Abstract
N-doping plays an irreplaceable role in controlling the electron concentration of organic semiconductors thus to improve performance of organic semiconductor devices. However, compared with ...many mature p-doping methods, n-doping of organic semiconductor is still of challenges. In particular, dopant stability/processability, counterion-semiconductor immiscibility and doping induced microstructure non-uniformity have restricted the application of n-doping in high-performance devices. Here, we report a computer-assisted screening approach to rationally design of a triaminomethane-type dopant, which exhibit extremely high stability and strong hydride donating property due to its thermally activated doping mechanism. This triaminomethane derivative shows excellent counterion-semiconductor miscibility (counter cations stay with the polymer side chains), high doping efficiency and uniformity. By using triaminomethane, we realize a record n-type conductivity of up to 21 S cm
−1
and power factors as high as 51 μW m
−1
K
−2
even in films with thicknesses over 10 μm, and we demonstrate the first reported all-polymer thermoelectric generator.
•Paternal depression and social relations worsened during the postpartum period.•Parity significantly affected perinatal mental health in men but not in women.•Experienced fathers exhibited a ...significantly higher risk of paternal distress.•Experienced fathers had significantly poorer physical health and social relations.
Mental distress patterns in first-time or experienced mothers and fathers during the transition to parenthood have been inadequately studied. This longitudinal study thus investigated changes in depression, anxiety, and health-related quality of life in both parents from early pregnancy until 1 year postpartum. Parity effects were specifically examined.
In total, 531 pregnant women and their partners were recruited in Taiwan during early prenatal visits from 2011 to 2015, with five follow-ups from midpregnancy to 1 year postpartum. The participants’ self-reported data were collected and analyzed using generalized estimating equation models.
Maternal mental distress levels were highest at 1 month postpartum. During postpartum periods, depression scores increased and social relations domain scores decreased in men. Although mental distress levels were higher in mothers than in fathers, parity evidently affected men. Experienced fathers were independently associated with a 70% higher risk of perinatal depression (odds ratio OR = 1.7, 95% confidence interval CI = 1.2–2.3) and anxiety (OR = 1.7, 95% CI = 1.2–2.6). Experienced fathers also exhibited significantly lower perinatal scores than first-time fathers in the physical health and social relations domains.
Selection of both parents in metropolitan areas with higher socioeconomic status may restrict the generalizability of our findings.
In addition to maternal mental distress during the transition to parenthood, we highlighted experienced fathers’ psychological difficulties throughout perinatal periods. Such trends may indicate unsatisfied needs and could guide timely intervention to prevent adverse consequences.
The level of vitamin D in pregnant women and the effect of vitamin D supplementation are lack in Taiwan.
To investigate the vitamin D serum level and the effect of its supplementation on pregnancy.
...We included 1048 pregnant women who underwent prenatal exam with known serum 25-hydroxyvitamin D3 25(OH)D3 levels and delivery at the Mackay Memorial Hospital, Taipei, Taiwan during 2015–2018. A daily dose 2000 IU of vitamin D was given, starting at 12–16 weeks of pregnancy, to reach the level of 20 ng/mL, and then a maintenance dose of 800 IU/day was given. The other 3654 women without vitamin D supplementation delivered in 2018 served as control group. Pregnancy outcomes were recorded for analysis.
Over 80% of the 1048 pregnant women were vitamin D deficiency. There was an inverse correlation between serum vitamin D levels and maternal body mass index (p = 0.0366). We compared 375 women with serum vitamin D levels increased above 30 ng/mL after supplementation with control group. The rates of preterm birth, low birth weight, and postpartum hemorrhage between these 2 groups were 6.67% vs. 11.19% (p = 0.007), 6.40% vs. 10.0% (p = 0.025), and 1.33% vs. 3.20% (p = 0.04), respectively.
Vitamin D deficiency is very prevalent in pregnant women, especially those with high BMI, in Taiwan. It can be corrected by adequate vitamin D supplementation, which may decrease the risk of pregnancy complications and bring benefits to the fetus.
To explore the outcome and prognostic factors between inv(16) and t(8;21) disrupt core binding factor (CBF) in acute myeloid leukemia (AML).
The clinical characteristic, probability of achieving ...complete remission (CR), overall survival (OS) and cumulative incidence of relapse (CIR) were compared between inv(16) and (8;21).
The CR rate was 95.2%, 10-year OS was 84.4% and CIR was 29.4%. Subgroup analysis showed that patients with t(8;21) had significant lower 10-year OS and CIR than patients with inv(16). Unexpectedly, there was a trend for pediatric AML receiving five courses cytarabine to have a lower CIR than four courses cytarabine (19.8% vs 29.3%, P = 0.06). Among the cohort of no-gemtuzumab ozogamicin(GO) treatment, inv (16) patients showed a similar 10-year OS (78.9% vs 83.5%; P = 0.69) and an inferior outcome on 10-year CIR (58.6% vs 28.9%, P = 0.01) than those patients with t(8;21). In contrast, inv (16) and t(8;21) patients receiving GO treatment had comparable OS (OS: 90.5% vs. 86.5%, P = 0.66) as well as CIR (40.4% vs. 21.4%, P = 0.13).
Our data demonstrated that more cumulative cytarabine exposure could improve the outcome of childhood patients with t(8;21), while GO treatment was beneficial to the pediatric patients with inv(16).
Previous studies have stressed the importance of tobacco exposure for the mood disorders of depression and anxiety. Although a few studies have focused on perinatal women, none have specifically ...considered the effects of smoking and secondhand smoke exposure on perinatal suicidal ideation. Thus, this study aimed to investigate the relationships of smoking/secondhand smoke exposure status with suicidal ideation, depression, and anxiety from the first trimester to the first month post partum.
This cross-sectional study based on self-reported data was conducted at five hospitals in Taipei, Taiwan from July 2011 to June 2014. The questionnaire inquired about women's pregnancy history, sociodemographic information, and pre-pregnancy smoking and secondhand smoke exposure status, and assessed their suicidal ideation, depression, and anxiety symptoms. Logistic regression models were used for analysis.
In the 3867 women in the study, secondhand smoke exposure was positively associated with perinatal depression and suicidal ideation. Compared with women without perinatal secondhand smoke exposure, women exposed to secondhand smoke independently exhibited higher risks for suicidal ideation during the second trimester (odds ratio (OR) = 7.63; 95 % confidence interval (CI) = 3.25-17.93) and third trimester (OR = 4.03; 95 % CI = 1.76-9.23). Women exposed to secondhand smoke had an increased risk of depression, especially those aged 26-35 years (OR = 1.71; 95 % CI = 1.27-2.29).
Secondhand smoke exposure also considerably contributes to adverse mental health for women in perinatal periods, especially for the severe outcome of suicidal ideation. Our results strongly support the importance of propagating smoke-free environments to protect the health of perinatal women.
Iron deficiency anemia (IDA) is a major health burden among women in Asia. Key issues in IDA management in Asia are under-diagnosis and under-treatment. The lack of Asia-specific guidelines, and ...suboptimal utilization of treatment compounds the management of IDA. To address these gaps, a panel of 12 experts in obstetrics, gynecology, and hematology from six regions in Asia convened to review current practices and clinical evidence and provide practical guidance on IDA diagnosis and management in Asian women. The Delphi approach was used to obtain objective opinions and attain consensus on statements pertaining to awareness, diagnosis, and management of IDA. In total, 79 statements attained consensus and are summarized to provide guidance on raising awareness of IDA and approaches for improved diagnosis and treatment of IDA among women in various settings: pregnancy, postpartum, heavy menstrual bleeding, gynecologic cancers, and perioperative care. This clinician-led consensus integrates appropriate recommendations based on clinical evidence and best practices and is intended to guide decision making in the management of iron deficiency/IDA in women. The expert panel raises a call for timely diagnosis and utilization of appropriate treatment, including use of high-dose intravenous iron, stringent blood management, and interdisciplinary collaboration, for optimization of IDA management among women in Asia.
The efficacy and safety on the addition of vincristine (VCR) and dexamethasone (DEX) pulses to maintenance therapy among childhood acute lymphoblastic leukemia (ALL) remain uncertain. Herein, we ...perform an open‐label, multicentre, randomized, phase III clinical trial that was conducted at nine major medical centers in Guangdong Province, China. Patients were randomly assigned either the conventional maintenance therapy (control group, n = 384) or the VCR/DEX pulse (treatment group, n = 375). When limited to the SR cohort, 10‐year EFS was 82.6% (95% CI: 75.9–89.9) in the control group and 80.7% (95% CI: 74–88.1) in the treatment group (pnon‐inferiority = .0002). Similarly, patients with IR also demonstrated non‐inferiority of the treatment group to the control group in terms of 10‐year EFS (73.6% 95% CI: 67.6–80 vs. 77.6% 95% CI: 71.8–83.9; pnon‐inferiority = .005). Among the HR cohort, compared with the control group, patients in the treatment group experienced a significant benefit in terms of 10‐year EFS (61.1% 95% CI: 47.7–78.2 vs. 72.6% 95% CI: 55.6–94.7, p = .026) and a trend toward higher 10‐year OS (73.8% 95% CI: 61.6–88.4 vs. 87.9% 95% CI: 579.2–97.5, p = .068). In the HR cohort, the total rate of drug‐induced liver injury and Grade 3 chemotherapy‐induced anemia were both lower for patients in the treatment group than in the control group (55.6% vs. 100%, p = .033; 37.5% vs. 60%, p = .036). Conversely, the total prevalence of chemotherapy‐induced thrombocytopenia was higher for patients in the treatment group than in the control group (88.9% vs. 40%, p = .027). Pediatric acute lymphoblastic leukemia with high risk is suitable to VCR/DEX pulse during maintenance phase for the excellent outcome, while the standard‐to‐intermediate‐risk patients could eliminate the pulses.
Background:
Reconstruction of Myerson type III (defect size more than 5 cm) chronic Achilles tendon ruptures (CATRs) is a surgical challenge due to its large Achilles tendon defect. This study aims ...to describe our operative technique for Myerson type III CATR and its clinical outcomes.
Patients and Methods:
From May 2012 to April 2015, we treated seven patients (6 males, 1 female) with Myerson type III CATR using semitendinosus tendon and gracilis tendon autograft. The mean age was 47.3 years (range: 37–56). Patients were followed for a mean time of 31.3 months. All patients’ defect size between Achilles ends after debridement was more than 5 cm and hence classified as Myerson type III. The clinical outcomes were evaluated by visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score, Achilles tendon total rupture score (ATRS), and the Short Form 36 (SF-36).
Results:
All patients reported good postoperative clinical outcomes. The average AOFAS score increased from 54.29 points (range: 46–65 points) preoperatively to 97.57 points (range: 90–100 points) at last follow-up. The average ATRS increased from 51.43 points (range: 40–61 points) preoperatively to 92.71 points (range: 83–100 points) at last follow-up. And the average VAS for pain was 0 at the last follow-up. The mean value of SF-36 physical increased from 32.14 points (range: 25–35 points) to 90 points (range: 80–95 points). And the mean value of SF-36 mental was improved from 37.14 points (range: 32–40 points) to 90.86 points (range: 84–96 points).
Conclusions:
Semitendinosus tendon combined gracilis tendon autograft is a safe and effective technique in the reconstruction of Myerson type III CATR.
Purpose To evaluate the prognostic factors and outcome for acute lymphoblastic leukemia (ALL) in children with MLL rearrangement (MLL-r). Methods A total of 124 pediatric patients who were diagnosed ...with ALL were classified into two groups based on the MLL-r status by using a retrospective case-control study method from June 2008 to June 2020. Results The prevalence of MLL-r positive in the whole cohort was 4.9%. The complete remission (CR) rate on Day 33 in the MLL-r positive group was not statistically different from the negative group (96.8% vs 97.8%, P = 0.736). Multivariate analysis showed that T-cell, white blood cell counts (WBC) greater than or equal to 50 x 10.sup.9/L, MLL-AF4, and D15 minimal residual disease (MRD) positive were independent risk factors affecting the prognosis of MLL-r positive children. Stem cell transplantation (SCT) was a favorable independent prognostic factor affecting event-free survival (EFS) in MLL-r positive patients (P = 0.027), and there was a trend toward an independent prognostic effect on overall survival (OS) (P = 0.065). The 10-year predicted EFS for patients with MLL-AF4, MLL-PTD, MLL-ENL, other MLL partner genes, and MLL-r negative cases were 46.67 + or - 28.61%, 85.71 + or - 22.37%, 75 + or - 32.41%, 75 + or - 32.41%, and 77.33 + or - 10.81%, respectively (P = 0.048). The 10-year predicted OS were 46.67 + or - 28.61%, 85.71 + or - 22.37%, 75 + or - 32.41%, 75 + or - 32.41%, and 85.2 + or - 9.77%, respectively (P = 0.049). The 124 patients with ALL were followed up and eventually 5 (4%) cases relapsed, with a median relapse time of 3.9 years. Conclusion Patients with MLL-r positive ALL have moderate remission rates, but are prone to relapse with low overall survival. The outcome of MLL-r positive ALL was closely related to the partner genes, and clinical attention should be paid to screening for MLL partner genes and combining them with other prognostic factors for accurate risk stratification. Keywords: MLL, Children, Acute lymphoblastic leukemia, Outcome, Prognosis
Objective
To explore the effectiveness of a nurse‐led mobile health (mHealth) intervention to prevent excessive gestational weight gain (GWG) in overweight and obese women.
Methods
A randomized ...controlled trial with an experimental study design. Ninety‐two pregnant women with body mass index (BMI) ≥25 kg/m2 at less than 17 weeks gestation were recruited from two prenatal clinics in northern Taiwan from January to June 2020. The experimental group used the MyHealthyWeight (MHW) app and a wearable activity tracker (WAT), and the controls received standard antenatal treatments with no mHealth‐based elements. Two hospital follow‐up visits were scheduled at 24–26 weeks in the second trimester and 34–36 weeks in the third trimester. A generalized estimating equation (GEE) was used to examine the trajectories and the effectiveness of mHealth on GWG.
Results
No difference in GWG was found between the intervention and control groups at baseline (p > 0.05). The GWG trajectory in the entire cohort of women with obesity exhibited a quadratic pattern (ß = 1.8, 95% confidence interval CI = 1.27–2.32), and intervention participants' weekly GWG was gained significantly lower than their controls in the second trimester (p < 0.05). Throughout the pregnancy, the mHealth intervention group had a significantly lower proportion of individuals who exceeded their GWG in both total (21.6% vs. 32.6%) and weekly weight gain (first trimester = 58.7% vs. 65.2%; second trimester = 45% vs. 67.4%; third trimester = 48.6% vs. 55.1%). In particular, among obese women in the third trimester, those in the intervention group gained less gestational weight than their controls. The adjusted body weight difference was 5.44 kg (p = 0.023), signifying the total GWG difference (3.30 vs. 8.74 kg) between the means of the two groups. The GEE model indicated that obese women who were aged 35 years, had prepregnancy exercise habits, perceived self‐efficacy of diet, and more physical activity tended to have low GWG (p < 0.05).
Conclusions
The nurse‐led mHealth‐based intervention shows promising results in significantly preventing excessive GWG among high‐BMI women. More effectiveness was found among the obese subgroup.
Clinical relevance
The mHealth‐based intervention would be successfully implemented by nurses to help high‐BMI women maintain their optimal body weight and promote healthy behavioral changes, particularly in diet and physical activity during pregnancy.
PDF
