Efforts have been made to reduce epidemiological indicators of osteoradionecrosis in patients with head and neck cancer over recent years. This umbrella review aims to synthesize the information of ...the systematic reviews/meta-analyses investigating the effect of radiotherapy in patients with head and neck cancer on the frequency of osteoradionecrosis and to identify and analyze the gaps in current scientific literature.
A systematic review of systematic reviews with and without meta-analysis of intervention studies was conducted. Qualitative analysis of the reviews and their quality evaluation were performed.
A total of 152 articles were obtained, and ten of them were selected for the final analysis, where six were systematic reviews and four were meta-analysis. According to the guide Assessing the Methodological Quality of Systematic Reviews (Amstar), eight articles included were of high quality and two of medium quality. These descriptive systematic reviews/meta-analyses included a total of 25 randomized clinical trials, showing that radiotherapy has positive effects on the frequency of osteoradionecrosis. Even though a reduction in the incidence of osteoradionecrosis was observed back in the history, in systematic reviews with meta-analysis, overall effect estimators were not significant.
Differential findings are not enough to demonstrate that there is a significant reduction in the frequency of osteoradionecrosis in patients with head and neck cancer treated by radiation. Possible explanations are related to factors such as the type of studies analyzed, indicator of irradiated complication considered, and specific variables included in the analysis. Many systematic reviews did not address publication bias and did identify gaps in knowledge that require further clarification.
Voriconazole is frequently utilized for the prevention and treatment of invasive fungal infections (IFIs), and is extensively metabolized by the cytochrome P450 (CYP) system. The impact of activity ...of the genes encoding CYP3A4, CYP3A5, and CYP2C9 on the pharmacokinetics of voriconazole cannot be ignored because, second to CYP2C19, they are the most important enzymes involved in voriconazole metabolism. The influence of genetic polymorphisms in
CYP3A4
,
CYP3A5
, and
CYP2C9
on the plasma concentrations of voriconazole was evaluated in the present study. The study cohort comprised 158 patients with IFIs in whom 22 single-nucleotide polymorphisms (SNPs) in
CYP3A4
,
CYP3A5
, and
CYP2C9
were genotyped using the Sequenom MassARRAY RS1000 system, and voriconazole plasma concentrations were measured by high-performance liquid chromatography (HPLC). 40, 91, and 27 patients presented with low (<1 mg/L), normal (1–4 mg/L), and high (>4 mg/L) plasma voriconazole concentrations, respectively. Correlation analysis between polymorphisms and the plasma voriconazole concentration revealed an association between the presence of the rs4646437 T allele and a higher plasma voriconazole concentration
p
= 0.033, odds ratio (OR) = 2.832, 95 % confidence interval (CI) = 1.086–7.384. This study has identified a new SNP related to the metabolism of voriconazole, potentially providing novel insight into the influence of CYP3A4 on the pharmacokinetics of this antifungal agent.
A transmission electron microscope and an atom probe tomography were used to quantitatively characterize the microstructural evolution of Al-XCu alloys (X = 1.0, 1.5, and 2.5 wt%) with 0.3 wt% Sc ...addition. A dual solute alloying/microalloying effect on the microstructural evolution was demonstrated. On the one hand, the nucleation and coarsening of Al3Sc dispersoids displayed a Cu alloying effect. By increasing the Cu content, both the Al3Sc disperoid size and the volume fraction decreased after solution treatment. On the other hand, the precipitation of θ′-Al2Cu strengthening particles during aging treatment was promoted by Sc segregation at the θ′/matrix interfaces, showing a notable Sc microalloying effect. The strongest interfacial Sc segregation was generated in the Al-2.5 wt%Cu-Sc alloy, resulting in the most promoted θ′ precipitation. The Sc partitioning between Al3Sc dispersoids and Sc segregation at the θ′/matrix interfaces, tailored by the Cu content, impacted the mechanical properties and deformation behavior at both room temperature and high temperature. The Al-2.5 wt%Cu-Sc alloy had a room temperature yield strength of approximately 2.2 times that in its Sc-free counterpart and approximately 1.8 times that in the Al-1.5 wt%Cu-Sc alloy, which is rationalized by strengthening models. In addition, the improvement in the high-temperature mechanical properties after Sc addition was discussed in terms of the Sc segregation-induced high coarsening resistance of θ′ precipitates.
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Previous experimental results from our laboratory demonstrated that monocyte chemoattractant protein-1 (MCP-1) depolarizes or increases the excitability of nociceptive neurons in the intact dorsal ...root ganglion (DRG) after a chronic compression of the DRG (CCD), an injury that upregulates neuronal expression of both MCP-1 and mRNA for its receptor CCR2. We presently explore the ionic mechanisms underlying the excitatory effects of MCP-1. MCP-1 (100 nM) was applied, after CCD, to acutely dissociated small DRG neurons with nociceptive properties. Under current clamp, the proportion of neurons depolarized was similar to that previously observed for CCD-treated neurons in the intact ganglion, although the magnitude of depolarization was greater. MCP-1 induced a decrease in rheobase by 44 +/- 10% and some cells became spontaneously active at resting potential. Action potential width at a voltage equal to 10% of the peak height was increased from 4.94 +/- 0.23 to 5.90 +/- 0.47 ms. In voltage clamp, MCP-1 induced an inward current in 27 of 50 neurons held at -60 mV, which increased with concentration over the range of 3 to 300 nM (EC(50) = 45 nM). The MCP-1-induced current was not voltage dependent and had an estimated reversal potential of -27 mV. In addition, MCP-1 inhibited a voltage-dependent, noninactivating outward current, presumably a delayed rectifier type K(+) conductance. We conclude that MCP-1 enhances excitability in CCD neurons by, at least, two mechanisms: 1) activation of a nonvoltage-dependent depolarizing current with characteristics similar to a nonselective cation conductance and 2) inhibition of a voltage-dependent outward current.
As a new class of sustainable carbon material, “carbon dots” is an umbrella term covering many types of materials. Herein, a broad range of techniques was used to develop the understanding of ...hydrothermally synthesized carbon dots, and it is shown how fine‐tuning the structural features by simple reduction/oxidation reactions can drastically affect their excited‐state properties. Structural and spectroscopic studies found that photoluminescence originates from direct excitation of localized fluorophores involving oxygen functional groups, whereas excitation at graphene‐like features leads to ultrafast phonon‐assisted relaxation and largely quenches the fluorescent quantum yields. This is arguably the first study to identify the dynamics of photoluminescence including Stokes shift and allow the relaxation pathways in these carbon dots to be fully resolved. This comprehensive investigation sheds light on how understanding the excited‐state relaxation processes in different carbon structures is crucial for tuning the optical properties for any potential commercial applications.
Dot products: The structural evolution of hydrothermally synthesized carbon dots after oxidation and reduction is studied, and it is demonstrated how fine‐tuning of the structure can dramatically change their optical properties. An in‐depth spectroscopic analysis identifies the dynamics of photoluminescence, and this allows the relaxation pathways in these carbon dots to be fully resolved.
The intention of the present study is to review and compare the effect of various well-studied alloying elements on the microstructure and soft magnetic properties of the Fe-based ...amorphous/nanocrystalline system. The state-of-the-art Fe-based amorphous/nanocrystalline alloys have been developed because of their unique soft magnetic properties such as low core loss, high permeability(104–105 at 1kHz) and low magnetostriction (<10ppm) as compared to conventional silicon steels which are also called electrical steels. In Fe-based amorphous/nanocrystalline system, the chemical composition and microstructural features particularly grain size play an indispensable role on the saturated magnetization (Bs) and coercivity (Hc) values. An ideal Fe-based soft magnetic material is defined as a material possessing higher Bs and lower Hc. The problem of the new material is its low Bs value (for commercial material is 1.4T) than silicon steels (≈2T). In addition to Bs content of new material, many attempts have been made to reduce the Hc value which could be achieved via a decrease of grain size (<50nm). To reach this goal (Bs↑ and Hc↓), the effect of a variety of elements on the microstructure, crystallization process and soft magnetic properties of the Fe-based amorphous/nanocrystalline alloys has been investigated so far. The aim of all these studies is to find an appropriate replacement for conventional silicon steels because of their high core loss and low permeability. Effect of alloying elements including Si, B, Cu, Nb, Zr, N-doping, P, Ni, Co, H-doping, Ge and W on the microstructure and magnetic properties is the main subject of this study in order to shed light on the dependence of magnetic properties with composition and grain size.
•N-doped alloys showedsuperior soft magnetic properties.•Cu and Nb are the most effective elements in refining grain size.•Soft magnetic properties highly depends on the primary composition and grain size.
Transcription of endogenous retroviral elements are tightly regulated during development by members of the KRAB‐containing zinc finger proteins (KRAB‐ZFPs) and the co‐repressor Trim28 (also known as ...Kap‐1 or Tif1β). KRAB‐ZFPs form the largest family of transcription regulators in mammals and initiate transcriptional silencing by tethering Trim28 to a target locus. Subsequently, Trim28 recruits chromatin modifying effectors resulting in the formation of heterochromatin. In the present study, we identify surface exposed residues on the central six turns of the Trim28 coiled‐coil region forming the binding interface for the KRAB domain. Using AlphaFold2 (AF2) we provide high confidence models of the interface between Trim28 and the KRAB domain and identified leucine 301 on each chain of the Trim28 monomer to act as a pin extending into a hydrophobic pocket on the KRAB domain surface. Site directed mutations in the Trim28‐KRAB binding interface abolished binding to the KRAB domain. Our work provides a detailed understanding of the specific interactions between the KRAB domain and the Trim28 coiled‐coil and how this interaction may be regulated during silencing events.
Background and purpose
Large‐scale studies of utilization of medical services among patients with Alzheimer's disease (AD) are lacking. We aimed to investigate the usage of Western medicine and ...traditional Chinese medicine (TCM) among these patients in Taiwan.
Methods
We analyzed one million samples from the National Health Insurance Research Database in Taiwan. Patients (n = 1814) newly diagnosed with AD in 2001–2010 were divided into TCM users (n = 528) and non‐TCM users (n = 1286).
Results
Compared with non‐TCM users, TCM users were younger, had a higher female:male ratio and higher utilization rate of Western medicine. The median interval between diagnosis and the first TCM consultation was 7.92 months. Donepezil and rivastigmine were commonly prescribed medications. Chinese herbal medicine was the most popular treatment among TCM users.
Conclusions
This study revealed the specific usage patterns of TCM and non‐TCM medical services among patients with AD. The information could be used for improving the healthcare of patients with AD.
The as-extruded AZ91D magnesium alloy processed by conventional extrusion exhibits a yield strength of 320 MPa, an ultimate tensile strength of 382 MPa and a fracture elongation of 13.8%, superior ...than most AZ91D alloys reported so far, which is mainly attributed to ultra-fine grains, sub-micron precipitates, and strong texture.
Objective
To study the risk factors for recurrent ectopic pregnancy (REP).
Design
A retrospective case–control study.
Setting
A university medical centre.
Population
554 women with a history of ...ectopic pregnancy (EP) were included. Among them were 181 women with current EP, 184 women with current intrauterine pregnancy (IUP) and 189 nonpregnant women (NonP).
Methods
The three groups were matched at a ratio of 1:1 with respect to current age, age of initial EP and gestational week of initial EP. Socio‐demographic characteristics, reproductive history, gynaecological and surgical history, and experience of contraception were compared among the three groups. A multivariable logistic regression analysis was used to adjust for confounders and calculate adjusted odds ratios (AORs).
Results
The risk of REP increased with history of infertility (AOR = 3.84, 95%CI 2.16–6.86) in REP women compared with IUP controls. Compared with NonP controls, salpingotomy (AOR = 3.04, 95%CI 1.21–36.51) for previous EP was a risk factor for REP. Multiparous women were less likely to suffer REP when compared with NonP women (AOR = 0.36, 95%CI 0.18–0.62) or IUP controls (AOR = 0.35, 95%CI 0.20–0.62). Current use of an intrauterine device (IUD) (REP versus NonP, AOR = 0.02, 95%CI 0.00–0.08) or condoms (REP versus NonP, AOR = 0.16, 95%CI 0.07–0.38) significantly reduced the risk of REP compared with those not using any contraception. Similarly, previous use of condoms also prevented REP compared with those with no previous condom use (REP versus NonP, AOR = 0.20, 95%CI 0.08–0.49; REP versus IUP, AOR = 0.40, 95%CI 0.22–0.71).
Conclusions
Women with history of infertility or salpingotomy should be alert for the recurrence of EP. Multiparous women are less likely to suffer REP. We propose the use of condoms for effective prevention of REP.
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History of infertility and salpingotomy for last EP are risk factors for recurrent EP.
摘要目的
探讨重复异位妊娠(recurrent ectopic pregnancy,REP) 的危险因素。
研究类型
回顾性病例对照研究。
研究单位
大学附属医院。
研究人群
本研究共纳入554例有异位妊娠(ectopic pregnancy,EP)史的病例。其中此次重复EP 181例,宫内妊娠(intrauterine pregnancy, IUP)184例、非妊娠(non‐pregnant, NonP)189例。
方法
三组病人按照年龄、首次EP年龄和首次EP孕周以1:1比例匹配(EP组、IUP组、NonP组)。记录并比较三组社会人口学资料、生育史、妇科史、手术史以及避孕方法使用情况。应用单因素条件logistic回归分析和多因素logistic回归分析分别计算组间变量的粗比值比(crude odds ratios, CORs)、95%置信区间(confidence intervals,CI)以及调整比值比(adjusted odds ratios, AORs)。
结果
与IUP组相比,不孕史增加REP风险(AOR = 3.84, 95%CI: 2.16‐6.86)。相较于NonP组,前次EP时的输卵管切开术是REP的危险因素(AOR = 3.04, 95%CI: 1.21–36.51)。与NonP组(AOR = 0.36, 95%CI: 0.18–0.62)或IUP组(AOR = 0.35, 95%CI: 0.20–0.62)相比,多产者REP风险降低。与不使用任何避孕方式者相比,本周期使用宫内节育器(intrauterine devices, IUDs) (REP versus NonP, AOR = 0.02, 95%CI: 0.00–0.08)和避孕套(REP versus NonP, AOR = 0.16, 95%CI: 0.07–0.38)均显著降低REP风险。此外,既往曾使用避孕套是REP保护因素(REP versus NonP, AOR = 0.20, 95%CI: 0.08‐0.49; REP versus IUP, AOR = 0.40, 95%CI: 0.22–0.71)。
结论
具有不孕史或经输卵管切开取胚治疗者须警惕REP的发生。多产者REP风险较小。我们提倡合理使用避孕套以有效预防REP发生。
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History of infertility and salpingotomy for last EP are risk factors for recurrent EP.
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