In LUX-Lung 7, the irreversible ErbB family blocker, afatinib, significantly improved progression-free survival (PFS), time-to-treatment failure (TTF) and objective response rate (ORR) versus ...gefitinib in patients with epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC). Here, we present primary analysis of mature overall survival (OS) data.
LUX-Lung 7 assessed afatinib 40 mg/day versus gefitinib 250 mg/day in treatment-naïve patients with stage IIIb/IV NSCLC and a common EGFR mutation (exon 19 deletion/L858R). Primary OS analysis was planned after ∼213 OS events and ≥32-month follow-up. OS was analysed by a Cox proportional hazards model, stratified by EGFR mutation type and baseline brain metastases.
Two-hundred and twenty-six OS events had occurred at the data cut-off (8 April 2016). After a median follow-up of 42.6 months, median OS (afatinib versus gefitinib) was 27.9 versus 24.5 months hazard ratio (HR) = 0.86, 95% confidence interval (CI) 0.66‒1.12, P = 0.2580. Prespecified subgroup analyses showed similar OS trends (afatinib versus gefitinib) in patients with exon 19 deletion (30.7 versus 26.4 months; HR, 0.83, 95% CI 0.58‒1.17, P = 0.2841) and L858R (25.0 versus 21.2 months; HR 0.91, 95% CI 0.62‒1.36, P = 0.6585) mutations. Most patients (afatinib, 72.6%; gefitinib, 76.8%) had at least one subsequent systemic anti-cancer treatment following discontinuation of afatinib/gefitinib; 20 (13.7%) and 23 (15.2%) patients received a third-generation EGFR tyrosine kinase inhibitor. Updated PFS (independent review), TTF and ORR data were significantly improved with afatinib.
In LUX-Lung 7, there was no significant difference in OS with afatinib versus gefitinib. Updated PFS (independent review), TTF and ORR data were significantly improved with afatinib.
NCT01466660.
Networks of sensors placed on the skin can provide continuous measurement of human physiological signals for applications in clinical diagnostics, athletics and human-machine interfaces. Wireless and ...battery-free sensors are particularly desirable for reliable long-term monitoring, but current approaches for achieving this mode of operation rely on near-field technologies that require close proximity (at most a few centimetres) between each sensor and a wireless readout device. Here, we report near-field-enabled clothing capable of establishing wireless power and data connectivity between multiple distant points around the body to create a network of battery-free sensors interconnected by proximity to functional textile patterns. Using computer-controlled embroidery of conductive threads, we integrate clothing with near-field-responsive patterns that are completely fabric-based and free of fragile silicon components. We demonstrate the utility of the networked system for real-time, multi-node measurement of spinal posture as well as continuous sensing of temperature and gait during exercise.
It has been widely accepted worldwide that global warming is by far the greatest threat and challenge in the new millennium. In order to stop global warming and to promote sustainable development, ...renewable energy is a perfect solution to achieve both targets. Presently million hectares of land in Malaysia is occupied with oil palm plantation generating huge quantities of biomass. In this context, biomass from oil palm industries appears to be a very promising alternative as a source of raw materials including renewable energy in Malaysia. Thus, this paper aims to present current scenario of biomass in Malaysia covering issues on availability and sustainability of feedstock as well as current and possible utilization of oil palm biomass. This paper will also discuss feasibility of some biomass conversion technologies and some ongoing projects in Malaysia related to utilization of oil palm biomass as a source of renewable energy. Based on the findings presented, it is definitely clear that Malaysia has position herself in the right path to utilize biomass as a source of renewable energy and this can act as an example to other countries in the world that has huge biomass feedstock.
The most recent version of the European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of early and locally-advanced non-small-cell lung ...cancer (NSCLC) was published in 2017, and covered the diagnosis, staging, management and treatment of both early stage I and II disease and locally-advanced stage III disease. At the ESMO Asia Meeting in November 2018, it was decided by both the ESMO and the Korean Society of Medical Oncology (KSMO) to convene a special face-to-face guidelines meeting in 2019 in Seoul. The aim was to adapt the ESMO 2017 guidelines to take into account potential differences related to ethnicity, cancer biology and standard practices associated with the treatment of locally-advanced, unresectable NSCLC in Asian patients. These guidelines represent the consensus opinions reached by those experts in the treatment of patients with lung cancer who represented the oncology societies of Korea (KSMO), China (CSCO), India (ISMPO), Japan (JSMO), Malaysia (MOS), Singapore (SSO) and Taiwan (TOS). The voting was based on scientific evidence, and it was independent of both local current treatment practices and the treatment availability and reimbursement situations in the individual participating Asian countries.
The quest for renewable energy has intensified since the escalating price of crude petroleum in the recent years. Renewable energy such as biodiesel has the potential to replace petroleum-derived ...transportation fuel in the future. Biodiesel is defined as the mono-alkyl esters of long-chain fatty acids derived from vegetable oils such palm oil, rapeseed and soybean. Currently, more than 80% of the world biodiesel productions are from rapeseed oil. However, the cost of palm oil which is at least US$ 200 per tonne cheaper than rapeseed oil indicates that palm oil could be a more suitable and attractive candidate as the source of biodiesel compared to other vegetable oils. Although palm oil is known to be a multi-purpose vegetable oil with products ranging from food to biodiesel, there are a lot of issues surrounding palm oil production. Nevertheless, some of these issues reported in the literature were found to be misleading and are thus confusing the public perception on palm oil. Thus, the aim of this paper is to highlight and clarify the negative issues reported in the literature surrounding palm oil production. Apart from that, various policies or/and strategies that will lead to a more sustainable production and development of palm oil industries will also be proposed. Hence, palm oil will be able to become the leading vegetable oil in terms of food and non-food production, especially as the main source of renewable energy, biodiesel.
Thioamides antithyroid‐drugs (ATDs) are important in hyperthyroid disease management. Identification of the susceptibility locus of ATD‐induced agranulocytosis is important for clinical management. ...We performed a genome‐wide association study (GWAS) involving 20 patients with ATD‐induced agranulocytosis and 775 healthy controls. The top finding was further replicated. A single‐nucleotide polymorphism (SNP), rs185386680, showed the strongest association with ATD‐induced agranulocytosis in GWAS (odds ratio (OR) = 36.4; 95% confidence interval (CI) = 12.8–103.7; P = 1.3 × 10‐24) and replication (OR = 37; 95% CI = 3.7–367.4; P = 9.6 × 10‐7). HLA‐B*38:02:01 was in complete linkage disequilibrium with rs185386680. High‐resolution HLA typing confirmed that HLA‐B*38:02:01 was associated with carbimazole (CMZ)/methimazole (MMI)‐induced agranulocytosis (OR = 265.5; 95% CI = 27.9–2528.0; P = 2.5 × 10‐14), but not associated with propylthiouracil (PTU). The positive and negative predictive values of HLA‐B*38:02:01 in predicting CMZ/MMI‐induced agranulocytosis were 0.07 and 0.999. Approximately 211 cases need to be screened to prevent one case. Screening for the risk allele will be useful in preventing agranulocytosis in populations in which the frequency of the risk allele is high.
Disposal of waste palm cooking oil (WPCO) via an environmental-friendly route is of major importance in the quest for sustainable development. In this study, WPCO was utilized instead of refined ...vegetable oils as the source of triglycerides for biodiesel production. WPCO contains several impurities, such as water and free fatty acids, which limit its application in catalytic transesterification processes. Consequently, a catalyst-free process using supercritical methanol was employed to investigate the potential of WPCO as an economical feedstock for biodiesel production. The parameters that influence the reaction, including reaction time, temperature and the molar ratio of alcohol to oil, were investigated. For comparison purposes, refined palm oil (RPO) was also subjected to supercritical methanol reaction and it was found that both processes produced comparable optimum yields of 80% at their respective optimum conditions. Hence, it can be concluded that WPCO has high potential as an economical and practical future source of biodiesel.
Remote digital pathology allows healthcare systems to maintain pathology operations during public health emergencies. Existing Clinical Laboratory Improvement Amendments regulations require ...pathologists to electronically verify patient reports from a certified facility. During the 2019 pandemic of COVID-19 disease, caused by the SAR-CoV-2 virus, this requirement potentially exposes pathologists, their colleagues, and household members to the risk of becoming infected. Relaxation of government enforcement of this regulation allows pathologists to review and report pathology specimens from a remote, non-CLIA certified facility. The availability of digital pathology systems can facilitate remote microscopic diagnosis, although formal comprehensive (case-based) validation of remote digital diagnosis has not been reported. All glass slides representing routine clinical signout workload in surgical pathology subspecialties at Memorial Sloan Kettering Cancer Center were scanned on an Aperio GT450 at ×40 equivalent resolution (0.26 µm/pixel). Twelve pathologists from nine surgical pathology subspecialties remotely reviewed and reported complete pathology cases using a digital pathology system from a non-CLIA certified facility through a secure connection. Whole slide images were integrated to and launched within the laboratory information system to a custom vendor-agnostic, whole slide image viewer. Remote signouts utilized consumer-grade computers and monitors (monitor size, 13.3–42 in.; resolution, 1280 × 800–3840 × 2160 pixels) connecting to an institution clinical workstation via secure virtual private network. Pathologists subsequently reviewed all corresponding glass slides using a light microscope within the CLIA-certified department. Intraobserver concordance metrics included reporting elements of top-line diagnosis, margin status, lymphovascular and/or perineural invasion, pathology stage, and ancillary testing. The median whole slide image file size was 1.3 GB; scan time/slide averaged 90 s; and scanned tissue area averaged 612 mm2. Signout sessions included a total of 108 cases, comprised of 254 individual parts and 1196 slides. Major diagnostic equivalency was 100% between digital and glass slide diagnoses; and overall concordance was 98.8% (251/254). This study reports validation of primary diagnostic review and reporting of complete pathology cases from a remote site during a public health emergency. Our experience shows high (100%) intraobserver digital to glass slide major diagnostic concordance when reporting from a remote site. This randomized, prospective study successfully validated remote use of a digital pathology system including operational feasibility supporting remote review and reporting of pathology specimens, and evaluation of remote access performance and usability for remote signout.
The state of understanding on the devastating effects of hydrothermal ageing on the properties of yttria-tetragonal zirconia polycrystal (Y-TZP) when exposed to humid environment are reviewed. The ...prime factors governing the ageing-induced tetragonal to monoclinic phase transformation include the tetragonal grain size, sintering techniques particularly two-step sintering, microwave sintering and electric field assisted sintering, and yttria content are discussed. In addition, the beneficial effects of sintering additives or dopants in promoting sintering as well as suppressing the ageing-induced monoclinic formation are also deliberated. Selective dopants and co-dopants such as copper oxide, alumina, iron oxide and magnesium oxide were found to be beneficial in suppressing hydrothermal ageing in zirconia. Other important boundary conditions to be considered when evaluating the ageing behaviour of Y-TZP includes the ageing environment i.e. temperature, medium and applied pressure which were discovered to have an impact on the rate of phase transformation. Furthermore, the effects of ageing-induced monoclinic formation on the surface topography and mechanical properties of Y-TZP are reviewed. This review indicated that the ageing of Y-TZP can be rather intricate as there are many combinatory factors that needs to be tailored in order to develop an ageing-resistant zirconia without compromising on the transformation toughening effect and other properties.
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