The aim of this study was to explore the incidence and outcomes of patients with oral cavity squamous cell carcinoma (OSCC) and fourth primary tumors (PTs) in a betel-chewing endemic area.We ...retrospectively examined the records of 1836 OSCC patients who underwent radical tumor resection between 1996 and 2014. The outcome measures included the incidence and number of multiple PTs, the main risk factors, and their associations with overall survival (OS).Of the 1836 patients, 1400 (76.3%) had a single PT, 344 (18.7%) a second PT, 67 (3.6%) a third PT, and 25 (1.4%) a fourth PT. Univariate analyses (log-rank test) identified the following factors as significantly associated with a fourth PT: simultaneous first and second PTs, betel quid chewing, buccal subsite, and pT3-4 status. After allowance for the potential confounding effect of other risk factors, all of these factors retained their independent prognostic significance in stepwise multivariate analyses, the only exception being betel chewing. The incidences of second, third, and fourth PTs at 5 and 10 years were 20.2%/34.6%, 4.0%/8.6%, and 1.0%/2.3%, respectively. The 5 and 10-year OS rates (calculated from the diagnosis of each PTs) for patients with a single, second, third, and fourth PTs were 68%/61%, 43%/37%, 45%/39%%, and 30%/30%, respectively (P < 0.0001). Among patients with a fourth PT, those who underwent radical surgery showed a significantly higher 3-year OS than those who did not (57% vs 13%; P = 0.0442).Fourth PTs are rarely observed in OSCC patients in a betel quid-chewing endemic area. Long-term survival rates of patients treated with radical surgery seems acceptable, being 4-fold higher than their counterparts.
To better understand the channel-hot-carrier (CHC)-induced reliability problems, a modified charge-pumping (CP) technique is proposed to characterize the distribution profiles of trap generation in ...MOSFETs with high- k gate-stack. The effects of gate leakage current on CP measurements were minimized to ensure the correct CP data. While applying dynamic drain bias, the gate-induced drain leakage current is also considered to get correct CP data. Through the CP with dynamic drain bias and various gate pulse frequencies, the profiling of CHC stress-induced interface- and border-traps can be achieved. The CHC stress-induced interface trap generation appears along whole the channel but that-induced border trap generation is mainly located above the pinchoff region near the drain and decreases dramatically toward the center of the channel. Thus, the CHC stress causes quite localized border trap generation at the gate-edge region inside the high- k dielectric. The reliability data measured by CP with different gate voltage swings confirm that CHC stress causes interface trap generation through whole the channel and significant border trap generation at gate-edge region.
Formation of ordered poly(3-hexylthiophene-2,5-diyl) (P3HT) molecular stacking during the freeze-drying process is tracked with in situ spectroscopy of Raman scattering, absorption, and ...photoluminescence. Raman spectra of pristine P3HT dissolved in 1,2-dichlorobenzene show that P3HT polymers undergo drastic ordered aggregation upon being lower than 0 °C, at which the solubility of P3HT is reached, as evidenced by the emergence of pronounced red-shifted, narrow Raman peaks (1422 and 1435 cm–1) caused by intermolecular coupling. The absorption and photoluminescence spectra bear similar temperature dependence as the results of Raman. Aggregation of P3HT is further confirmed by coarse-grained molecular dynamics simulation showing the enhanced order parameters of distance and orientation between P3HT chains upon cooling. The incorporation of 6,6-phenyl-C61-butyric acid methyl ester (PCBM) does not significantly alter the P3HT packing configuration, as verified by nearly identical Raman features observed in P3HT:PCBM mixing solution upon cooling. While optical spectroscopy and MD simulation portrayed the short-range order of P3HT aggregates, grazing-incident X-ray diffraction exposed the long-range order by the pronounced diffraction spots corresponding to the lamellar stacking of P3HT. This study demonstrates the ability of Raman spectroscopy to reveal the short-range order of polymer packing, while the in situ monitoring illustrates that the ability of freeze-drying to separate molecular aggregation from solvent removal thus is advantageous for photovoltaic device fabrication without resorting to trial and error.
•Stage IVB OCSCC is defined as either pT4b or pN3 disease.•The 5-year outcomes of pT4a and pT4b tumors are similar.•The prognosis of pT3-4N3b is less favorable than that of pT1-2N3b disease.•pT4bN0-2 ...and pT1-2N3b should be downstaged from pStage IVB to IVA.•The newly proposed pStage IV improves prognostic stratification.
pStage IVB oral cavity squamous cell carcinoma (OCSCC) is defined as either pT4b or pN3 disease. We sought to devise an improved prognostic stratification of this patient group.
Between December 2003 and January 2018, we retrospectively reviewed the clinical records of 1331 consecutive patients with OCSCC who received tumor excision and neck dissection. The number of patients with pT4a/pT4b, pT1N3b/pT2N3b/pT3N3b/pT4N3b, and pStage IVA/IVB was 370/83, 3/49/42/142, and 332/295, respectively.
The 5-year rates of disease-free survival (DFS) and disease-specific survival (DSS) for patients with pT4a/pT4b disease were 64%/63% (p = 0.973) and 72%/69% (p = 0.672), respectively. The 5-year DFS and DSS rates for patients with pT1N3b/pT2N3b/pT3N3b/pT4N3b disease were 67%/65%/40%/42% (p < 0.001; pT1-2N3b versus pT3-4N3b, p = 0.002) and 100%/68%/45%/49% (p < 0.001; pT1-2N3b versus pT3-4N3b, p = 0.002), respectively. We devised a new definition for pStage IV by considering patients with pT4bN0-2 and pT1-2N3b diseases as pStage-IVA. The number of patients with pStage IVA/IVB (pT3-4N3b) was 443/184. The 5-year rates of AJCC pStage IVA/IVB and the newly proposed pStage IVA/IVB (pT3-4N3b) were as follows: DFS, 74%/52% and 72%/42%; DSS, 83%/58% and 81%/47%; respectively, all p value < 0.001.
The clinical outcomes of pT4b and pT4a OCSCC are similar. However, patients with pT3-4N3b disease have a less favorable 5-year prognosis compared with cases with pT1-2N3b. In light of the unfavorable outcomes, pT3-4N3b disease should continue to be classified as pStage IVB. Conversely, pT4bN0-2 and pT1-2N3b diseases portend a less adverse prognosis and should therefore be downstaged to pStage IVA.
Studies show that vertebral fractures could predict the risk of hip fractures. We aimed to evaluate the potential benefits of whether the timing of vertebroplasty (VP) for vertebral fracture ...associated with the risk of hip fracture for hip replacement.We identified 142,782 patients from the Taiwan National Health Insurance Database with thoracolumbar vertebral fracture (International Classification of Diseases, Ninth Revision, Clinical Modification:805.2-805.9) who were followed up from 2000 to 2013. These patients were divided into those who underwent VP (VP group) (International Classification of Diseases, Ninth Revision, Clinical Modification : 78.49) within 3 months and those who did not (non-VP group). After adjusting for the confounding factors, the Cox proportional hazards analysis was used to estimate the effect of early VP on reducing the risk of hip fracture. The difference in the risk of hip replacement, between the VP group and non-VP group was estimated using the Kaplan-Meier method with the log-rank test.In the 14-year follow-up, the cumulative incidence rate of hip replacement in the VP group was lower than that in the non-VP group (0.362% and 0.533%, respectively, long-rank P < .001). There was a significant difference between the 2 groups since the first-year follow-up.Our study showed that early VP performed to avoid progression of the kyphotic changes following thoracolumbar vertebral fracture may reduce the risk of hip fracture. These results, obtained from retrospective data, indicate that a prospective study is warranted.
Is income still an obstacle that influences health in Taiwan, the National Health Insurance system was instituted in 1995? After collecting injured inpatient data from the health insurance ...information of nearly the whole population, we categorized the cases as either low-income or nonlow-income and tried to determine the correlation between poverty and injury. Chi-square tests, Fisher's exact tests, an independent-samples t-test, and percentages were used to identify differences in demographics, causes for hospitalization, and other hospital care variables. Between 1998 and 2015, there were 74,337 inpatients with low-income injuries, which represented 1.6% of all inpatients with injury events. The hospitalization mortality rate for the low-income group was 1.9 times higher than that of the nonlow-income group. Furthermore, the average length of hospital stay (9.9 days), average medical expenses (1681 USD), and mortality rate (3.6%) values for the low-income inpatients were higher than those of the nonlow-income group (7.6 days, 1573 USD, and 2.1%, respectively). Among the injury causes, the percentages of "fall," "suicide," and "homicide" incidences were higher for the low-income group than for the nonlow-income group. These findings support our hypothesis that there is a correlation between poverty and injury level, which results in health inequality. Achieving healthcare equality may require collaboration between the government and private and nonprofit organizations to increase the awareness of this phenomenon.
•Compared to lower gum SCC, upper gum SCC had less favorable 5-year DSS and OS rates.•Upper gum SCC had higher frequencies of aged ≥ 65 years and margin status ≤ 4 mm.•Wide resection margins are ...recommended to improve outcomes of upper gum SCC.
This large-scale cohort study was designed to compare the clinical outcomes of Taiwanese patients with squamous cell carcinoma (SCC) of the upper versus lower gum.
Between 2004 and 2017, we identified 4244 patients with first primary SCC of the gum (694 upper gum; 3550 lower gum) who were treated with surgery either with or without adjuvant therapy. Of them, 1990 patients (329 upper gum; 1661 lower gum) enrolled from 2011 to 2017 had a higher number of histopathological variables and entered subgroup analyses. Five-year disease-specific survival (DSS) and overall survival (OS) rates served as outcome measures.
The 5-year DSS and OS rates of patients with upper gum SCC were lower than those of cases with lower gum SCC (65%/74%, p < 0.0001; and 55%/65%, respectively, p < 0.0001). Compared with lower gum SCC, upper gum SCC had a higher prevalence of the following variables: female sex, age ≥ 65 years, pNx (without neck dissection), no-betel chewing (2011–2017), no-smoking (2011–2017), and margin status ≤ 4 mm (positive and close margins, 2011–2017). On multivariable analysis, gum subsite (upper versus lower), age (≥65 versus < 65 years), pT (T3 − 4 versus T1 − 2), pN (N1 − 3 versus N0/Nx), depth (≥10 mm versus < 10 mm, 2011–2017), ENE (present versus absent, 2011–2017), and margins (≤4 mm versus > 4 mm 2011–2017, only DSS) were identified as independent adverse prognostic factors for 5-year DSS and OS.
Compared to lower gum SCC, upper gum SCC had less favorable 5-year outcomes. Wide resection margins are recommended to improve prognosis of upper gum SCC.
The expression of vascular adhesion molecule-1 (VCAM-1) by endothelial cells may play a major role in atherogenesis. The actual mechanisms of chlamydia pneumoniae (C. pneumoniae) relate to ...atherogenesis are unclear. We investigate the influence of VCAM-1 expression in the GroEL1 from C. pneumoniae-administered human coronary artery endothelial cells (HCAECs) and hypercholesterolemic rabbits. In this study, we constructed the recombinant GroEL1 from C. pneumoniae. The HCAECs/THP-1 adhesion assay, tube formation assay, western blotting, enzyme-linked immunosorbent assay, actinomycin D chase experiment, luciferase reporter assay, and immunohistochemical stainings were performed. The results show that GroEL1 increased both VCAM-1 expression and THP-1 cell adhesives, and impaired tube-formation capacity in the HCAECs. GroEL1 significantly increased the VCAM-1 mRNA stability and cytosolic AU-binding factor 1 (AUF1) level. Overexpression of the p37(AUF1) significantly increased VCAM-1 gene expression in GroEL1-induced bovine aortic endothelial cells (BAECs). GroEL1 prolonged the stability of VCAM-1 mRNA by increasing both p37(AUF1) and the regulation of the 5' untranslated region (UTR) of the VCAM-1 mRNA in BAECs. In hypercholesterolemic rabbits, GroEL1 administration enhanced fatty-streak and macrophage infiltration in atherosclerotic lesions, which may be mediated by elevated VCAM-1 expression. In conclusion, GroEL1 induces VCAM-1 expression by p37(AUF1) in endothelial cells and enhances atherogenesis in hypercholesterolemic rabbits.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
New ERA Yang, Ming-Chang; Chang, Yuan-Hao; Tsao, Che-Wei ...
2013 50th ACM/EDAC/IEEE Design Automation Conference (DAC),
05/2013
Conference Proceeding
As the program/erase (P/E) cycles of flash memory keep decreasing, improving the lifetime/endurance of flash memory has become a fundamental issue in the design of flash devices. This work is ...motivated by the observation that flash blocks endured the same P/E cycles usually have different bit error rates. In contrast to the existing wear-leveling techniques that try to distribute erases to flash blocks as evenly as possible, we propose an efficient reliability-aware wear-leveling scheme to distribute block erases based on the bit error rates of blocks so as to even out the error rate among flash blocks, to maximize the number of good blocks, and thus to ultimately prolong the lifetime of flash storage devices. The experiments were conducted based on representative realistic workloads to evaluate the efficacy of the proposed scheme, for which the results are very encouraging.
Human papillomavirus (HPV) infections predict mortality in Taiwanese patients with oral cavity squamous cell carcinoma (OCSCC). To address their prognostic significance for local recurrence (LR), in ...this retrospective cohort study we investigated different serologic and molecular markers of HPV 16 infection in 85 consecutive patients with primary OCSCC who received standard treatment and had their sera stored before treatment. Resected tumor specimens were examined with PCR-based assays for HPV 16 E6/E7 mRNA expression. Sera were tested with suspension arrays for the presence of HPV-specific antibodies using synthetic L1 and E6 peptides as well as a synthetic E7 protein. HPV 16 E6/E7 mRNA, anti-L1, anti-E6, and anti-E7 antibodies tested positive in 12%, 25%, 38%, and 41% of the study patients, respectively. Multivariate analysis identified pathological T3/T4, E6/E7 mRNA, and anti-E7 antibodies as independent risk factors for LR, whereas anti-E6 antibodies were an independent protective factor. In patients with ≥ 3 (high-risk group), 2 (intermediate-risk), and ≤ 1 (low-risk) independent risk factors (predictors), the 5-year LR rates were 75%, 42%, and 4%, respectively. Results were validated in an independent cohort. Together, our preliminary data indicate that HPV 16 infections as well as low and high serum levels of anti-E6 and anti-E7 antibodies, respectively, can serve as biomarkers of LR in patients with OCSCC, whereas the clinical usefulness of anti-HPV 16 antibodies for risk stratification of newly diagnosed cases deserves further scrutiny.
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