Health Questionnaire and Hospital Anxiety and Depression Scale was satisfactory, indicating favourable convergent validity as well. The inter-rater and test-retest reliability were also satisfactory. Receiver operating characteristic analyses suggested an optimal cut-off point of 11/12 for detecting diagnosable CMDs (sensitivity: 0.69; specificity: 0.93) and 17/18 for identifying a need for treatment (sensitivity: 0.70; specificity: 0.95). In conclusion, C-CIS-R is a valid diagnostic instrument for CMDs in a Chinese community. Its cut-off points for clinically significant symptoms and treatment needs among Chinese are identical to those adopted in the original English version.
Next-generation sequencing comprehensive genomic panels (NGS CGPs) have enabled the delivery of tailor-made therapeutic approaches to improve survival outcomes in patients with cancer. Within the ...China Greater Bay Area (GBA), territorial differences in clinical practices and health care systems and strengthening collaboration warrant a regional consensus to consolidate the development and integration of precision oncology (PO). Therefore, the Precision Oncology Working Group (POWG) formulated standardized principles for the clinical application of molecular profiling, interpretation of genomic alterations, and alignment of actionable mutations with sequence-directed therapy to deliver clinical services of excellence and evidence-based care to patients with cancer in the China GBA.
Thirty experts used a modified Delphi method. The evidence extracted to support the statements was graded according to the GRADE system and reported according to the Revised Standards for Quality Improvement Reporting Excellence guidelines, version 2.0.
The POWG reached consensus in six key statements: harmonization of reporting and quality assurance of NGS; molecular tumor board and clinical decision support systems for PO; education and training; research and real-world data collection, patient engagement, regulations, and financial reimbursement of PO treatment strategies; and clinical recommendations and implementation of PO in clinical practice.
POWG consensus statements standardize the clinical application of NGS CGPs, streamline the interpretation of clinically significant genomic alterations, and align actionable mutations with sequence-directed therapies. The POWG consensus statements may harmonize the utility and delivery of PO in China's GBA.
Background: Insulin-treated patients with long duration of type 2 diabetes mellitus (T2DM) are at increased risk of ketoacidosis related to sodium-glucose co-transporter 2 inhibitor (SGLT2i). The ...extent of circulating ketone elevation in these patients remains unknown. We conducted this study to compare the serum ketone response between dapagliflozin, an SGLT2i, and sitagliptin, a dipeptidyl peptidase-4 inhibitor, among insulin-treated T2DM patients.
Methods: This was a randomized, open-label, active comparator-controlled study involving 60 insulin-treated T2DM patients. Participants were randomized 1:1 for 24-week of dapagliflozin 10 mg daily or sitagliptin 100 mg daily. Serum β-hydroxybutyrate (BHB) levels were measured at baseline, 12 and 24 weeks after intervention. Comprehensive cardiometabolic assessments were performed with measurements of high-density lipoprotein cholesterol (HDL-C) cholesterol efflux capacity (CEC), vibration-controlled transient elastography and echocardiography.
Results: Among these 60 insulin-treated participants (mean age 58.8 years, diabetes duration 18.2 years, glycosylated hemoglobin 8.87%), as compared with sitagliptin, serum BHB levels increased significantly after 24 weeks of dapagliflozin (P=0.045), with a median of 27% increase from baseline. Change in serum BHB levels correlated significantly with change in free fatty acid levels. Despite similar glucose lowering, dapagliflozin led to significant improvements in body weight (P=0.006), waist circumference (P=0.028), HDL-C (P=0.041), CEC (P=0.045), controlled attenuation parameter (P=0.007), and liver stiffness (P=0.022). Average E/e’, an echocardiographic index of left ventricular diastolic dysfunction, was also significantly lower at 24 weeks in participants treated with dapagliflozin (P=0.037).
Conclusion: Among insulin-treated T2DM patients with long diabetes duration, compared to sitagliptin, dapagliflozin modestly increased ketone levels and was associated with cardiometabolic benefits.
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