Quenching upon aggregation: 11‐Mercaptoundecanoic acid (11‐MUA)‐protected Au nanoparticles (11‐MUA‐AuNPs) are much more stable and fluoresce much more strongly than the corresponding unmodified ...AuNPs. After addition of 2,6‐pyridinedicarboxylic acid, the 11‐MUA‐AuNPs bind to HgII with both high sensitivity and selectivity.
Objective
To explore the impact of textbook outcome (TO) on long‐term survival in oral cancer surgery.
Subjects and Methods
In total, 386 patients with tumor resection, neck dissection (ND), and ...reconstruction between 2011 and 2020 were included. TO was defined as negative margin; adequate ND; no 3‐day emergency room revisit; no 30‐day readmission; and length of stay ≤22 days. Multivariate Cox regression was used to evaluate the impact of TO and 5‐year overall survival (OS).
Results
The TO rate was 35%. Younger age, subsite in buccal area, Charlson Comorbidity Index Score of 0, higher body mass index, higher hemoglobin, higher albumin, and unilateral ND were associated with TO. 5‐year OS was 70.5% in overall TO patients and 49.0% in non‐TO patients (HR, 0.47; 95% CI, 0.31–0.70; p < 0.001). Non‐TO was associated with an increased mortality rate (aHR, 1.73; 95% CI, 1.14–2.63) after adjusting other factors and the result remained robust with inverse probability of treatment weighting analysis. The impact of TO on OS was more significant in age <60, advanced stage, and diagnosis year before 2018.
Conclusion
Not achieving TO in oral cancer surgery was associated with worse long‐term outcome. TO could be used as a proxy for surgical quality improvement.
Background
The prevalence of HPV‐negative oropharyngeal cancer (OPC) is higher in Asian countries. Patients with HPV‐negative OPC suffer poor outcomes. Multi‐omics analysis could provide researchers ...and clinicians with more treatment targets for this high‐risk group. We aimed to explore the prognostic significance of EGFR overexpression and macrophage infiltration in OPC, especially HPV‐negative OPC in this study.
Methods
EGFR alternation was evaluated with TCGA, PanCancer Atlas through cBioProtal. EGFR mRNA expression in HPV‐negative head and neck squamous cell carcinoma was analyzed using the Tumor Immune Estimation Resource (TIMER 2.0). We also examined EGFR/STAT6/MRC1 expression in paraffin‐embedded tissues from a p16‐negative OPC cohort. The correlation between EGFR expression and macrophage activation was explored using Person's correlation coefficient. The impact of biomarkers or macrophage infiltration on 5‐year overall survival and recurrence‐free survival were analyzed using Kaplan–Meier survival curves.
Results
EGFR alteration rate was 15%, 13%, and 0% for HPV‐negative HNSCC (excluding OPC), HPV‐negative OPC, and HPV‐positive OPC. High EGFR expression was associated with increased tumor infiltration of immune cells, such as macrophages. We observed positive correlations between EGFR, STAT6, and MRC1 expression in p16‐negative OPC. Higher MRC1 expression was associated with poorer survival rates.
Conclusions
There is strong correlation between EGFR overexpression and M2 polarization in patients with p16‐negative OPC. Immunotherapy with or without EGFR inhibitor could be considered in these high‐risk patients.
In the long history of traditional Chinese medicine, single herbs and complex formulas have been suggested to increase lifespan. However, the identification of single molecules responsible for ...lifespan extension has been challenging. Here, we collected a list of traditional Chinese medicines with potential longevity properties from pharmacopeias. By utilizing the mother enrichment program, we systematically screened these traditional Chinese medicines and identified a single herb, Psoralea corylifolia, that increases lifespan in Saccharomyces cerevisiae. Next, twenty-two pure compounds were isolated from Psoralea corylifolia. One of the compounds, corylin, was found to extend the replicative lifespan in yeast by targeting the Gtr1 protein. In human umbilical vein endothelial cells, RNA sequencing data showed that corylin ameliorates cellular senescence. We also examined an in vivo mammalian model, and found that corylin extends lifespan in mice fed a high-fat diet. Taken together, these findings suggest that corylin may promote longevity.
Background: Screening or diagnosis for the elderly with dementia in rural regions might be delayed and underestimated due to limited utilization of healthcare resources. This study aimed to evaluate ...the disparities of prevalence and risk factors of mild cognitive impairment (MCI) and dementia between urban and rural residence.Methods: In this nationwide door-to-door survey, 10,432 participants aged 65 years and more were selected through computerized random sampling from all administrative districts in Taiwan and were assessed using an in-person interview. We calculated the prevalence of MCI and dementia, with their risk factors examined using multivariable logistic regression.Results: The prevalence of dementia in rural, suburban, and urban areas among the elderly was 8.69% (95% CI, 8.68–8.69), 6.63% (95% CI, 6.62–6.63), and 4.46% (95% CI, 4.46–4.47), respectively. A similar rural-suburban-urban gradient relationship on the dementia prevalence was observed in any age and sex group. The rural:urban ratio was higher in women than in men for both MCI and dementia. Urbanization remained to be an independent factor for both MCI and dementia after adjustment for age, gender, education, lifestyle, and health status. The beneficial effects of exercise on dementia were more evident in rural areas than in urban ones.Conclusion: Significantly higher prevalence of MCI and dementia were found in rural areas than in urban ones, especially for women. The odds of risk factors for MCI and dementia varied by urbanization status. Focus on the rural-urban inequality and the modification of associated factors specifically for different urbanization levels are needed.
This study aimed to identify the trends in the incidence of thymic cancer, i.e., thymoma, thymic carcinoma, and thymic neuroendocrine tumor, in the United States. Data from the United States Cancer ...Statistics (USCS) database (2001-2015) and those from the Surveillance, Epidemiology, and End Results (SEER) database (SEER 9 1973-2015, SEER 13 1992-2015, and SEER 18 2000-2015) were used in this study. All incidences were per 100,000 population at risk. The trends in incidence were described as annual percent change (APC) using the Joinpoint regression program. Data from the USCS (2001-2015) database showed an increase in thymic cancer diagnosis with an APC of 4.89% from 2001 to 2006, which is mainly attributed to the significant increase in the incidence of thymoma and thymic carcinoma particularly in women. The incidence of thymic cancer did not increase from 2006 to 2015, which may be attributed to the increase in the diagnosis of thymic carcinoma from 2004 to 2015, with a concomitant decrease in thymoma from 2008 to 2015. Before declining, the age-specific incidence of thymic cancer peaked at ages 70-74 years, with a peak incidence at 1.06 per 100,000 population, and decreased in older age groups. The incidence of thymic cancer was higher in men than in women. Asian/Pacific Islanders had the highest incidence of thymoma, followed by black and then white people. The incidence of thymic carcinoma increased from 2004 to 2015, with a concomitant decrease in thymoma from 2008 to 2015. Asian/Pacific Islanders had the highest incidence of thymoma than other races.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
It is known that the risk of dementia in patients with moderate to severe traumatic brain injury (TBI) is higher. However, the relationship between mild traumatic brain injury (mTBI) and dementia has ...never been established.
We investigated the incidences of dementia among patients with mTBI in Taiwan to evaluate if there is higher risk compared with general population.
We utilized a sampled National Health Insurance (NHI) claims data containing one million beneficiaries. We followed all adult beneficiaries from January 1, 2005 till December 31, 2009 to see if they had been diagnosed with dementia. We further identify patients with mTBI and compared their risk of dementia with the general population.
We identified 28551 patients with mTBI and 692382 without. After controlled for age, gender, urbanization level, socioeconomic status, diabetes, hypertension, coronary artery disease, hyperlipidemia, history of alcohol intoxication, history of ischemic stroke, history of intracranial hemorrhage and Charlson Comorbidity Index Score, the adjusted hazard ratio is 3.26 (95% Confidence interval, 2.69-3.94).
TBI is an independent significant risk factor of developing dementia even in the mild type.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Introduction.
Although palliative chemotherapy during end‐of‐life care is used for relief of symptoms in patients with metastatic cancer, chemotherapy may lead to more aggressive end‐of‐life care and ...less use of hospice service. This is a population‐based study of the association between palliative chemotherapy and aggressiveness of end‐of‐life care.
Patients and Methods.
Using the National Health Insurance Research Database of Taiwan, we identified 49,920 patients with metastatic cancer who underwent palliative chemotherapy from January 1, 2009, to December 31, 2011. Patients who received chemotherapy 2–6 months before death were included. Aggressiveness of end‐of‐life care was examined by previously reported indicators. Cardiopulmonary resuscitation and endotracheal tube intubation were included as indicators of aggressive end‐of‐life care. The association between palliative chemotherapy and hospice care was studied.
Results.
Palliative chemotherapy was associated with more aggressive treatment. After adjustment for patient age, sex, Charlson Comorbidity Index score, cancer group, primary physician's specialty, postdiagnosis survival, hospital characteristics, hospital caseload, urbanization, and geographic regions, more than one emergency room visit (p < .001), more than one intensive care unit admission (p < .001), and endotracheal intubation (p = .02) during end‐of‐life care were significantly more common in patients receiving palliative chemotherapy. Patients who did not receive palliative chemotherapy received more hospice care in the last 6 months of life (p < .001).
Conclusion.
Although the decision to initiate palliative chemotherapy was made several months before death, this study showed that palliative chemotherapy was associated with more aggressive end‐of‐life care, including more emergency room visits and intensive care unit admissions, and endotracheal intubation. The patients who received palliative chemotherapy received less hospice service toward the end of life.
Implications for Practice:
Palliative chemotherapy is used for patients with incurable cancer toward the end of life (EOL). Aggressiveness of EOL care and hospice care are related to the quality of life of these patients. This study of data from the Taiwanese National Health Insurance Research Database found that palliative chemotherapy led to more aggressive EOL care and less hospice care. There is a need to provide patients with terminal cancer access to care information that best meets their needs, especially those patients who receive palliative chemotherapy.
This population‐based study found that compared with patients with metastatic cancer who did not receive palliative chemotherapy, those who did also received more aggressive end‐of‐life care and less hospice care. More than one emergency room visit, more than one intensive care unit admission, and endotracheal intubation during end‐of‐life care were significantly more common in patients receiving palliative chemotherapy.
Currently, two major processes are being used to produce prototypes, namely machining and rapid prototyping. Machining is generally more accurate and precise, but it is difficult to produce objects ...with certain complicated features. In contrast, rapid prototyping can produce objects with complicated features, which allows materials to be used more efficiently. However, due to the uneven shrinkage and residual stresses within rapid prototyping products, their accuracy is usually uncertain. This study attempts to integrate these two manufacturing processes and develop a hybrid rapid prototyping system in order to overcome the disadvantages associated with each process and to develop new applications. Fused deposition modeling (FDM) was used as the rapid prototyping process in this work. A spindle and a low-cost FDM extruder were designed to be placed on each end of a rotary axis in a five-axis machine tool. The proposed design allows the rotation of the axis on the five-axis machine to switch between machining and FDM, thus achieving the advantage of reducing costs for extra actuators without sacrificing working space. The case studies demonstrated that the proposed hybrid system can build FDM objects without using support materials and produce FDM parts with metal embedded to increase the stiffness. The system can also conduct five-axis machining on a completed FDM part or trim the freeform surface fabricated by FDM to achieve more accurate dimensions or better surface finish.
Background Malfunction of the arteriovenous fistula (AVF) is an important cause of morbidity and hospitalization in hemodialysis (HD) patients. The aim of this study is to evaluate the effect of far ...infrared therapy on the maturation and patency of newly created AVFs in patients with chronic kidney disease stage 4 or 5. Study Design Randomized controlled study. Setting & Participants Patients with estimated glomerular filtration rate of 5-20 mL/min/1.73 m2. Intervention 40 minutes of far infrared therapy 3 times weekly for a year. Outcomes The primary outcome is the rate of AVF malfunction within 12 months, with malfunction defined as either: (1) thrombosis without thrill for AVFs not undergoing HD or (2) receiving any type of interventional procedure due to a lower Kt/V (<1.2) for patients undergoing HD. Secondary outcomes include: (1) cumulative primary unassisted AVF patency, defined as time from creation of the AVF to the first episode of AVF malfunction; (2) physiologic maturation of the AVF by the definition of AVF access blood flow (Qa) ≥500 mL/min and AVF diameter ≥4 mm at 3 months; and (3) clinical maturation of the AVF suitable for HD at 1 year. Measurements AVF Qa was measured by Doppler ultrasonography at 2 days and 1, 2, 3, and 12 months. Results We enrolled 122 patients who were randomly allocated to the intervention (n = 60) and control (n = 62) groups. In comparison to controls, patients in the intervention group had higher Qa values at 1, 2, 3, and 12 months; a higher rate of physiologic maturation (90% vs 76%; P = 0.04) at 3 months; and a lower rate of AVF malfunction (12% vs 29%; P = 0.02) but higher rates of AVF cumulative unassisted patency (87% vs 70%; P = 0.01) and clinical maturation (82% vs 60%; P = 0.008) within 12 months. Limitations This is a single-center nonblinded study. Conclusions Far infrared therapy improves the access flow, maturation, and patency of newly created AVFs in patients with chronic kidney disease stages 4 and 5.
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