Nilotinib has been approved for the treatment of Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase (Ph
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CML-CP). However, the real-world evidence of nilotinib in newly ...diagnosed untreated Ph
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CML-CP is limited in Taiwan. The NOVEL-1st study was a non-interventional, multi-center study collecting long-term safety and effectiveness data in patients with newly diagnosed and untreated Ph
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CML-CP receiving nilotinib. We enrolled 129 patients from 11 hospitals. Overall, 1,466 adverse events (AEs) were reported; among these, 151 were serious and 524 were nilotinib-related. Common hematological AEs were thrombocytopenia (31.0%), anemia (20.9%), and leukopenia (14.0%); common nilotinib-related AEs were thrombocytopenia (29.5%), anemia (14.7%), and leukopenia (12.4%). Early molecular response, defined as BCR-ABL ≤ 10% at Month 3, was seen in 87.6% of patients. By 36 months, the cumulative rates of complete hematologic response, complete cytogenetic response, major molecular response, molecular response 4.0-log reduction, and molecular response 4.5-log reduction were 98.5, 92.5, 85.8, 65.0, and 45.0%, respectively. Nilotinib is effective and well-tolerated in patients with newly diagnosed Ph
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CML-CP in the real-world setting. Long-term holistic care and a highly tolerable AE profile may contribute to good treatment outcomes in Ph
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CML-CP under first-line treatment with nilotinib.
There is a discrepancy between west and east on the relationship between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD). This study aimed to find out the possible reason ...for this and to clarify the association between NAFLD and CKD by analyzing two population-based datasets from the US and China.
Two health examination datasets from China and the US were used. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m
or and/or abnormal albuminuria and/or overt proteinuria. Binary logistic regression was used to examine the association between NAFLD and CKD.
A total of 60,965 participants were analyzed, including 11,844 from the US and 51,229 from China. The prevalence of NAFLD was 27.12% in the Chinese population and 36.08% in the US population (p < 0.001). The proportions of CKD and late stage CKD (stages 3-5) were higher in the US population than the Chinese one. NAFLD was independently associated with an increased risk of CKD in Chinese population, whereas in the US population, the NAFLD was not an independent risk factor of CKD. In subgroup analyses which excluded late stages CKD (stages 3-5), the risks of mild renal function decline became consistent: NAFLD was associated with early stages of CKD but not the late stages of CKD in both populations.
NAFLD increased the risk of early stages of CKD in both Chinese and the US population. The conflicting results reported by previous studies might result from the different proportion of late stages of CKD.
The aim of this study was to investigate changes in plasma fatty acids proportions and estimated desaturase activities for variable grading of liver steatosis in children.
In total, 111 ...schoolchildren (aged 8-18 years) were included in the analysis from March 2015 to August 2016. Anthropometric evaluation, liver ultrasound examination and scoring for nonalcoholic fatty liver disease (NAFLD score = 0-6), and biochemical and plasma fatty acids analysis were performed. We compared the composition ratio of fatty acids between children with high-grade liver steatosis (NAFLD score = 4-6), low-grade liver steatosis (NAFLD score = 1-3), and healthy controls (NAFLD score = 0). In addition, correlation coefficients (r) between NAFLD score, metabolic variables, and estimated activity of desaturase indices (stearoyl-coenzyme A desaturase-1 (SCD1), delta-5 and delta-6 desaturase) were calculated.
Compared with healthy controls, children with liver steatosis showed a higher proportion of monounsaturated fatty acids (21.16 ± 2.81% vs. 19.68 ± 2.71%, p = 0.024). In addition, children with high- grade liver steatosis exhibited higher proportions of palmitic acid (C16:0), palmitoleic acid (C16:1n-7), dihomo-γ-linolenic acid (C20:3n-6), adrenic acid (C22:4n-6), and docosapentaenoic acid (C22:5n-6); and lower proportions of eicosapentaenoic acid (C20:5n-3) (P< 0.05). In all subjects, the NAFLD score was positively correlated with body mass index (BMI) (kg/m2) (r = 0.696), homeostasis model of assessment ratio-index (HOMA-IR) (r = 0.510), SCD1(16) (r = 0.273), and the delta-6 index (r = 0.494); and inversely associated with the delta-5 index (r = -0.443).
Our current data suggested that children with liver steatosis was highly associated with obesity, and insulin resistance. In addition, increased endogenous lipogenesis through altered desaturase activity may contribute to the progression of liver steatosis in children.
Cytomegalovirus (CMV) infection of the gastrointestinal (GI) tract can be fatal. However, very few studies have provided comprehensive analyses and specified the differences in symptoms observed in ...different parts of the GI tract. This study aimed to comprehensively analyze clinical manifestations and management of GI CMV disease. This retrospective cohort study enrolled the patients who had CMV diseases of the GI tract proved by CMV immunohistochemistry stain from the pathology database in a 4000-bed tertiary medical center between January 2000 and May 2021. The patient characteristics, clinical manifestations, endoscopic features, treatments, outcomes, and prognostic factors were analyzed. A total of 356 patients were enrolled, including 46 infected in the esophagus, 76 in the stomach, 30 in the small intestine, and 204 in the colon. In total, 49.4% patients were immunocompromised. The overall in-hospital mortality rate was 20.8%: CMV enteritis had the highest rate (23.3%). Sixty percent of patients received antiviral treatment and 16% were administered both intravenous and oral anti-viral drugs (Combo therapy, minimal and mean treatment duration were 14 and 39.9 ± 25 days). Prognostic factors of in-hospital mortality included age, immune status, albumin level, platelet count, GI bleeding, time-to-diagnosis, and Combo therapy. In the survival analysis, immunocompetent patients receiving Combo therapy had the best survival curve, and immunocompromised patients receiving non-Combo therapy had the worst survival curve. Combo therapy ≥14 days resulted in a better outcome for both immunocompromised and immunocompetent patients. In conclusion, CMV GI diseases affect both immunocompromised and immunocompetent hosts, and a complete treatment course should be considered for patients with poor prognostic factors.
In this study, the transverse indentation test was applied to simulate the damage caused by impact to the carbon fiber‐reinforced plastics (CFRP)/Al hybrid tube, and composites patch repair ...technology was used to repair the hybrid tube with different damage degrees. The effects of width and ply‐number of the patch on failure behavior and crashworthiness under axial load were investigated. It was concluded that the technology can effectively reduce stress concentration around the indentation and then improve compressive strength. Increasing the ply‐number of the patch can mitigate the failure mode of med‐length collapse of the hybrid tube and can effectively improve the crashworthiness indicators. The optimal repair strategy increased energy absorption by 54.02% and mean crushing force by 53.66%. However, the improvement of failure behavior by the ply‐number is limited by patch width. Acoustic emission and infrared thermography technologies were used to further analyze the damage characteristics and damage evolution of the hybrid tubes in pre‐crushing stage. It was found that the crushing form of the middle collapse tended to produce a more intense acoustic emission response and higher temperature change than that of the end crushing. In engineering practice, it provides a valuable reference for the reasonable repair of composite tubular structures and their hybrid structures.
Highlights
Composite repair technology is used for the repair of CFRP/Al hybrid tubes.
The effects of ply‐number and width of patch on repair quality are studied.
The technology can effectively improve residual crashworthiness of structure.
The improvement of failure behavior by ply‐number is limited by patch width.
The damage behavior of various crushing forms can be revealed by AE and IR.
The effect of composite patch repair on failure behavior and crashworthiness of composites‐metal hybrid tubes.
Harvesting the narrow bandgap excitons of charge‐transfer (CT) complexes for the achievement of near‐infrared (NIR) emission has attracted intensive attention for its fundamental importance and ...practical application. Herein, the triphenylene (TP)‐2,3,5,6‐tetrafluoro‐7,7,8,8‐tetracyanoquinodimethane (F4TCNQ) CT organic complex is designed and fabricated via the supramolecular self‐assembly process, which demonstrates the NIR emission with a maximum peak of 770 nm and a photoluminescence quantum yield (PLQY) of 5.4%. The segregated stacking mode of TP‐F4TCNQ CT complex based on the multiple types of intermolecular interaction has a low CT degree of 0.00103 and a small counter pitch angle of 40° between F4TCNQ and TP molecules, which breaks the forbidden electronic transitions of CT state, resulting in the effective NIR emission. Acting as the promising candidates for the active optical waveguide in the NIR region beyond 760 nm, the self‐assembled TP‐F4TCNQ single‐crystalline organic microwires display an ultralow optical‐loss coefficient of 0.060 dB µm−1. This work holds considerable insights for the exploration of novel NIR‐emissive organic materials via an universal “cocrystal engineering” strategy.
Through changing mixed stacking into segregated stacking mode, triphenylene (TP)‐2,3,5,6‐tetrafluoro‐7,7,8,8‐tetracyanoquinodimethane (F4TCNQ) charge‐transfer (CT) complex demonstrates a low CT degree and a small counter pitch angle between TP and F4TCNQ molecules, benefiting for breaking the forbidden electronic transitions of CT state for realizing the near‐infrared emission with a maximum peak of 770 nm and a photoluminescence quantum yield of 5.4%.
The thermal aging behavior of glass fiber reinforced composites has attracted much attention because of its application in elevated temperatures environments. In this study, to improve the thermal ...aging resistance performance of composites, multilayer graphene was embedded in glass fiber reinforced composites and the damage evolution behaviors of the composites after thermal aging treatments were investigated. The mapping relationship between damage modes and acoustic emission parameters is established by principal component analysis and k‐means clustering methods, then the acoustic emission data were trained by K‐Nearest Neighbor algorithms to obtain a damage modes identification model with positive predictive values above 90%. The results showed that more matrix cracking signals are captured (or matrix cracking accumulation acoustic emission (AE) energy is abruptly raised) at the early stage of loading after 32 days of thermal aging. With the addition of multilayer graphene, the fiber/matrix debonding accumulation AE energy is significantly less than the matrix cracking accumulation AE energy, which is more obvious after thermal aging. Damage initiation and extension obtained by the acoustic emission events help to find the correlation between aging time and interior interface damage mechanism.
Patients with end-stage renal disease (ESRD) may demonstrate secondary hyperparathyroidism (SHPT), characterized by parathyroid hormone oversecretion in response to electrolyte imbalance (e.g., ...hypocalcemia and hyperphosphatemia). Moreover, this electrolyte imbalance may affect vocal cord muscle contraction and lead to voice change. Here, we explored the effects of SHPT on the voices of patients with ESRD. We used data of 147,026 patients with ESRD from the registry for catastrophic illness patients, a sub-database of Taiwan National Health Insurance Research Database. We divided these patients into 2 groups based on whether they had hyperparathyroidism (HPT) and compared vocal dysfunction (VD) incidence among them. We also prospectively included 60 ESRD patients with SHPT; 45 of them underwent parathyroidectomy. Preoperatively and postoperatively, voice analysis was used to investigate changes in vocal parameters. In the real-world database analysis, the presence of HPT significantly increased VD incidence in patients with ESRD (p = 0.003): Cox regression analysis results indicated that patients with ESRD had an approximately 1.6-fold increased VD risk (p = 0.003). In the clinical analysis, the "jitter" and "shimmer" factors improved significantly after operation, whereas the aerodynamic factors remained unchanged. In conclusion, SHPT was an independent risk factor for VD in patients with ESRD, mainly affecting their acoustic factors.
Fe–Mn–Si bearing shape memory alloys are used as structural and functional materials, and have the potential for application in industrial and architectural fields. Fe–Mn–Si–Cr–Ni based shape memory ...alloys were selected to elucidate the impact of C and Si content on shape memory effect, where Si was replaced by Co. In this regard, Fe–15Mn–5Si–8Cr–5Ni, Fe–15Mn–5Si–8Cr–5Ni-0.1C, and Fe–15Mn–3Si–8Cr–5Ni-0.1C–2Co alloys were designed to simultaneously elucidate the shape memory effect (SME) and mechanical properties in relation to the microstructure. The study indicated that the addition of 0.1 wt% C significantly improved the SME of Fe–Mn–Si–Cr–Ni alloy, and the shape recovery rate of Fe–15Mn–5Si–8Cr–5Ni-0.1C alloy aged at 750 °C for 4 h was maximum at 55.45%. The content of thermally-induced martensite was reduced, which led to decrease in the probability of α′-martensite formation, and promoted inverse transformation of stress-induced martensite and enhanced the shape memory effect. In addition, the strength of the parent phase was enhanced by segregation of elements during aging. Furthermore, the plastic deformation involving slip during stress-induced martensitic transformation was reduced. The reduced content of α′-martensite promoted reversal of stress-induced martensite. On the other hand, Co increased the stacking fault energy and reduced nucleation of stress-induced martensite, such that the number density of stacking faults decreased the shape memory effect of the experimental steel.
Aim
To evaluate the prevalence of pain in cancer outpatients in Taiwan and to investigate the impact of pain on quality of life (QoL) and patient satisfaction. Results were compared to those of a ...similarly designed study conducted in 2008 to identify trends.
Methods
Adult patients with cancer treated as outpatients in hospitals throughout Taiwan were recruited. Pain intensity and the extent to which pain interfered with QoL were self‐reported using a modified version of the Brief Pain Inventory. Patients also indicated their level of satisfaction with their physician, as well as with their pain control.
Results
A total of 2652 patients were enrolled from 16 sites. Of these, 1167 (44.0%) patients reported experiencing pain during the previous week. Prevalence and severity of pain were highest in patients with progressive disease. A higher pain severity score was significantly associated with greater interference in both physical and psychological functions. Overall, 86.0% of all participants expressed satisfaction with their physician and 84.8% were satisfied with their pain control; satisfaction rates were associated with pain severity. Compared with the findings from the 2008 study, pain prevalence was notably lower and patient satisfaction was significantly greater in the current study.
Conclusions
Prevalence and severity of pain were associated with disease stage. Pain interference on QoL correlated significantly with pain severity. Treatment of pain in cancer patients in Taiwan seems to have improved from 2008 to 2014, possibly attributable to new cancer pain treatment guidelines and the wider availability of novel analgesic therapies.
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