Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are fast becoming the most common chronic liver disease and are often preventable with healthy dietary habits and ...weight management. Sugar-sweetened beverage (SSB) consumption is associated with obesity and NAFLD. However, the impact of different types of SSBs, including artificially sweetened beverages (ASBs), is not clear after controlling for total sugar intake and total caloric intake. The aim of this study was to examine the association between the consumption of different SSBs and the risk of NAFLD and NASH in US adults. The representativeness of 3739 US adults aged ≥20 years old who had completed 24 h dietary recall interviews and measurements, including dietary, SSBs, smoking, physical activity, and liver stiffness measurements, were selected from the National Health and Nutrition Examination Survey 2017–2020 surveys. Chi-square tests, t-tests, and weighted logistic regression models were utilized for analyses. The prevalence of NASH was 20.5%, and that of NAFLD (defined without NASH) was 32.7% of US. adults. We observed a higher prevalence of NASH/NAFLD in men, Mexican-Americans, individuals with sugar intake from SSBs, light–moderate alcohol use, lower physical activity levels, higher energy intake, obesity, and medical comorbidities. Heavy sugar consumption through SSBs was significantly associated with NAFLD (aOR = 1.60, 95% CI = 1.05–2.45). In addition, the intake of ASBs only (compared to the non-SSB category) was significantly associated with NAFLD (aOR = 1.78, 95% CI = 1.04–3.05), after adjusting for demographic, risk behaviors, and body mass index. A higher sugar intake from SSBs and exclusive ASB intake are both associated with the risk of NAFLD.
This is a retrospective cohort study by analyzing a multi‐institutional electronic medical records database in Taiwan to compare long‐term effectiveness and risk of major adverse cardiac events ...(MACE) in chemotherapy‐naïve metastatic castration‐resistant prostate cancer (mCRPC) patients treated with enzalutamide (ENZ) or abiraterone (AA). Patients aged 20 years and older and newly receiving androgen receptor targeted therapies ENZ or AA from September 2016 to December 2019 were included. We followed patients from initiation of therapies to the occurrence of outcomes (prostate‐specific antigen (PSA) response rate, PSA progression free survival (PFS), overall survival (OS), and MACE), death, the last clinical visit, or December 31, 2020. We performed multivariable Cox proportional hazard models to compare ENZ and AA groups for the measured outcomes. A total of 363 patients treated with either ENZ (n = 157) or AA (n = 206) were identified. The analysis found a significantly higher proportion of patients with a PSA response rate higher than 50% among those receiving ENZ than among those receiving AA (ENZ vs AA: 75.80% vs 63.59%, P = .01). However, there was no significant difference in PSA PFS (adjusted hazard ratio: 0.86; 95% CI 0.63‐1.17) and OS (0.68: 0.41‐1.14) between the use of ENZ and AA in chemotherapy‐naïve mCRPC patients. Regarding the cardiovascular (CV) safety outcome, there was a significantly lower risk of MACE in patients receiving ENZ, compared to patients receiving AA (0.20: 0.07‐0.55). The findings suggest that enzalutamide may be more efficacious for PSA response and suitable for chemotherapy‐naïve mCRPC patients with high CV risk profile.
What's new?
While second generation androgen receptor (AR)‐targeted therapies are promising for the treatment of chemotherapy‐naïve metastatic castration‐resistant prostate cancer (mCRPC), data on survival benefit and cardiovascular safety are lacking. Here, using a multi‐institutional electronic health records database, the authors investigated the effectiveness, long‐term outcome, and cardiovascular safety of the AR‐targeted mCRPC therapies enzalutamide and abiraterone. Compared to abiraterone, enzalutamide is more efficacious in terms of prostate‐specific antigen response and carries a lower risk of major adverse cardiac events. The findings are relevant for treatment decisions regarding AR‐targeted therapies for chemotherapy‐naïve mCRPC patients with high risk of adverse cardiovascular events.
The question of whether the metal chalcogenides (phosphides) that have been acknowledged to be efficient materials for bifunctional electrocatalysts really perform as the active species or just ...“pre-catalysts” has been debated. Herein, a series of operando measurements, including in situ X-ray absorption spectroscopy, liquid-phase transmission electron microscopy, and in situ Raman spectroscopy, were conducted to unravel in real time the structural and chemical stability of P-substituted CoSe2 electrocatalysts under both hydrogen and oxygen evolution reactions (HER and OER, respectively) in an alkaline electrolyte. It can be conclusively revealed that, in an alkaline electrolyte, the P-substituted CoSe2 electrocatalyst was acting as the “pre-catalyst” rather than the real reactive species. The introduction of phosphorus is speculated to generate more vacancies or defects around Co cations in the initial CoSe2 and considerably facilitates the structural transformation into the “real reactive species”, such as metallic cobalt (for HER) and cobalt oxyhydroxide (for OER).
The rate of preterm birth is increasing globally. It causes significant short-term and long-term health care burdens. A comprehensive recognition of the risk factors related to preterm births is ...important in the prevention of preterm birth. Our study is to investigate the incidence and maternal risk factors of preterm birth from a nationwide population-based perspective.
This is a retrospective cohort study. All live births from 2004 to 2014 in Taiwan enrolled. The main data source was Taiwan’s Birth Certificate Application (BCA) database. The BCA database was linked with the National Health Insurance Research Database (NHIRD) to establish any links between information on newborns and maternal underlying disease.
A total of 1,385,979 births were included in the analysis. The incidence of preterm birth increased gradually in Taiwan from 8.85% in 2004 to 10.73% in 2014. Maternal age, socioeconomic status, maternal allergy and autoimmune diseases, gynecological diseases, and pregnancy-related complications were significant risk factors for preterm birth.
The overall incidence of preterm births has gradually increased in Taiwan. Maternal age, socioeconomic status, certain underlying diseases, and pregnancy-related complications were risk factors for preterm birth.
Endovascular thrombectomy (EVT) is the standard of care for anterior circulation acute ischemic stroke (AIS) with large vessel occlusion (LVO). Young patients with AIS‐LVO have distinctly different ...underlying stroke mechanisms and etiologies. Much is unknown about the safety and efficacy of EVT in this population of young AIS‐LVO patients.
All consecutive AIS‐LVO patients aged 50 years and below were included in this multicenter cohort study. The primary outcome measured was functional recovery at 90 days, with modified Rankin Scale of 0–2 deemed as good functional outcome.
A total of 275 AIS‐LVO patients that underwent EVT from 10 tertiary centers in Germany, Sweden, Singapore, and Taiwan were included. Successful reperfusion was achieved in 85.1% (234/275). Good functional outcomes were achieved in 66.0% (182/275). Arterial dissection was the most prevalent stroke etiology (42/195, 21.5%). National Institutes of Health Stroke Scale (NIHSS) score at presentation was inversely related to good functional outcomes (aOR: 0.92, 95% CI: 0.88–0.96 per point increase, p < 0.001). Successful reperfusion (aOR: 3.22, 95% CI: 1.44–7.21, p = 0.005), higher ASPECTS (aOR: 1.21, 95% CI: 1.01–1.44, p = 0.036), and bridging intravenous thrombolysis (aOR: 2.37, 95% CI: 1.29–4.34, p = 0.005) independently predicted good functional outcomes. Successful reperfusion was inversely associated with in‐hospital mortality (aOR: 0.14, 95% CI: 0.03–0.57, p = 0.006). History of hypertension strongly predicted in‐hospital mortality (aOR: 4.59, 95% CI: 1.10–19.13, p = 0.036).
While differences in functional outcomes exist across varying stroke aetiologies, high rates of successful reperfusion and good outcomes are generally achieved in young AIS‐LVO patients undergoing EVT.
AIM：To compare neoadjuvant chemoradiotherapy and surgery with surgery alone for resectable esophageal carcinoma. METHODS：We used MEDLINE and EMBASE databases to identify eligible studies and manual ...searches were done to ensure no studies were missed.Trial validity assessment was performed and a trial quality score was assigned. RESULTS：Eleven randomized controlled trials（RCTs） including 1308 patients were selected.Neoadjuvant chemoradiotherapy significantly improved the overall survival compared with surgery alone.Odds ratio（OR） 95%confidence interval（CI）,P value,expressed as neoadjuvant chemoradiotherapy and surgery vs surgery alone,was 1.28（1.01-1.64,P=0.05）for 1-year survival,1.78（1.20-2.66,P=0.004）for 3-year survival,and 1.46（1.07-1.99,P=0.02）for 5-year survival.Postoperative mortality increased in patients treated by neoadjuvant chemoradiotherapy（OR： 1.68,95%CI：1.03-2.73,P=0.04）,but incidence of postoperative complications was similar in two groups （OR：1.14,95%CI：0.88-1.49,P=0.32）.Neoadjuvant chemoradiotherapy lowered the local-regional cancer recurrence（OR：0.64,95%CI：0.41-0.99,P=0.04）, but incidence of distant cancer recurrence was similar （OR：0.94,95%CI：0.68-1.31,P=0.73）.Histological subgroup analysis indicated that esophageal squamous cell carcinoma did not benefit from neoadjuvantchemoradiotherapy,OR（95%CI,P value）was 1.16（0.85-1.57,P=0.34）for 1-year survival,1.34 （0.98-1.82,P=0.07）for 3-year survival and 1.41 （0.98-2.02,P=0.06）for 5-year survival. CONCLUSION：Neoadjuvant chemoradiotherapy can raise the survival rate of patients with esophageal adenocarcinoma.
Background: The International Society of Urological Pathology (ISUP) grade and positive surgical margins (PSMs) after radical prostatectomy (RP) may reflect the prognosis of prostate cancer (PCa) ...patients. This study aimed to investigate whether DCE-MRI parameters (i.e., Ktrans, kep, and IAUC) could predict ISUP grade and PSMs after RP. Method: Forty-five PCa patients underwent preoperative DCE-MRI. The clinical characteristics and DCE-MRI parameters of the 45 patients were compared between the low- and high-risk (i.e., ISUP grades III-V) groups and between patients with or without PSMs after RP. Multivariate logistic regression analysis was used to identify the significant predictors of placement in the high-risk group and PSMs. Results: The DCE parameter Ktrans-max was significantly higher in the high-risk group than in the low-risk group (p = 0.028) and was also a significant predictor of placement in the high-risk group (odds ratio OR = 1.032, 95% confidence interval CI = 1.005–1.060, p = 0.021). Patients with PSMs had significantly higher prostate-specific antigen (PSA) titers, positive biopsy core percentages, Ktrans-max, kep-median, and kep-max than others (all p < 0.05). Of these, positive biopsy core percentage (OR = 1.035, 95% CI = 1.003–1.068, p = 0.032) and kep-max (OR = 1.078, 95% CI = 1.012–1.148, p = 0.020) were significant predictors of PSMs. Conclusion: Preoperative DCE-MRI parameters, specifically Ktrans-max and kep-max, could potentially serve as preoperative imaging biomarkers for postoperative PCa prognosis based on their predictability of PCa risk group and PSM on RP, respectively.
•rTR was an independent prognostic factor for OS and LRC in lrNPC patients.•Risk score model to predict patients’ sensitivity to re-radiotherapy was developed.•The risk score model serves as a ...treatment decision-making tool for clinicians.
To investigate the prognostic value of tumor response (TR) for locoregionally recurrent nasopharyngeal carcinoma (lrNPC) patients at the end of re-radiotherapy (re-RT) and develop a risk score model to predict patient’s radiosensitivity to re-RT.
A total of 594 patients with lrNPC from 2010 to 2020 were retrospectively reviewed as the total cohort. Among these, 310 patients with complete first-line treatment data were reviewed as a secondary cohort. Overall survival (OS) was the primary endpoint. Locoregional control (LRC) was the secondary endpoint. Multivariate Cox analysis was performed to investigate the prognostic value of TR at the end of re-RT (rTR). A risk score model for predicting rTR was obtained by logistic regression analysis, and its effectiveness was compared using receiver operating characteristic (ROC) analysis.
Patients with complete response (CR) to rTR had higher 5-year OS and LRC rate than non-CR patients in both the total and secondary cohort. rTR was an independent prognostic factor for OS (P = 0.002) and LRC (P = 0.008). We developed a risk score model including four significant risk factors (relapse T stage, relapse gross tumor volume, time to recurrence, and initial TR). The area under the curve of the risk score model was 0.73 (95% CI: 0.678 to 0.780), which was significantly higher than that of each variable alone. Patients with the highest risk scores may be insensitive to re-RT and had a residual tumor risk of 89.9% after rRT.
rTR was an independent prognostic factor for OS and LRC in lrNPC patients. We developed a risk score model for predicting patients’ sensitivity to re-RT to screen for radiosensitive patients. This can serve as a treatment decision-making tool for clinicians.
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