Food safety has become an increasingly significant public concern in both developed and under-developed nations around the world; it increases morbidity, mortality, human suffering, and economic ...burden. This Opinion focuses on (i) examining the influence of pathogens and chemicals (e.g., food additives and pesticide residue) on food-borne illnesses, (ii) summarizing food hazards that are present in Asia, and (iii) summarizing the array of current point-of-care (POC) detection devices that have potential applications in food safety monitoring. In addition, we provide insight into global healthcare issues in both developing and under-developed nations with a focus on bridging the gap between food safety issues in the public sector (associated with relevant clinical cases) and the use of POC detection devices for food safety monitoring.
Silicon/reduced graphene oxide/carbon (Si/rGO/C) composite material prepared with a carboxyl methyl cellulose and styrene butadiene rubber (CMC + SBR) hybrid binder is successfully synthesized, ...characterized, and evaluated as a composite anode for lithium–ion batteries (LIBs). The porous Si/rGO/C composite microspheres with interior meso–pores are obtained by encapsulating Si–based nanoparticles into the rGO/C dual–carbon matrix via self–assembling, ball milling, polystyrene sphere (PSS) template–assisting, and spray drying techniques, which facilitate a fast electron and Li+ ion transport, and mitigate Si pulverization. Compared with bare copper (Cu) foil, as–prepared Si/rGO/C composite electrode based on a carbon–coated Cu (C–Cu) foil assembled with a polyethylene (PE) separator exhibits better rate capability, in particular, at high rates, and a capacity increases to ca. 6–10%. By cycling at 400 mA g−1 for 500 cycles, the Si/rGO/C/C–Cu composite electrode with a capacity retention (CR%) of ∼75% and Coulombic efficiency (CE%) of ∼99.7% retains a higher specific capacity of ∼602 mAh g−1 than that on bare Cu foil (∼314 mAh g−1), which is comparable to those reported in the literature. The synergistic effect of the hierarchical composite anode material together with highly adhesive and electrolyte−hydrophilic C–Cu foil results in much better electrochemical performance as a promising LIB anode.
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•Si/rGO/C composite with a CMC + SBR hybrid binder is synthesized as a LIB anode.•The microspheres with interior meso–pores facilitate fast e– and Li+ transports.•The Si/rGO/C composite coated on C–Cu foil exhibits a better C–rate capability.•The Si/rGO/C/C–Cu electrode retains a CR% of ∼75% at 400 mA g−1 for 500 cycles.
Glycosylated hemoglobin (HbA1c) targets for patients with chronic kidney disease (CKD) and type 2 diabetes remain controversial. To evaluate whether baseline HbA
1c
and HbA
1c
trajectories are ...associated with the risk of end-stage kidney disease (ESKD) and all-cause mortality, we recruited adult patients with CKD and type 2 diabetes from a “Pre-ESKD Program” at a medical center in Taiwan from 2003 to 2017. Group-based trajectory modeling was performed to identify distinct patient groups that contained patients with similar longitudinal HbA1c patterns. Cox proportional hazard models were used to estimate hazard ratios (HRs) of ESKD and mortality associated with baseline HbA
1c
levels and HbA
1c
trajectories. In the analysis related to baseline HbA
1c
(
n
= 4543), the adjusted HRs 95% confidence interval (CI) of all-cause mortality were 1.06 (0.95–1.18) and 1.25 (95% CI, 1.07–1.46) in patients with an HbA
1c
level of 7%–9% (53–75 mmol/mol) and >9% (>75 mmol/mol), respectively, as compared with those with an HbA1c level < 7% (<53 mmol/mol). In the trajectory analysis
(n
= 2692), three distinct longitudinal HbA
1c
trajectories were identified: nearly optimal (55.9%), moderate to stable (34.2%), and poor control (9.9%). Compared with the “nearly optimal” HbA
1c
trajectory group, the “moderate-to-stable” group did not have significantly higher mortality, but the “poorly controlled” group had 35% higher risk of mortality (adjusted HR = 1.35, 95% CI = 1.06–1.71). Neither baseline levels of HbA
1c
nor trajectories were associated with ESKD risk. In conclusion, in patients with CKD and type 2 diabetes, poor glycemic control was associated with an elevated risk of mortality but not associated with a risk of progression to ESKD.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Summary
Chronic lymphocytic leukaemia (CLL) is the most common leukaemia in Western countries but very rare in Asia. Peripheral blood or bone marrow mononuclear cells obtained at initial diagnosis ...from 194 patients with CLL were analysed to determine the ethnic difference in genetic abnormalities. Mutated IGHV was detected in 71·2% of Taiwanese CLL and IGHV3‐23 was the most frequently used gene. Stereotyped BCR was present in 18·3% with subset 8 being the most frequent. All cases with subset 8 belonged to IGHV 4‐39 and were exclusively associated with un‐mutated IGHV and poor outcome. Mutation frequencies of SF3B1 (9·7%), NOTCH1 (8·6%), BIRC3 (1·1%), ATM (16·9%) or TP53 (8·1%), and frequencies of cytogenetic abnormalities including trisomy 12 (18·6%), del(17p) (10·4%), del(13q) (43·7%) and IGH translocation (10·1%) were comparable to those reported from Western countries, except del(11q) (6·9%) which was lower in our patients. Patients with un‐mutated IGHV, subset 8, disrupted TP53, trisomy 12, and SF3B1 mutations had a worse outcome compared to patients without these mutations. In conclusion, IGHV3‐23 usage, stereotyped subset 8 and lower frequency of del(11q) show an ethnicity‐dependent association in Taiwanese CLL patients.
Abstract
The fasting blood glucose (FBG) values extracted from electronic medical records (EMR) are assumed valid in existing research, which may cause diagnostic bias due to misclassification of ...fasting status. We proposed a machine learning (ML) algorithm to predict the fasting status of blood samples. This cross-sectional study was conducted using the EMR of a medical center from 2003 to 2018 and a total of 2,196,833 ontological FBGs from the outpatient service were enrolled. The theoretical true fasting status are identified by comparing the values of ontological FBG with average glucose levels derived from concomitant tested HbA1c based on multi-criteria. In addition to multiple logistic regression, we extracted 67 features to predict the fasting status by eXtreme Gradient Boosting (XGBoost). The discrimination and calibration of the prediction models were also assessed. Real-world performance was gauged by the prevalence of ineffective glucose measurement (IGM). Of the 784,340 ontologically labeled fasting samples, 77.1% were considered theoretical FBGs. The median (IQR) glucose and HbA1c level of ontological and theoretical fasting samples in patients without diabetes mellitus (DM) were 94.0 (87.0, 102.0) mg/dL and 5.6 (5.4, 5.9)%, and 92.0 (86.0, 99.0) mg/dL and 5.6 (5.4, 5.9)%, respectively. The XGBoost showed comparable calibration and AUROC of 0.887 than that of 0.868 in multiple logistic regression in the parsimonious approach and identified important predictors of glucose level, home-to-hospital distance, age, and concomitantly serum creatinine and lipid testing. The prevalence of IGM dropped from 27.8% based on ontological FBGs to 0.48% by using algorithm-verified FBGs. The proposed ML algorithm or multiple logistic regression model aids in verification of the fasting status.
Whether preexisting sleep disorder is an independent risk factor for cancer remains unclear. Therefore, we performed this propensity score–matched population-based cohort study to compare the ...incidence rate ratios (IRRs) of specific cancers between patients with and without sleep disorders.
Patients were categorized into two groups on the basis of the presence or absence of sleep disorders and matched at a 1:1 ratio.
Propensity score matching yielded a final cohort of 289,162 patients (i.e., 144,581 and 144,581 in the sleep disorder and nonsleep disorder groups, respectively) who were eligible for further analysis. In multivariate Cox regression analysis, the adjusted hazard ratio (aHR; 95% confidence interval CI) of cancer risk in the sleep disorder group compared with the nonsleep disorder group was 1.07 (1.04–1.12; P = 0.0001). Furthermore, the adjusted IRRs (95% CIs) for all cancers, breast cancer, and ovarian cancer in the patients with sleep disorders were 1.08 (1.02–1.18), 1.20 (1.08–1.32), and 1.30 (1.10–1.52), respectively.
The results suggested that sleep disorders are a significant risk factor for all cancers, breast cancer, and ovarian cancer.
•Whether preexisting sleep disorder is an independent risk factor for cancer remains unclear. This study investigated the effect of sleep disorders on cancer incidence.•We determined the significant adjusted incidence rate ratios of the risks of all cancers, breast cancer, and ovarian cancer in patients with or without a diagnosis of sleep disorder before cancer.
Colorectal cancer is one of the most frequently diagnosed forms of cancer, and it is associated with several common symptoms and signs such as rectal bleeding, altered bowel habits, abdominal pain, ...anemia, and unintentional weight loss. Sciatica, a debilitating condition in which the patient experiences paresthesia and pain in the dermatome of associated lumbosacral nerve roots or sciatic nerve distribution, is not considered one of these. Here we present a case of colorectal cancer manifesting symptoms of sciatica alone.
A 68-year-old male presented with progressive lower back pain radiating to his left thigh and calf over L5/S1 dermatome. Sciatica was suspected and initially underwent conservative treatment with analgesics. However, the symptoms progressed and MRI revealed an epidural abscess surprisingly. Surgical debridement was performed and pus culture isolated Streptococcus gallolyticus. Based on the strong association of S. gallolyticus with colorectal cancer, the presence of this pathogen prompted further tumor evaluation, even in the absence of the typical symptoms and signs. This investigation ultimately leads to the diagnosis of sigmoid adenocarcinoma.
Although rare, sciatica caused by S. gallolyticus infection of the spinal epidural space may serve as the initial presentation of colorectal cancer. Physicians should be aware of the strong association between S. gallolyticus and colorectal cancer. Based on what we currently know about the condition; a thorough systematic assessment of occult neoplasia for patients with S. gallolyticus infection is recommended.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Recently, deep neural network (DNN) schemes based on big data-driven methods have been successfully applied to image classification, communication, translation of language, speech recognition, etc. ...However, more efforts are still needed to apply them to complex robust nonlinear filter design in signal processing, especially for the robust nonlinear <inline-formula> <tex-math notation="LaTeX">H_{\infty } </tex-math></inline-formula> filter design for robust state estimation of nonlinear stochastic signal system under uncertain external disturbance and output measurement noise. In general, the design problem of robust nonlinear <inline-formula> <tex-math notation="LaTeX">H_{\infty } </tex-math></inline-formula> filter needs to solve a complex Hamilton-Jacobi-Isaacs equation (HJIE), which is not easily solved analytically or numerically. Further, the robust nonlinear <inline-formula> <tex-math notation="LaTeX">H_{\infty } </tex-math></inline-formula> filter is not easily designed by training DNN directly via conventional big data schemes. In this paper, a novel robust <inline-formula> <tex-math notation="LaTeX">H_{\infty } </tex-math></inline-formula> HJIE-embedded DNN-based filter design is proposed as a co-design of <inline-formula> <tex-math notation="LaTeX">H_{\infty } </tex-math></inline-formula> filtering algorithm and DNN learning algorithm for the robust state estimation of nonlinear stochastic signal systems with external disturbance and output measurement noise. In the proposed robust <inline-formula> <tex-math notation="LaTeX">H_{\infty } </tex-math></inline-formula> DNN-based filter design, we have proven that when the approximation error of HJIE by the trained DNN through Adam learning algorithm approaches to 0, the HJIE-embedded DNN-based filter will approach the robust nonlinear <inline-formula> <tex-math notation="LaTeX">H_{\infty } </tex-math></inline-formula> filter of nonlinear stochastic signal system with uncertain external disturbance and output measurement noise. Finally, a trajectory estimation problem of 3-D geometry incoming nonlinear stochastic missile system by the proposed robust <inline-formula> <tex-math notation="LaTeX">H_{\infty } </tex-math></inline-formula> HJIE-embedded DNN-based filter scheme through the measurement by the sensor of radar system with external disturbance and measurement noise is given to illustrate the design procedure and validate its robust <inline-formula> <tex-math notation="LaTeX">H_{\infty } </tex-math></inline-formula> filtering performance when compared with the extended Kalman filter and particle filter.
According to the preclinical data, sodium-glucose cotransporter 2 (SGLT2) inhibitors (SGLT2is) may exert anticancer effects. Here, we clarified the cancer-specific mortality (primary outcome) and ...all-cause mortality (secondary outcome) of SGLT2is and their dose-dependency in patients with cancer undergoing standard curative treatments.
We analyzed data from patients with type 2 diabetes mellitus (T2DM) diagnosed with cancer between January 1, 2016, and December 31, 2018, enrolled from the Taiwan Cancer Registry database. Kaplan-Meier method was used to estimate all-cause mortality and cancer-specific mortality, comparing survival curves between SGLT2i users and nonusers using the stratified log-rank test. Cox proportional hazards regression was conducted to identify independent predictors for all-cause and cancer-specific mortality among the covariates.
We performed 1:2 propensity score matching of our data, which yielded a final cohort of 50,133 patients with cancer; of them, 16,711 and 33,422 were in the SGLT2i user and nonuser groups, respectively. The adjusted hazard ratio (aHR) for cancer-specific and all-cause mortality in SGLT2i users compared with nonusers was 0.21 (95 % confidence interval CI: 0.20–0.22) and 0.22 (95 % CI: 0.21–0.23). We divided the patients into four subgroups stratified by quartiles (Q) of cumulative defined daily doses per year (cDDDs), and all-cause and cancer-specific mortality was noted to significantly decrease with increases in dosage (from Q1 to Q4 cDDDs) in SGLT2i users compared with in nonusers (P < 0.001).
SGLT2is increase overall survival and cancer-specific survival in patients with cancer in a dose-dependent manner.
Polatuzumab vedotin (PoV) has recently shown promising activity when combined with rituximab-bendamustine (BR) in patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL). ...However, few studies have described the prognostic factors predicting response. Here, we aimed to evaluate the efficacy and safety profile of PoV-based chemotherapy, including regimens other than BR, as third-line or beyond treatment for patients with R/R DLBCL and to explore prognostic factors. Overall, 40 patients, including 37 with de novo and 3 with transformed DLBCL, were enrolled. The overall response rate was 52.5%, and 25% and 27.5% of patients showed a complete response and partial response, respectively. With a median follow-up of 18.8 months, the median overall survival (OS) of the total cohort was 8.5 months, and that of those receiving subsequent hematopoietic stem cell transplantation (HSCT) was 24 months. Low/intermediate risk according to the revised International Prognostic Index score at diagnosis and before PoV treatment predicted better OS. Furthermore, a normal lactate dehydrogenase level and an absolute lymphocyte count/absolute monocyte count ratio > 1.5 were favorable OS prognostic factors. The most common adverse event was cytopenia, with 42.5% of patients developing febrile neutropenia. Grade 1–3 peripheral neuropathy associated with PoV was reported in 25% of patients and resolved in most patients after the cessation of treatment. In summary, we demonstrated that PoV combined with either BR or other intensive chemotherapy is an effective and well-tolerated salvage option for patients with R/R DLBCL. Subsequent HSCT has the potential to further improve survival outcomes in this high-risk population. Clinicaltrials.gov number: NCT05006534.
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