The Clinical Dementia Rating (CDR) Scale comprising global score (CDR-GS) and sum of boxes scores (CDR-SB) is commonly used in staging cognitive impairment; however, its diagnostic accuracy is not ...well clarified. The meta-analysis aimed to investigate the diagnostic accuracy of the CDR for mild cognitive impairment (MCI) and dementia in older populations.
Studies examining the diagnostic accuracy of the CDR for MCI or dementia against reference standards were included from seven electronic databases. The bivariate analysis with a random-effects model was adopted to calculate the pooled sensitivity and specificity of the CDR for MCI and dementia.
Fifteen studies investigating the diagnostic accuracy of the CDR-GS (n = 13) or CDR-SB (n = 5) for MCI or dementia were included. The pooled sensitivity and specificity of the CDR-GS for MCI were 93% and 97%, respectively. With respect to dementia, the CDR-GS had superior pooled specificity compared to the CDR-SB (99% vs. 94%), while similar sensitivities were found between the CDR-GS and CDR-SB (both 87%). Significant moderators of an old age, a high educational level, a high prevalence of MCI or dementia, being in a developing country, and a lack of informants' observations may affect the estimation of the sensitivity or specificity of the CDR.
Evidence supports the CDR being useful for detecting MCI and dementia; applying the CDR for staging cognitive impairment in at risk populations should be considered. Furthermore, including objective observations from relevant informants or proxies to increase the accuracy of the CDR for dementia is suggested.
Cryptococcal meningitis (CM) is the most fatal adult meningitis in patients with human immunodeficiency virus (HIV). There is no conclusive evidence for the superiority of 1-week amphotericin B ...deoxycholate (AmphB) + flucytosine (5-FC) regimen over other antifungals in the management of HIV patients with CM (HIV-CM patients). We aimed to evaluate the differences in efficacy and tolerability of different antifungal agents in HIV-CM patients by conducting a current network meta-analysis NMA. Overall, 19 randomized controlled trials were included with 2642 participants. A regimen indicated a possibly lower early mortality rate, namely, AmphB + 5-FC + Azole (OR = 1.1E-12, 95% CIs = 1.3E-41 to 0.06) comparing to AmphB + 5-FC. The current NMA provides evidence that AmphB + 5-FC + Azole are superior to all the investigated treatments for induction regimen in HIV-CM patients.
Despite the increasingly recognized impact of novel coronavirus disease (COVID-19), caused by severe acute respiratory syndrome (SARS) coronavirus 2 (SARS-CoV-2), on many aspects of health in adults ...and children, its effects on neonates born to infected mothers remain unclear. We conducted this study to investigate the outcomes of neonates born to mothers with COVID-19.
We searched the medical databases from inception to March 31, 2020 to perform a systematic review of outcomes in neonates born to mothers with COVID-19. Data were pooled using a random effects regression model. Primary and secondary outcomes were neonatal clinical outcomes and infectious status, respectively.
Fourteen studies involving 105 neonates fulfilling the study criteria were identified. The rates of preterm neonates and those small for gestational age (SGA) were 25 (23.8%) and 10 (11.2%), respectively. Among 91 neonates who were tested, 8 (8.8%) were positive for nucleic acids or antibodies for SARS-CoV-2. Additionally, 28 (26.7%) of the neonates were symptomatic and two test-negative neonates died, including one stillbirth. Between test-positive and test-negative groups, the rates of SGA, preterm delivery, duration between maternal symptom onset and delivery, and perinatal complication were not significantly different; but the rate of symptomatic after birth reached significant difference (62.5% vs 20.5%, p = 0.008).
Most neonates born to infected mothers had favorable outcomes. Although direct evidences of intrauterine infection were scarce, the risk of intrauterine infection should be considered based on a positive test in 8.8% of the neonates. Symptomatic neonates born to infected mothers should receive tests for SARS-CoV-2 to initiate appropriate treatment and quarantine. Further studies are warranted to assess the outcomes of COVID-19 in neonates.
This work investigates deformation-induced micro-damage modes in ferrite-martensite dual-phase (DP) steels utilizing a state-of-the-art semi in-situ deformation apparatus integrated with scanning ...electron microscope. By integrating secondary electron imaging, electron backscatter diffraction, and electron channeling contrast, we provide comprehensive statistical results on micro-damages and strain localization events of their formation in DP780 and DP980 steels. The current observations indicate that interface decohesion plays a critical role in DP780, particularly under plastic instability. Based on maps of Kernel averaged misorientation, interface decohesion arises from the accumulation of geometrically necessary dislocations, which serve to compensate for the deformation incompatibility between ferrite and martensite. In contrast, the dominant damage mode in DP980 under plastic instability involves ferrite cracking within martensite-surrounded ferritic grains. This type of micro-damage is a result of strain localization by shear bands that accommodate the global deformation while the grain is constrained by martensite islands. Martensite cracking does not show as predominate sites under the condition of plastic instability in both steels. In summary, our findings highlight the importance of deformation incompatibility and constraint on occurrence of micro-damages through distinct strain localization events, which are determined by both microstructure of damage site and its environmental microstructure. In this work, we shed light on the role of microstructural engineering as a critical strategy for enhancing the resistance of DP steels or hetero-phase steels against deformation-induced damage.
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•Semi in-situ observation in SEM explores micro-damages in DP steels.•Interface decohesion (ID) comprises 52% damage in DP780 necking.•Ferrite cracking (FC) explains 67% damage in DP980 necking.•GND and shear bands clarify ID and FC under martensite constraints, respectively.•Deformation incompatibility or constraint in DP steel is vital in damage formation.
Lamivudine is effective to control hepatitis B virus (HBV) reactivation in HBV‐carrying cancer patients who undergo chemotherapy, but the optimal treatment protocol remains undetermined. In this ...study, HBV carriers with newly diagnosed non‐Hodgkin's lymphoma (NHL) who underwent chemotherapy were randomized to either prophylactic (P) or therapeutic (T) lamivudine treatment groups. Group P patients started lamivudine from day 1 of the first course of chemotherapy and continued treatment until 2 months after completion of chemotherapy. Group T patients received chemotherapy alone and started lamivudine treatment only if serum alanine aminotransferase (ALT) levels elevated to greater than 1.5‐fold of the upper normal limit (ULN). The primary endpoint was incidence of HBV reactivation during the 12 months after starting chemotherapy. During chemotherapy, fewer group P patients had HBV reactivation (11.5% versus 56%, P = 0.001), HBV‐related hepatitis (7.7% versus 48%, P = 0.001), or severe hepatitis (ALT more than 10‐fold ULN) (0 versus 36%, P < 0.001). No hepatitis‐related deaths occurred during protocol treatment. Prophylactic lamivudine use was the only independent predictor of HBV reactivation. After completion of chemotherapy, the incidence of HBV reactivation did not differ between the 2 groups. Two patients, both in group P, died of HBV reactivation–related hepatitis, 173 and 182 days, respectively, after completion of protocol treatment. When compared with an equivalent group of lamivudine‐naïve lymphoma patients who underwent chemotherapy, therapeutic use of lamivudine neither reduced the severity of HBV‐related hepatitis nor changed the patterns of HBV reactivation. Conclusion: Prophylactic lamivudine use, but not therapeutic use, reduces the incidence and severity of chemotherapy‐related HBV reactivation in NHL patients. (HEPATOLOGY 2008;47:844–853.)
A series of 4-anilinoquinolinylchalcone derivatives were synthesized and evaluated for antiproliferative activities against the growth of human cancer cell lines (Huh-7 and MDA-MB-231) and normal ...lung cells (MRC-5). The results exhibited low cytotoxicity against human lung cells (MRC-5). Among them, (
)-3-{4-{4-(benzyloxy)phenylamino}quinolin-2-yl}-1-(4-methoxyphenyl) prop-2-en-1-one (
) was found to have the highest cytotoxicity in breast cancer cells and low cytotoxicity in normal cells. Compound
causes ATP depletion and apoptosis of breast cancer MDA-MB-231 cells and triggers reactive oxygen species (ROS)-dependent caspase 3/7 activation. In conclusion, it is worth studying 4-anilinoquinolinylchalcone derivatives further as new potential anticancer agents for the treatment of human cancers.
Xerostomia (dry mouth) is the cardinal symptom of Sjögren's syndrome (SS), which is an autoimmune disease involving the exocrine glands and other organs. Xerostomia may predispose patients to ...periodontal disease (PD) and an association between SS and PD has been reported. This association may be bidirectional; therefore, we conducted this study to investigate the risk of SS in patients with PD using data from the National Health Insurance Research Database of Taiwan. A total of 135,190 patients were enrolled in our analysis. In all, 27,041 patients with PD were matched by gender, age, insured region, urbanization and income, with cases and controls in a 1:4 ratio. Both groups were followed and the risks of SS were calculated by Cox proportional hazards regression. Finally, 3292 (2.4%) patients had newly diagnosed SS. Patients with PD had a significantly higher risk of subsequent SS (903 (3.3%) vs. 2389 (2.2%), adjusted hazard 1.47, 95% confidence interval: 1.36⁻1.59). In conclusion, patients with PD had an approximately 50% increased risk of subsequent SS. Physicians should be aware of the symptoms and signs of SS in patients with PD.
PurposeUnderstanding people’s intentions to be an internet entrepreneur is an important issue for educators, academics and practitioners. The purpose of this paper is to develop and validate a scale ...to measure internet entrepreneurial self-efficacy.Design/methodology/approachBased on an analysis of 356 responses, a scale of internet entrepreneurial self-efficacy is validated in accordance with established scale development procedures.FindingsThe internet entrepreneurial self-efficacy scale has 16 items under three factors (i.e. leadership, technology utilization and internet marketing and e-commerce). The scale demonstrated adequate convergent validity, discriminant validity and criterion-related validity. Nomological validity was established by the positive correlation between the scale and, respectively, internet entrepreneurship knowledge and entrepreneurial intention.Originality/valueThis study is a pioneering effort to develop and validate a scale to measure internet entrepreneurial self-efficacy. The results of this study are helpful to researchers in building internet entrepreneurship theories and to educators in assessing and promoting individuals’ internet entrepreneurial self-efficacy and behavior.
Bacterial contamination of ready-to-eat (RTE) street foods is a major concern worldwide. Dissemination of antibiotic resistant pathogens from food is an emerging public-health threat. To investigate ...the prevalence of antibiotic resistance genes and ceftazidime resistance-associated efflux pumps in foodborne pathogens, 270 RTE street foods samples were collected in three densely populated Taiwanese cities. Among 70 ceftazidime non-susceptible isolates, 21 Stenotrophomonas maltophilia, 12 Pseudomonas spp., 22 Acinetobacter spp., and 15 Enterobacteriaceae isolates were identified. Phylogenetic analyses revealed high levels of genetic diversity between all of the different strains. Multi-drug resistance was observed in 86.4% (19/22) of Acinetobacter spp., 100% (12/12) of Pseudomonas spp., 71.4% (15/21) of S. maltophilia, and 93.3% (14/15) of Enterobacteriaceae. Of 70 ceftazidime non-susceptible isolates, 13 contained ESBLs or plasmid-mediated ampC genes and 23 contained ceftazidime resistance-associated efflux pumps, with Acinetobacter spp. identified as predominant isolate (69.6%; 16/23). AdeIJK pump RNA expression in Acinetobacter isolates was 1.9- to 2-fold higher in active efflux strains. Nine clinically resistant genes were detected: catIII and cmlA (chloramphenicol); aacC1, aacC2, aacC3, and aacC4 (gentamicin); tet(A), tet(C), and tet(D) (tetracycline). The scope and abundance of multidrug-resistant bacteria described in this report underscores the need for ongoing and/or expanded RTE monitoring and control measures.
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