Starting from Tesla's principles of wireless power transfer a century ago, this critical review outlines recent magneto-inductive research activities on wireless power transfer with the transmission ...distance greater than the transmitter coil dimension. It summarizes the operating principles of a range of wireless power research into 1) the maximum power transfer and 2) the maximum energy efficiency principles. The differences and the implications of these two approaches are explained in terms of their energy efficiency and transmission distance capabilities. The differences between the system energy efficiency and the transmission efficiency are also highlighted. The review covers the two-coil systems, the four-coil systems, the systems with relay resonators and the wireless domino-resonator systems. Related issues including human exposure issues and reduction of winding resistance are also addressed. The review suggests that the use of the maximum energy efficiency principle in the two-coil systems is suitable for short-range rather than mid-range applications, the use of the maximum power transfer principle in the four-coil systems is good for maximizing the transmission distance, but is under a restricted system energy efficiency (<;50%); the use of the maximum energy efficiency principle in relay or domino systems may offer a good compromise for good system energy efficiency and transmission distance on the condition that relay resonators can be placed between the power source and the load.
Treatment options for previously treated metastatic triple-negative breast cancer (mTNBC) are limited. In cohort A of the phase II KEYNOTE-086 study, we evaluated pembrolizumab as second or later ...line of treatment for patients with mTNBC.
Eligible patients had centrally confirmed mTNBC, ≥1 systemic therapy for metastatic disease, prior treatment with anthracycline and taxane in any disease setting, and progression on or after the most recent therapy. Patients received pembrolizumab 200 mg intravenously every 3 weeks for up to 2 years. Primary end points were objective response rate in the total and PD-L1–positive populations, and safety. Secondary end points included duration of response, disease control rate (percentage of patients with complete or partial response or stable disease for ≥24 weeks), progression-free survival, and overall survival.
All enrolled patients (N = 170) were women, 61.8% had PD-L1–positive tumors, and 43.5% had received ≥3 previous lines of therapy for metastatic disease. ORR (95% CI) was 5.3% (2.7–9.9) in the total and 5.7% (2.4–12.2) in the PD-L1–positive populations. Disease control rate (95% CI) was 7.6% (4.4–12.7) and 9.5% (5.1–16.8), respectively. Median duration of response was not reached in the total (range, 1.2+–21.5+) and in the PD-L1–positive (range, 6.3–21.5+) populations. Median PFS was 2.0 months (95% CI, 1.9–2.0), and the 6-month rate was 14.9%. Median OS was 9.0 months (95% CI, 7.6–11.2), and the 6-month rate was 69.1%. Treatment-related adverse events occurred in 103 (60.6%) patients, including 22 (12.9%) with grade 3 or 4 AEs. There were no deaths due to AEs.
Pembrolizumab monotherapy demonstrated durable antitumor activity in a subset of patients with previously treated mTNBC and had a manageable safety profile.
ClinicalTrials.gov, NCT02447003
Pembrolizumab for Early Triple-Negative Breast Cancer Schmid, Peter; Cortes, Javier; Pusztai, Lajos ...
New England journal of medicine/The New England journal of medicine,
02/2020, Letnik:
382, Številka:
9
Journal Article
Recenzirano
Odprti dostop
The addition of pembrolizumab to platinum-based neoadjuvant chemotherapy significantly increased the percentage of patients with a pathological complete response among patients with locally advanced ...triple-negative breast cancer. Side effects of the immunotherapy were added to the usual toxic effects of chemotherapy, but most patients completed planned treatment.
An interim analysis of a randomized trial in triple-negative breast cancer comparing the addition of pembrolizumab to neoadjuvant chemotherapy with chemotherapy alone and adjuvant pembrolizumab with ...placebo after definitive surgery was reported after 39 months of follow-up. Event-free survival at 3 years was 84.5% in the pembrolizumab group and 76.8% in the group that did not receive pembrolizumab.
Summary
Background
Indigo naturalis and its refined formulation, Lindioil, are effective in treating psoriatic symptoms topically. Indirubin is the active ingredient in indigo naturalis.
Objectives
...To determine the efficacy and safety of different concentrations of indirubin in Lindioil ointment for treating psoriasis.
Methods
In this randomized, double‐blind trial, adult patients presenting with chronic plaque psoriasis for > 1 year and with < 20% of the body surface area (BSA) affected were randomized to apply Lindioil ointment containing 200, 100, 50 or 10 μg g−1 of indirubin twice daily for 8 weeks followed by an additional 12‐week safety/extension period. The primary end point was the mean percentage change in Psoriasis Area and Severity Index (PASI) score along with the proportion of participants achieving 75% and 90% reductions in PASI scores (PASI 75 and PASI 90, respectively) from baseline to week 8.
Results
The results from week 8 revealed that the 200 μg g−1 group had the greatest reduction in PASI score 69·2%, 95% confidence interval (CI) 55·5–82·8, followed by the 100 μg g−1 group (63·1%, 95% CI 52·8–73·5), the 10 μg g−1 group (53·4%, 95% CI 42·8–64·0) and the 50 μg g−1 group (50·3%, 95% CI 37·4–63·2), with a between‐group comparison of P = 0·0445. The group with the highest proportion of the patients achieving PASI 75 (57%, P = 0·0474) and PASI 90 (30%, P = 0·0098) was the 200 μg g−1 group. No severe treatment‐related adverse events were reported during the 20‐week evaluation.
Conclusions
An amount of 200 μg g−1 of indirubin in Lindioil ointment is the most effective concentration studied so far for treating psoriasis topically, and is safe.
What's already known about this topic?
As a result of safety concerns about the long‐term use of corticosteroids and other standard treatments, there is a growing demand for herbal treatments for psoriasis.
Indigo naturalis, a herb used in Chinese medicine, is effective for the topical treatment of psoriasis when used as a crude ointment or in its refined form, Lindioil.
What does this study add?
Indirubin is the active ingredient in indigo naturalis, and different concentrations of indirubin in indigo naturalis ointment yield different results in treating psoriasis.
This study provides evidence that 200 μg g−1 of indirubin, the highest concentration studied so far, is the most effective concentration and is safe.
Linked Comment: Sekhon and Koo. Br J Dermatol 2018; 178:21.
Plain language summary available online
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Relapse is common in patients with locally advanced unresectable lung cancer after concurrent chemotherapy and radiation therapy. In a randomized study, addition of the anti–PD-L1 antibody durvalumab ...every 2 weeks for 12 months increased relapse-free survival by 47%.
The walkability of a neighborhood impacts public health and leads to economic and environmental benefits. The condition of sidewalks is a significant indicator of a walkable neighborhood as it ...supports and encourages pedestrian travel and physical activity. However, common sidewalk assessment practices are subjective, inefficient, and ineffective. Current alternate methods for objective and automated assessment of sidewalk surfaces do not consider pedestrians' physiological responses. We developed a novel classification framework for the detection of irregular walking surfaces that uses a machine learning approach to analyze gait parameters extracted from a single wearable accelerometer. We also identified the most suitable location for sensor placement. Experiments were conducted on 12 subjects walking on good and irregular walking surfaces with sensors attached at three different locations: right ankle, lower back, and back of the head. The most suitable location for sensor placement was at the ankle. Among the five classifiers trained with gait features from the ankle sensor, Support Vector Machine (SVM) was found to be the most effective model since it was the most robust to subject differences. The model's performance was improved with post-processing. This demonstrates that the SVM model trained with accelerometer-based gait features can be used as an objective tool for the assessment of sidewalk walking surface conditions.
Background and aims Despite the important role of biological soil crusts in desert ecosystems, the responses of the crustal composition and distribution to changes in both climatic and edaphic ...factors at different spatial scales are not well understood. The goal of our research was to study the drivers of crustal community diversity at different scales, determine how crustal diversity and distribution patterns are related to abiotic and biotic factors, and identify the characteristics of crustal communities along a precipitation gradient. Methods We investigated the distribution and characteristics of crustal communities based on 457 soil samples that were randomly collected from six desert regions of northern China. These regions represent a precipitation gradient from 450 mm in the east to 80–100 mm in the west. The measured environmental variables included soil moisture, pH, clay and silt content, soil organic carbon (SOC), total N, total P, total K, CaCO3 content, annual and perennial plant cover and crustal variables, including species richness, crustal cover and biomass. An ANOVA analysis, a stepwise regression and a redundancy analysis were used to analyse and interpret the response of biological soil crusts to environmental factors at two spatial scales. Results Our results showed that the moss distribution and biomass were strongly related to the topsoil moisture content. The highest diversity of cyanobacteria and algae was observed at sites with relatively dry topsoil, and lichen diversity was promoted at sites with fine-textured soils. In addition, the cover and biomass of moss were positively correlated with perennial plant cover and higher topsoil moisture, which was expected because plant cover provides shade for the moss. The cover and biomass of lichens, cyanobacteria and algae were positively correlated with that of annual plants because these plants may create an ideal habitat and provide nutrients. The physiochemical properties of the topsoil greatly influenced the distribution pattern of the crustal communities at the regional scale. The species richness and biomass of the crustal mosses were positively correlated with precipitation, whereas the species richness and biomass of cyanobacteria and algae were negatively correlated with precipitation at the landscape scale. Conclusions Rainfall largely determined the species richness and cover of the crustal cyanobacteria and mosses, whereas soil properties had a greater impact on the crustal lichens. Future changes to rainfall regimes could result in the conversion of biological soil crusts and further contribute to changes in the structure and functioning of desert ecosystems.
Objectives
Multicomponent exercise program have shown to improve function and cognition in older adults but studies on pre-frail older adults in the primary care setting are limited. This study aimed ...i) to evaluate impact of 6 months exercise (Ex) versus complementary effect of 3 months of cognitive stimulation therapy (CST) to 6 months of Ex (Ex+CST) on physical function, muscle mass and cognition versus control group at 3, 6 and 12 months ii) inflammatory biomarkers such as Interleukin-6 (IL-6) and Tumor Necrosis Factor Alpha (TNF-α).
Design
Cluster randomised control trial.
Setting & Intervention
Pre-frail older adults ≥ 65 years attending primary care clinic. Two intervention groups i) Ex 6 months ii) CST 3 months with Ex 6 months.
Measurements
At 0, 3, 6 and 12 months, questionnaires (on demographics, physical function, cognition, and depression) were administered and physical function assessment (gait speed, short physical performance battery (SPPB) test, handgrip strength, five times sit-to-stand (5x-STS)) was conducted. Muscle mass and its surrogates such as phase angle and body cell mass were measured using bioelectrical impedance analysis machine. Inflammatory biomarkers were measured at 0 and 3 months.
Results
Data from 190 participants was analysed at 3 months (111 control, 37 Ex and 41 Ex+CST). At 3 months, significant improvement in cognition was seen only in the Ex+CST group whereas improvements in depression, gait speed, SPPB and 5x-STS were seen in both the Ex and Ex+CST groups. At 6 months, the Ex+CST group improved in cognition and depression whereas improvement in frailty and muscle mass indices were seen in both the interventions groups. At 12 months, both the interventions groups had better perceived health, gait speed and less decline in muscle mass compared with control groups. Both the Ex and Ex+CST had significant association with TNF-α at 3 months (β −2.71 (95% CI −4.80–−0.62); p = 0.012 and β −1.74 (95% CI −3.43–−0.06); p = 0.043 respectively).
Conclusion
Combined Ex+CST had significant improvement in cognition whereas the intervention groups improved in depression, physical function, muscle mass, frailty, perceived health and TNF-α levels. With growing evidence of the benefits of multicomponent interventions at primary care level, incorporating it into mainstream care with action plans on long-term sustainability and scalability should be a priority for every country.
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