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.
Background
This study aimed to identify the potential circulating biomarkers of protein, mRNAs, and long non-coding RNAs (lncRNAs) to differentiate the papillary thyroid cancers from benign thyroid ...tumors.
Methods
The study population of 100 patients was classified into identification (10 patients with papillary thyroid cancers and 10 patients with benign thyroid tumors) and validation groups (45 patients with papillary thyroid cancers and 35 patients with benign thyroid tumors). The Sengenics Immunome Protein Array-combined data mining approach using the Open Targets Platform was used to identify the putative protein biomarkers, and their expression validated using the enzyme-linked immunosorbent assay. Next-generation sequencing by Illumina HiSeq was used for the detection of dysregulated mRNAs and lncRNAs. The website Timer v2.0 helped identify the putative mRNA biomarkers, which were significantly over-expressed in papillary thyroid cancers than in adjacent normal thyroid tissue. The mRNA and lncRNA biomarker expression was validated by a real-time polymerase chain reaction.
Results
Although putative protein and mRNA biomarkers have been identified, their serum expression could not be confirmed in the validation cohorts. In addition, seven lncRNAs (TCONS_00516490, TCONS_00336559, TCONS_00311568, TCONS_00321917, TCONS_00336522, TCONS_00282483, and TCONS_00494326) were identified and validated as significantly downregulated in patients with papillary thyroid cancers compared to those with benign thyroid tumors. These seven lncRNAs showed moderate accuracy based on the area under the curve (AUC = 0.736) of receiver operating characteristic in predicting the occurrence of papillary thyroid cancers.
Conclusions
We identified seven downregulated circulating lncRNAs with the potential for predicting the occurrence of papillary thyroid cancers.
Belatacept, a costimulation blocker, may preserve renal function and improve long‐term outcomes versus calcineurin inhibitors in kidney transplantation. This Phase III study (Belatacept Evaluation of ...Nephroprotection and Efficacy as First‐line Immunosuppression Trial) assessed a more intensive (MI) or less intensive (LI) regimen of belatacept versus cyclosporine in adults receiving a kidney transplant from living or standard criteria deceased donors. The coprimary endpoints at 12 months were patient/graft survival, a composite renal impairment endpoint (percent with a measured glomerular filtration rate (mGFR) <60 mL/min/1.73 m2 at Month 12 or a decrease in mGFR ≥10 mL/min/1.73 m2 Month 3–Month 12) and the incidence of acute rejection. At Month 12, both belatacept regimens had similar patient/graft survival versus cyclosporine (MI: 95%, LI: 97% and cyclosporine: 93%), and were associated with superior renal function as measured by the composite renal impairment endpoint (MI: 55%; LI: 54% and cyclosporine: 78%; p ≤ 0.001 MI or LI versus cyclosporine) and by the mGFR (65, 63 and 50 mL/min for MI, LI and cyclosporine; p ≤ 0.001 MI or LI versus cyclosporine). Belatacept patients experienced a higher incidence (MI: 22%, LI: 17% and cyclosporine: 7%) and grade of acute rejection episodes. Safety was generally similar between groups, but posttransplant lymphoproliferative disorder was more common in the belatacept groups. Belatacept was associated with superior renal function and similar patient/graft survival versus cyclosporine at 1 year posttransplant, despite a higher rate of early acute rejection.
In this Phase III trial, patients on belatacept‐based immunosuppressive regimens had similar patient/graft survival, superior renal function, and a better cardiovascular/metabolic risk profile than patients treated with cyclosporine, despite experiencing a higher incidence of early acute rejection. See editorial by Kaplan on page 441.
The purpose of this study was to determine factors associated with self‐perceived body image in female patients with head and neck cancer (HNC), and factors associated with healthcare professional's ...rating of disfigurement, as well as the correlation between patient and observer ratings. This cross‐sectional study recruited 105 women with HNC at a large medical centre. Measures of facial disfigurement and body image, as well as demographic and clinical characteristics, were collected. Multivariate multiple linear regression modelling was used to identify factors associated with healthcare professional's rating of disfigurement and patient self‐perceived body image. Disfigurement ratings by healthcare professionals were positively associated with patient self‐perceived body image. Medical treatment, cancer stage, radiation dose and cancer site were significantly associated with disfigurement. Medical treatment was an important predictor of perceived body image. These findings indicate a moderate prevalence of disfigurement among women with HNCs. Patients with more disfigurement were more likely to have dissatisfaction with their body image. Nursing professionals need to carefully assess the appearance of women with HNC. Camouflage interventions can be used to help appropriately cope with the disfigurement, and to achieve improved satisfaction with their body image.
Summary Objective To study the effect of intra-articular injection of meloxicam (Mobic) on the development of osteoarthritis (OA) in rats and examine concomitant changes in nociceptive behavior and ...the expression of mitogen-activated protein kinases (MAPKs) in articular cartilage chondrocytes. Methods OA was induced in Wistar rats by right anterior cruciate ligament transection (ACLT); the left knee was not treated. The OA + meloxicam (1.0 mg) group was injected intra-articularly in the ACLT knee with 1.0 mg of meloxicam once a week for 5 consecutive weeks starting 5 weeks after ACLT. The OA + meloxicam (0.25 mg) group was treated similarly with 0.25 mg meloxicam. The sham group underwent arthrotomy only and received vehicle of 0.1 mL sterile 0.9% saline injections, whereas the naive rats in meloxicam-only groups were treated similarly with 1.0- and 0.25-mg meloxicam. Nociception was measured as secondary mechanical allodynia and hind paw weight-bearing distribution at before (pre-) and 5, 10, 15, and 20 weeks post-ACLT. Histopathology of the cartilage and synovia was examined 20 weeks after ACLT. Immunohistochemical analysis was performed to examine the effect of meloxicam on MAPKs (p38, c-Jun N-terminal kinase (JNK), and extracellular signal-regulated kinase (ERK)) expression in the articular cartilage chondrocytes. Results OA rats receiving intra-articular meloxicam treatment showed significantly less cartilage degeneration and synovitis than saline-treated controls. Nociception were improved in the OA + meloxicam groups compared with the OA group. Moreover, meloxicam attenuated p38 and JNK but enhanced ERK expression in OA-affected cartilage. Conclusions Intra-articular injection of meloxicam (1) attenuates the development of OA, (2) concomitantly reduces nociception, and (3) modulates chondrocyte metabolism, possibly through inhibition of cellular p38 and JNK, but enhances ERK expression.
Treatment options for vancomycin-resistant enterococci (VRE) bloodstream infection are limited. Studies comparing daptomycin or linezolid in treating VRE bloodstream infection have conflicting ...results and suggest daptomycin underdosing. The responses to different daptomycin doses have not been studied. We conducted a multicentre prospective cohort study to compare linezolid and daptomycin (≥6 mg/kg) for the treatment of VRE bloodstream infection. The primary outcome was 14-day mortality. We used multivariate logistic regression analysis for outcome analysis and a generalized additive model for dose-dependent response estimation. Two hundred twelve patients were included (daptomycin, n = 141; linezolid, n = 71). All-cause 14-day mortality was higher in the daptomycin group (36.9% vs. 21.1%; p 0.03). After adjusting for confounders in logistic regression, mortality was lower in the linezolid group (adjusted odds ratio (aOR), 0.45; 95% confidence interval (CI), 0.21–0.96; p 0.04). The generalized additive model showed that higher-dose daptomycin (≥9 mg/kg) was associated with better survival than lower-dose daptomycin (6–9 mg/kg). Logistic regression showed that linezolid (aOR, 0.36; 95% CI, 0.17–0.79; p 0.01) and higher-dose daptomycin (aOR, 0.26; 95% CI, 0.09–0.74; p 0.01) independently predicted lower mortality compared to lower-dose daptomycin. Linezolid was not superior to higher-dose daptomycin in terms of mortality (aOR, 1.40; 95% CI, 0.45–4.37; p 0.57). Higher-dose daptomycin had lower mortality than lower-dose daptomycin. Despite higher mortality for lower-dose daptomycin than linezolid, linezolid conferred no survival benefit compared to higher-dose daptomycin. Our findings suggest that the recommended daptomycin dose is suboptimal for treating VRE bacteraemia.
The anterior, mid, and posterior insula show differential structural and resting state connectivity with other pain-related brain regions.
Functional neuroimaging studies suggest that the anterior, ...mid, and posterior division of the insula subserve different functions in the perception of pain. The anterior insula (AI) has predominantly been associated with cognitive–affective aspects of pain, while the mid and posterior divisions have been implicated in sensory-discriminative processing. We examined whether this functional segregation is paralleled by differences in (1) structural and (2) resting state connectivity and (3) in correlations with pain-relevant psychological traits. Analyses were restricted to the 3 insular subdivisions and other pain-related brain regions. Both type of analyses revealed largely overlapping results. The AI division was predominantly connected to the ventrolateral prefrontal cortex (structural and resting state connectivity) and orbitofrontal cortex (structural connectivity). In contrast, the posterior insula showed strong connections to the primary somatosensory cortex (SI; structural connectivity) and secondary somatosensory cortex (SII; structural and resting state connectivity). The mid insula displayed a hybrid connectivity pattern with strong connections with the ventrolateral prefrontal cortex, SII (structural and resting state connectivity) and SI (structural connectivity). Moreover, resting state connectivity revealed strong connectivity of all 3 subdivisions with the thalamus. On the behavioural level, AI structural connectivity was related to the individual degree of pain vigilance and awareness that showed a positive correlation with AI-amygdala connectivity and a negative correlation with AI–rostral anterior cingulate cortex connectivity. In sum, our findings show a differential structural and resting state connectivity for the anterior, mid, and posterior insula with other pain-relevant brain regions, which might at least partly explain their different functional profiles in pain processing.
To investigate the physico-chemical properties of aerosols in Taiwan, an observation network was initiated in 2003. In this work, the measurements of the mass concentration and carbonaceous ...composition of PM10 and PM2.5 are presented. Analysis on the data collected in the first 5-years, from 2003 to 2007, showed that there was a very strong contrast in the aerosol concentration and composition between the rural and the urban/suburban stations. The five-year means of EC at the respective stations ranged from 0.9±0.04 to 4.2±0.1 μgC m−3. In rural areas, EC accounted for 2–3% of PM10 and 3–5% of PM2.5 mass loadings, comparing to 4–6% of PM10 and 4–8% of PM2.5 in the urban areas. It was found that the spatial distribution of EC was consistent with CO and NOx across the network stations, suggesting that the levels of EC over Taiwan were dominated by local sources. The measured OC was split into POC and SOC counterparts following the EC tracer method. Five-year means of POC ranged from 1.8±0.1 to 9.7±0.2 μgC m−3 among the stations. It was estimated that the POM contributed 5–17% of PM10 and 7–18% of PM2.5 in Taiwan. On the other hand, the five-year means of SOC ranged from 1.5±0.1 to 3.8±.3 μgC m−3. The mass fractions of SOM were estimated to be 9–19% in PM10 and 14–22% in PM2.5. The results showed that the SOC did not exhibit significant urban-rural contrast as did the POC and EC. A significant cross-station correlation between SOC and total oxidant was observed, which means the spatial distribution of SOC in Taiwan was dominated by the oxidant mixing ratio. Besides, correlation was also found between SOC and particulate nitrate, implying that the precursors of SOA were mainly from local anthropogenic sources. In addition to the spatial distribution, the carbonaceous aerosols also exhibited distinct seasonality. In northern Taiwan, the concentrations of all the three carbonaceous components (EC, POC, and SOC) reached their respective minima in the fall season. POC and EC increased drastically in winter and peaked in spring, whereas the SOC was characterized by a bimodal pattern with the maximal concentration in winter and a second mode in summertime. In southern Taiwan, minimal levels of POC and EC occurred consistently in summer and the maxima were observed in winter, whereas the SOC peaked in summer and declined in wintertime. The discrepancies in the seasonality of carbonaceous aerosols between northern and southern Taiwan were most likely caused by the seasonal meteorological settings that dominated the dispersion of air pollutants. Moreover, it was inferred that the Asian pollution outbreaks could have shifted the seasonal maxima of air pollutants from winter to spring in the northern Taiwan, and that the increases in biogenic SOA precursors and the enhancement in SOA yield were responsible for the elevated SOC concentrations in summer.
The accretionary wedge in the incipient arc‐continent collisional zone offshore southwestern Taiwan is rich in gas hydrates as inferred from reflection seismic data and the geochemical analyses of ...shallow sediments. In this study, 2D and 3D seismic data were used to investigate the role of structural factors including mud diapirism on the formation of gas hydrates and associated free gas in the Quaternary Lower Fangliao Basin, a semi‐enclosed slope basin situated on the upper accretionary wedge. Albeit limited drilling information on lithostratigraphy and petroleum potential in the area together with seismic reflection data show that mud diapirs have influenced the formation of bottom‐simulating reflectors (BSRs) and the distribution of gas hydrates and free gas. On reflection seismic profiles, five seismic facies were observed and are characterised by: stratified parallel reflections; contorted reflections; semi‐parallel, high‐amplitude reflections; oblique, continuous high‐amplitude reflections; and generally transparent reflections. These seismic facies were respectively interpreted as hemipelagic sediments, mass transport deposits (MTDs), sandstone‐rich turbidites, overbank deposits and mud diapirs. The gas hydrate stability zone (GHSZ) is characterized by (i) high amplitude reflections with an analogous phase to that of seafloor, possibly indicating potential porous sandstone‐rich turbidite reservoirs; (ii) BSRs showing polarity reversal relative to seafloor, suggesting higher impedance gas hydrates overlying lower impedance intervals with free gas; (iii) blanking reflections in fault zones, interpreted as gas‐bearing fluid conduits; (iv) strong reflections on the flanks of mud diapirs (e.g. flank drags) and above buried mud diapirs, demonstrating the presence of gas hydrates; (v) high amplitude reflections dragging on diapiric flanks with reversed phase to that of seafloor, indicating free gas ‐charged zones abutting mud diapirs; and (vi) the presence of focused advection and diffusion flow through mud diapirs and faults, which is interpreted to control the migration of thermogenic gas. Based on the distribution of seismic amplitude characteristics and reflection strength with respect to depth of the BSRs, hydrocarbon prospects can be divided into gas‐hydrate compartments above BSRs, free gas compartments above BSRs, and free gas compartments below BSRs. From a combination of geobody extraction and Monte Carlo simulation, the prospects appear to hold about 2048 Bcf (billion cubic feet) of total gas volume over a study area of 60 km2. These observations provide first‐order estimates of methane resources in the Lower Fangliao Basin offshore southwestern Taiwan.
The NiO–Cu composite films with various Cu contents of 0–18.17
at.% are deposited on a glass substrate. An ultra high electrical resistivity (ρ) is obtained and cannot be detected by a four point ...probe measurement when the Cu content in the films is lower than 6.97
at.%. The ρ value is reduced significantly to 35.8
Ω-cm as Cu content is increased to 9.18
at.%, and it further decreases to 0.02
Ω-cm when the Cu content further increases to 18.17
at.%. The Hall measurement for all Cu-doped NiO films shows p-type conduction. In addition, the transmittance of NiO films also decreases continuously from 96% to 43% as Cu content increases from 0 to 18.17
at.%. The XRD patterns of Cu-doped NiO films show that only NiO peaks appear and the crystallinity of NiO films degrades as Cu content exceeds 6.97
at.%. A large amount of lattice sites of Ni
2+ ions in a NiO crystallite is replaced by the Cu
+ ions that lead to p-type conduction and result in the degradation of crystallinity for NiO–Cu composite films that have a higher Cu content.
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