Background
Gastrectomy remains the curative option in gastric cancer. However, the growing concern that preoperative waiting jeopardizes survival has not been fully addressed. The present ...population‐based cohort study aimed to clarify the impact of preoperative waiting time (PreWT).
Methods
We included patients with clinical Stage II–III gastric cancer who received curative surgery from 2008 to 2017 of Taiwan Cancer Registry. PreWT was defined as the time from endoscopic diagnosis to surgery. The prognostic impact on overall survival (OS) was evaluated with Cox and restricted cubic spline regressions.
Results
A total of 3059 patients with a median age of 68 years were evaluated. The median PreWT was 16 days (interquartile range, 11–24 days), and patients with a shorter PreWT were younger, had a more advanced disease and received adjuvant therapies. Despite a shorter OS occurring with prolonged PreWT (median OS by PreWT days: 7–13, 2.7 years; 14–20, 3.1 years; 21–27, 3.0 years; 28–34, 4.7 years; 35–31, 3.7 years; 42–48, 3.4 years; 49–118, 2.8 years; p = 0.029), the differences were not significant after adjustment. The Cox and restricted cubic spline regressions showed that prolonged PreWT was not a significant prognostic factor for OS (p = 0.719).
Conclusions
The population‐based study suggests that a PreWT of 49–118 days does not independently correlate with a poor prognosis in Stage II–III gastric cancer. The study provides rationale for a window period for preoperative therapies and patient optimization.
The population‐based study suggests that preoperative waiting within an acceptable range dose not impact the survival in Stage II–III gastric or gastroesophageal junction cancer.
•Reverse-transcriptase mutation K65N/R reduces the HIV susceptibility to tenofovir.•Bictegravir, emtricitabine, and tenofovir alafenamide were effective as maintenance therapy in people living with ...HIV with archived K65N/R.•The rate of experiencing viral rebound was 2.8% at week 48 of the stable switch.•The presence of M184V/I plus K65N/R was not associated with viral rebound.
Real-world experience with coformulated bictegravir, emtricitabine, and tenofovir alafenamide (BIC/FTC/TAF) is sparse as a switch regimen among people living with HIV (PLWH) having achieved viral suppression after previous virologic failures with the emergence of K65N/R.
In this retrospective study, PLWH aged ≥20 years who had previous virologic failures with emergent K65N/R were included for switching to BIC/FTC/TAF after having achieved plasma HIV RNA load (PVL) <200 copies/ml for ≥3 months. PLWH were excluded if integrase inhibitor resistance-associated mutations were detected. The primary end point was losing virologic control (PVL >50 copies/ml) at week 48 using a modified US Food and Drug Administration snapshot algorithm.
A total of 72 PLWH with K65N/R who switched to BIC/FTC/TAF were identified. A total of 42 (59.7%) had concurrent M184V/I, and 9 (12.5%) had ≥1 thymidine analog mutations. The median duration of viral suppression was 4.7 years (interquartile range 2.3-5.8), and 97.2% (n = 70) had PVL <50 copies/ml before switching. After a median observation of 98.6 weeks (interquartile range 77.9-120.3), 94.4% (n = 68) continued BIC/FTC/TAF. At week 48, the rate of losing virologic control was 2.8% (2/72). M184V/I was not associated with viral rebound.
Despite the emergence of K65N/R +/- M184V/I after virologic failures, BIC/FTC/TAF could be an option for simplification after viral suppression.
The crystal phase with a specific stacking sequence of atoms largely affects the catalytic performance of metal nanocrystals. Since the control of the phase at the same composition is extremely ...difficult, the phase-dependent performance of metal nanocrystals is studied rarely. Here, we show the synthesis of Ru nanocrystals with different percentages of face-centered cubic (FCC) and hexagonal close-packed (HCP) phases via kinetic control, further revealing a quantitative correlation between the phase percentage of Ru nanocrystals and the initial reduction rate of Ru(III) precursors. Specifically, we manipulate the single parameter-initial reduction rate by controlling the Ru(III) injection rate into the dropwise synthesis at a fixed reaction temperature and correlate the kinetic data with the Ru phase percentage analyzed by atomic-resolution electron microscopy and synchrotron X-ray scattering. Based on the quantitative analysis, the ranges of initial reduction rates of Ru precursors can be determined for synthesizing Ru nanocrystals with the percentages of unusual FCC phase from 9.0 to 55.1%. We demonstrate that a low initial reduction rate corresponds to the crystallization of the Ru HCP phase, while a high initial reduction rate favors the crystallization of the FCC lattice. Furthermore, we also systematically examine the catalytic performance of Ru nanocrystals with different phases.
Oral cancer is causally associated with environmental carcinogens, and the susceptibility to carcinogen‐mediated tumorigenesis is proposed to be genotype‐dependent. Leptin (LEP) and leptin receptor ...(LEPR) both play a crucial role in the mediation of physiological reactions and carcinogenesis and may serve as a candidate biomarker of oral cancer. The current case‐control study aimed to examine the effects of LEP −2548 G/A (rs7799039), LEPR K109R (rs1137100), and LEPR Q223R (rs1137101) single‐nucleotide polymorphisms (SNPs) with or without interacting to environmental carcinogens on the risk for oral squamous cell carcinoma. The SNPs of three genetic allele, from 567 patients with oral cancer and 560 healthy controls in Taiwan were analyzed. The results shown that the patients with polymorphic allele of LEP −2548 have a significant low risk for the development of clinical stage (A/G: adjusted odds ratio AOR = 0.670, 95% confidence interval CI = 0.454‐0.988, P < 0.05; A/G + G/G: AOR = 0.676, 95% CI = 0.467‐0.978, P < 0.05) compared to patients with ancestral homozygous A/A genotype. In addition, an interesting result was found that the impact of LEP −2548 G/A SNP on oral carcinogenesis in subjects without tobacco consumption is higher than subjects with tobacco consumption. These results suggest that the genetic polymorphism of LEP −2548 G/A (rs7799039), LEPR K109R (rs1137100), and LEPR Q223R (rs1137101) were not associated to the susceptibility of oral cancer; SNP in LEP −2548 G/A showed a poor clinicopathological development of oral cancer; population without tobacco consumption and with polymorphic LEP −2548 G/A gene may significantly increase the risk to have oral cancer.
Alcohol consumption is an established risk factor for head and neck cancer (HNC). The major carcinogen from alcohol is acetaldehyde, which may be produced by humans or by oral microorganisms through ...the metabolism of ethanol. To account for the different sources of acetaldehyde production, the current study examined the interplay between alcohol consumption, oral hygiene (as a proxy measure for the growth of oral microorganisms), and alcohol‐metabolizing genes (ADH1B and ALDH2) in the risk of HNC. We found that both the fast (*2/*2) and the slow (*1/*1 + *1/*2) ADH1B genotypes increased the risk of HNC due to alcohol consumption, and this association differed according to the slow/non‐functional ALDH2 genotypes (*1/*2 + *2/*2) or poor oral hygiene. In persons with the fast ADH1B genotype, the HNC risk associated with alcohol drinking was increased for those with the slow/non‐functional ALDH2 genotypes. For those with the slow ADH1B genotypes, oral hygiene appeared to play an important role; the highest magnitude of an increased HNC risk in alcohol drinkers occurred among those with the worst oral hygiene. This is the first study to show that the association between alcohol drinking and HNC risk may be modified by the interplay between genetic polymorphisms of ADH1B and ALDH2 and oral hygiene. Although it is important to promote abstinence from or reduction of alcohol drinking to decrease the occurrence of HNC, improving oral hygiene practices may provide additional benefit.
What's new?
Drinking alcohol increases risk of head and neck cancer, because the body metabolizes alcohol into acetaldehyde, a carcinogen. Bacteria lingering in the mouth can also perform this change, raising the question of whether oral hygiene influences cancer risk. These authors investigated the interaction between alcohol consumption, oral hygiene, and expression of alcohol metabolizing genes in relation to risk of head and neck cancer. They found that poor oral hygiene did indeed increase cancer risk among those with a genotype indicating slower alcohol metabolism, suggesting that careful teeth‐cleaning may reduce risk among those unwilling to forgo alcohol.
The international and national HIV treatment guidelines in 2016 have focused on scaling up access to combination antiretroviral therapy (cART). We aimed to assess the trends and treatment outcomes of ...late cART initiation in Taiwan.
Between June 2012 and May 2016, we retrospectively included antiretroviral-naive HIV-positive adults who initiated cART. Late initiation was defined as when cART was initiated in patients with a CD4 count <200 cells/mm3 or having experienced AIDS-defining illnesses. The treatment outcomes were assessed up to 6 months after starting cART.
We included 3655 HIV-positive patients, and the majority of the patients were male (95.4%) with a median age of 31 years and initiated non-nucleoside reverse-transcriptase inhibitor-containing regimens (87.0%). The median CD4 count at cART initiation increased from 207 cells/mm3 in 2012 to 298 cells/mm3 in 2016, and the overall proportion of late cART initiation decreased from 49.1% in 2012 to 29.0% in 2016 (P for trend <0.001). Late cART initiation mainly resulted from late presentation for HIV care and was associated with older age (per 1-year increase, adjusted odds ratio AOR, 1.05; 95% CI, 1.04-1.06), HBsAg seropositivity (AOR, 1.31; 95% CI, 1.04-1.64), HIV care in central and southern Taiwan, initiating cART in earlier year, non-intravenous drug users (AOR, 1.96; 95% CI, 1.33-2.86), and negative hepatitis C serostatus (AOR, 1.47; 95% CI, 1.04-2.08). Compared with non-late initiators, late initiators had a higher rate of all-cause mortality (1.7% vs. 0.3%) and regimen modification due to virological failure (7.1% vs. 2.6%). The predicting factors of all-cause mortality were late cART initiation (adjusted hazard ratio AHR, 5.40; 95% CI, 2.14-13.65) and older age (AHR, 1.06; 95% CI, 1.03-1.10).
While the proportion of late cART initiation decreased over time in Taiwan, late initiation remained in a substantial proportion of HIV-positive patients. The late initiators had higher risk for poor outcomes. The need for strategies to earlier detection of HIV infection and expediting cART initiation should be highlighted, especially among the older population.
A Bu3P‐mediated cyclization reaction of 3‐cinnamoyl‐4‐hydroxy‐2H‐chromen‐2‐ones though electrophilic addition of acyl chlorides towards the synthesis of highly functionalized furo3,2‐ccoumarins ...bearing a phosphorus ylide moiety is described. These unprecedented cyclization reaction proceeds under mild reaction conditions within short reaction times (1 min to 1 h), and can be further applied in the synthesis of alkenyl‐substituted furo3,2‐ccoumarins by the treatment with carbonyl electrophiles under basic conditions.
Building rings: The preparation of furo3,2‐ccoumarins with appending phosphorus ylides is realized through a Bu3P‐mediated cyclization reaction of 3‐cinnamoyl‐4‐hydroxy‐2H‐chromen‐2‐ones by electrophilic addition of acyl chlorides as the key step. These in situ generated ylide intermediates can efficiently react with carbonyl electrophiles to synthesize alkenyl‐substituted furo3,2‐ccoumarins in moderate to high yields.
Colorectal cancer is the second leading cause of death from cancer in the United States. Metastases in the liver, the most common metastatic site for colorectal cancer, are found in one-third of the ...patients who die of colorectal cancer. Currently, the genes and molecular mechanisms that are functionally critical in modulating colorectal cancer hepatic metastasis remain unclear. Here, we report our studies using functional selection in an orthotopic mouse model of colorectal cancer to identify a set of genes that play an important role in mediating colorectal cancer liver metastasis. These genes included APOBEC3G, CD133, LIPC, and S100P. Clinically, we found these genes to be highly expressed in a cohort of human hepatic metastasis and their primary colorectal tumors, suggesting that it might be possible to use these genes to predict the likelihood of hepatic metastasis. We have further revealed what we believe to be a novel mechanism in which APOBEC3G promotes colorectal cancer hepatic metastasis through inhibition of miR-29-mediated suppression of MMP2. Together, our data elucidate key factors and mechanisms involved in colorectal cancer liver metastasis, which could be potential targets for diagnosis and treatment.
Since few therapeutic options exist for extensively drug resistant Acinetobacter baumannii, an emerging threat in ICUs worldwide, and comparative prospective studies of colistin-based combination ...therapies are lacking, our objective was to compare the outcomes of patients with extensively drug-resistant A. baumannii bacteremia, treated with colistin-carbapenem and colistin-tigecycline combinations.
Prospective, observational, multicenter study.
Adults with extensively drug-resistant A. baumannii bacteremia were prospectively followed from 2010 to 2013 at three hospitals in Taiwan. Extensively drug-resistant A. baumannii was defined as A. baumannii (genospecies 2) nonsusceptible to all drug classes except for colistin and tigecycline, and standard combination therapy as use of parenteral colistin-carbapenem or colistin-tigecycline for at least 48 hours after onset of bacteremia.
Primary outcome measure was 14-day mortality. Of the 176 episodes of extensively drug-resistant A. baumannii bacteremia evaluated, 55 patients with a median (interquartile range) age of 62 years (44-79 yr) and Sequential Organ Failure Assessment score of 9 (5-13) points received standard combination therapy: colistin-tigecycline in 29 patients and colistin-carbapenem in 26. Crude 14-day and in-hospital mortality rates for patients receiving colistin-tigecycline versus patients receiving colistin-carbapenem were 35% versus 15% (p=0.105) and 69% versus 50% (p=0.152), respectively. Breakthrough extensively drug-resistant A. baumannii bacteremia under steady state concentrations of combination therapy for colistin-tigecycline group was 18% and for colistin-carbapenem group was 0% (p=0.059). Eleven patients (20.0%) developed nephrotoxicity. After adjusting for age, sex, comorbidity, initial disease severity, loading colistin dose, polymicrobial infection, and primary infection site, excess 14-day mortality was associated with the use of colistin-tigecycline in the subgroup with tigecycline minimum inhibitory concentration greater than 2 mg/L compared with the use of colistin-carbapenem (hazard ratio, 6.93; 95% CI, 1.61-29.78; p=0.009).
Increased 14-day mortality was associated with colistin-tigecycline therapy given tigecycline minimum inhibitory concentration greater than 2 mg/L compared with colistin-carbapenem therapy for extensively drug-resistant A. baumannii bacteremia.
Rice (Oryza sativa L.) is an important food crop in Taiwan, among which fragrant rice is highly regarded for its special aroma when cooked. During the storage of fragrant rice, the aroma components ...will change, which will affect the aroma quality of fragrant rice. Therefore, headspace solid-phase microextraction (HS-SPME) was used in this study, combined with gas chromatography and gas chromatography-mass spectrometry, to analyze the difference in the aroma components of Taikeng No. 4 (TK4), Tainung No. 71 (TN71), Kaohsiung No. 147 (KH147), and Taichung No. 194 (TC194) fragrant rice. A total of 28 aroma components were identified in the four varieties of fragrant rice, and the main components were all Nonanal. Among them, TK4 contains a very high content of hydrocarbons, including Tridecane and Dodecane; TN71, KH147, and TC194 contain mainly aldehydes such as Nonanal and Hexanal. During different storage times, the contents of alcohols, monoterpenes, aromatic aldehydes, and furans increased with storage time, while the content of aliphatic aldehydes decreased with storage time. After storage, the fragrant rice samples showed a tendency for the total volatile component content to decrease, with the most pronounced reduction observed in Nonanal content.
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