Background. A single administration of laninamivir octanoate, a long-acting neuraminidase inhibitor, against influenza infection has been proven effective in nonclinical studies. This study evaluated ...the clinical efficacy of laninamivir octanoate for the treatment of adult influenza patients. Methods. A double-blind, randomized controlled trial examined whether laninamivir octanoate was noninferior to oseltamivir. A total of 1003 patients aged ⩾20 years with febrile influenza symptoms for no more than 36 h were randomized to receive either 40 mg of laninamivir octanoate, 20 mg of laninamivir octanoate, or oseltamivir. Laninamivir octanoate was inhaled once on day 1, and oseltamivir (75 mg) was administered orally twice daily for 5 days. The primary end point was the time to illness alleviation. Results. A total of 996 patients were included in the primary analysis (40-mg laninamivir octanoate, n= 334; 20-mg laninamivir octanoate, n=326; and oseltamivir, n=336). The median time to illness alleviation in the 40-mg laninamivir octanoate, 20-mg laninamivir octanoate, and oseltamivir groups was 73.0, 85.8, and 73.6 h, respectively. The difference between laninamivir octanoate and oseltamivir was −0.6 h (95% confidence interval, −9.9 to 6.9 h) for the 40-mg group and 12.2 h (95% confidence interval, −1.5 to 17.2 h) for the 20-mg group. The upper limits of the 95% confidence intervals were less than the prespecified noninferiority margin (18 h). The proportion of patients shedding virus at day 3 was significantly lower in the 40-mg laninamivir octanoate group than in the oseltamivir group (P=.006). Conclusions. A single inhalation of laninamivir octanoate is effective for the treatment of seasonal influenza, including that caused by oseltamivir-resistant virus, in adults. Clinical trials registration. NCT00803595.
The incidence of invasive fungal infection (IFI) in patients with acute myeloid leukemia (AML) has decreased with the introduction of antimold prophylaxis. Although acute lymphoblastic leukemia (ALL) ...has a lower risk of IFI than does AML, the incidences of IFI in both AML and ALL in the era of antimold prophylaxis should be re-evaluated. We analyzed adults with AML or ALL who had undergone induction, re-induction, or consolidation chemotherapy from January 2017 to December 2019 at Seoul National University Hospital. Their clinical characteristics during each chemotherapy episode were reviewed, and cases with proven or probable diagnoses were regarded as positive for IFI. Of 552 episodes (393 in AML and 159 in ALL), 40 (7.2%) were IFI events. Of the IFI episodes, 8.1% (12/148) and 5.9% (13/220) (P = 0.856) occurred in cases of ALL without antimold prophylaxis and AML with antimold prophylaxis, respectively. After adjusting for clinical factors, a lack of antimold prophylaxis (adjusted odds ratio aOR, 3.52; 95% confidence interval CI, 1.35-9.22; P = 0.010) and a longer duration of neutropenia (per one day, aOR, 1.02; 95% CI, 1.01-1.04; P = 0.001) were independently associated with IFI. In conclusion, the incidence of IFI in ALL without antimold prophylaxis was not lower than that in AML. A lack of antimold prophylaxis and prolonged neutropenia were independent risk factors for IFI. Clinicians should be on guard for detecting IFI in patients with ALL, especially those with risk factors.
Highlights • A total of 9599 isolates of Gram-negative bacteria (GNB) causing urinary tract infections (UTIs) were collected from 61 centres in 13 countries in the Asia-Pacific region from 2010–2013. ...• China, Vietnam, India, Thailand and the Philippines had the highest rates of GNB species producing extended-spectrum β-lactamases (ESBLs) and of cephalosporin resistance. • ESBL production and hospital-acquired infection significantly compromised the susceptibility of E. coli and K. pneumoniae to ciprofloxacin, levofloxacin and most β-lactams, with the exception of imipenem and ertapenem.
This systematic review and meta-analysis aimed to summarize the effects of forest therapy on depression and anxiety using data obtained from randomized controlled trials (RCTs) and quasi-experimental ...studies. We searched SCOPUS, PubMed, MEDLINE(EBSCO), Web of science, Embase, Korean Studies Information Service System, Research Information Sharing Service, and DBpia to identify relevant studies published from January 1990 to December 2020 and identified 20 relevant studies for the synthesis. The methodological quality of eligible primary studies was assessed by ROB 2.0 and ROBINS-I. Most primary studies were conducted in the Republic of Korea except for one study in Poland. Overall, forest therapy significantly improved depression (Hedges's g = 1.133; 95% confidence interval (CI): -1.491 to -0.775) and anxiety (Hedges's g = 1.715; 95% CI: -2.519 to -0.912). The quality assessment resulted in five RCTs that raised potential concerns in three and high risk in two. Fifteen quasi-experimental studies raised high for nine quasi-experimental studies and moderate for six studies. In conclusion, forest therapy is preventive management and non-pharmacologic treatment to improve depression and anxiety. However, the included studies lacked methodological rigor and required more comprehensive geographic application. Future research needs to determine optimal forest characteristics and systematic activities that can maximize the improvement of depression and anxiety.
Abstract
A new three‐dimensional (3D) Zn‐based metal–organic framework (Zn‐MOF) with 1,3,5‐benzenetribenzoate (BTB
3−
), Zn
4
O(BTB)
2
(0.5H
2
O)
4
·H
2
O·8DEF (
1
), has been prepared using the ...reaction between Zn(NO
3
)
2
·6H
2
O and a tritopic bridging ligand 1,3,5‐benzenetribenzoic acid (H
3
BTB) in the presence of a potentially ditopic bridging ligand 3,3′‐terphenyldicarboxylic acid (H
2
TPDC). Interestingly, TPDC
2−
ligand did not incorporate into the resulting Zn‐MOF, and the title compound was not formed in the absence of TPDC
2−
ligand during the synthesis. After the solvate molecules were removed, Zn‐MOF
1
exhibited a doubly interpenetrated 3D ant net with a large solvent accessible void. The powder x‐ray diffraction pattern of the evacuated
1
did not change significantly compared to that of the as‐prepared
1
, thus indicating that
1
has permanent porosity. Gas sorption analyses were performed to investigate the sorption abilities of the evacuated
1
by using several different gases at suitable temperatures: N
2
, CO
2
, H
2
, and CH
4
.
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•A Si nanoparticle-based Cu2+-selective colorimetric signaling probe was developed.•Signaling is based on Cu2+-assisted oxidative coupling to yield quinonediimine dye.•Selective and ...sensitive sensing was possible with a detection limit of 2.13μM.•The probe system could easily determine Cu2+ levels in wastewater using a scanner.
A new Cu2+-selective chromogenic reaction-based probe system that functions via Cu2+-assisted quinonediimine dye formation has been investigated. Aniline-functionalized silica nanoparticles showed a pronounced selectivity and a colorimetric Cu2+ signaling behavior that could be discerned with the naked eye upon Cu2+-induced oxidative coupling with 4-aminoantipyrine in aqueous solution. The selectivity of the method was readily established by the vivid colorimetric responses shown by signaling experiments conducted in a microwell plate. Cu2+ signaling by the silica nanoparticles was most pronounced at pH 7.0, but was not significantly affected by solution pH values between 5.0 and 7.0. The marked color change from colorless to violet could be easily detected with a desktop office scanner as a readily available signal-capturing tool. Using the scanner, the detection limit for Cu2+ in simulated wastewater by the probe was found to be 2.13μM. The use of nanoparticle-immobilized aniline minimizes the possibility of human exposure to this toxic substance. Finally, a practical application of the designed method in the convenient determination of Cu2+ in simulated wastewater samples using an office scanner was demonstrated.
Lewis basic DABCO-functionalized 3D-like metal-organic framework, Zn-MOF, catalyzes nitroaldol (Henry) reaction of 4-nitrobenzaldehyde with nitroalkanes in a size-dependent manner. Small nitroalkanes ...give rise to higher conversion than larger ones. This MOF-based heterogeneous catalyst is very robust and can be recycled several times without losing its activity.
Splanchnic vein thrombosis (SpVT) in solid tumors has not been well investigated. Therefore, the treatment guidelines for SpVT are not well established. We aimed to conduct this prospective study to ...investigate the clinical characteristics and risk factors influencing survival in patients with gastrointestinal cancer with SpVT.
Fifty-one patients with gastrointestinal cancer diagnosed with SpVT were prospectively enrolled. The clinical characteristics and courses of SpVT were analyzed.
SpVT occurred in various clinical situations (at the time of initial cancer diagnosis or tumor recurrence after curative therapy, in the postoperative period, during chemotherapy, or in the period of end-of-life care). Among the total patients, 90.2% had no SpVT-related symptoms at initial SpVT diagnosis, and 82.4% did not receive any anticoagulation therapy. The clinical course of SpVT during the follow-up varied: (1) spontaneous resorption without any anticoagulation (47.1%), (2) resorption with anticoagulation (3.9%), (3) persistent thrombosis without progression (17.6%), and (4) SpVT extension (31.4%). Although the SpVT showed extension in some cases, most of them did not cause symptoms or had little impact on the patient's cancer treatment course. During the follow-up period, 23 patients died, all of which were caused by tumor progression. In the multivariable analysis, performance status and clinical situation at the time of SpVT diagnosis were significant prognostic factors.
Clinicians could adopt a strategy of close observation for incidentally detected SpVT in patients with gastrointestinal cancer. Anticoagulation should be considered only for SpVT cases selected strictly, weighing the risks and benefits.
Abstract This study aimed to assess the efficacy of dual T-cell suppression using individually tailored doses of antithymocyte globulin (ATG) and attenuated dose of post-transplant cyclophosphamide ...(PTCy) in haploidentical hematopoietic stem cell transplantation (haplo-HSCT). We conducted a retrospective analysis of 78 adults with acute leukemia or myelodysplastic syndrome who underwent haplo-HSCT using intravenous busulfan and fludarabine conditioning. Thirty-two patients received attenuated ATG/PTCy, while 46 patients received ATG (7.5 mg/kg) as GVHD prophylaxis. The 100-day cumulative incidence of grade III-IV (9.7% vs. 32.4%, P = 0.018) acute GVHD, as well as 2-year moderate-severe chronic GVHD (13.9% vs. 43.9%, P = 0.018) in the ATG/PTCy group were significantly lower than those in the ATG group. The 2-year overall survival was comparable between the two groups. However, 2-year GVHD-free, relapse-free survival in the ATG/PTCy group was significantly higher compared to that in the ATG group (38.9% vs. 21.7%, P = 0.021). Moreover, during post-engraftment period, the ATG/PTCy group exhibited lower incidences of life-threatening bacterial (12.5% vs. 37%, P = 0.033) and viral infection (0% vs. 17.4%, P = 0.035) than the ATG group. In conclusion, the combination of individually tailored ATG and low-dose PTCy appears to be a promising strategy in haplo-HSCT.
Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) remain important causes of morbidity and mortality. Increasing antimicrobial resistance has aroused the concern of the ...failure of antibiotic treatment.
To determine the distribution of the bacterial isolates of HAP and VAP, their antimicrobial resistance patterns, and impact of discordant antibiotic therapy on clinical outcome in Asian countries
A prospective surveillance study was conducted in 73 hospitals in 10 Asian countries from 2008-2009. A total of 2,554 cases with HAP or VAP in adults were enrolled and 2,445 bacterial isolates were collected from 1,897 cases. Clinical characteristics and antimicrobial resistance profiles were analyzed.
Major bacterial isolates from HAP and VAP cases in Asian countries were Acinetobacter spp., Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae. Imipenem resistance rates of Acinetobacter and P. aeruginosa were 67.3% and 27.2%, respectively. Multidrug-resistant rates were 82% and 42.8%, and extensively drug-resistant rates were 51.1% and 4.9%. Multidrug-resistant rate of K. pneumoniae was 44.7%. Oxacillin resistance rate of S. aureus was 82.1%. All-cause mortality rate was 38.9%. Discordant initial empirical antimicrobial therapy increased the likelihood of pneumonia-related mortality (odds ratio, 1.542; 95% confidence interval, 1.127-2.110).
Acinetobacter spp., P. aeruginosa, S. aureus, and K. pneumoniae are the most frequent isolates from adults with HAP or VAP in Asian countries. These isolates are highly resistant to major antimicrobial agents, which could limit the therapeutic options in the clinical practice. Discordant initial empirical antimicrobial therapy significantly increases the likelihood of pneumonia-related mortality.
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