TiO2nanorod arrays/Ti3C2TxMXene nanosheet composites with efficient photocatalytic activity.

Semiconductor photocatalysis holds significant promise in addressing both environmental and energy challenges. However, a major hurdle in photocatalytic processes remains the efficient separation of photoinduced charge carriers. In this study, TiO2nanorod arrays were employed by glancing angle deposition technique, onto which Ti3C2TxMXene was deposited through a spin-coating process. This hybrid approach aims to amplify the photocatalytic efficacy of TiO2nanorod arrays. Through photocurrent efficiency characterization testing, an optimal loading of TiO2/Ti3C2Txcomposites is identified. Remarkably, this composite exhibits a 40% increase in photocurrent density in comparison to pristine TiO2. This enhancement is attributed to the exceptional electrical conductivity and expansive specific surface area inherent to Ti3C2TxMXene. These attributes facilitate swift transport of photoinduced electrons, consequently refining the separation and migration of electron-hole pairs. The synergistic TiO2/Ti3C2Txcomposite showcases its potential across various domains including photoelectrochemical water splitting and diverse photocatalytic devices. As such, this composite material stands as a novel and promising entity for advancing photocatalytic applications. This study can offer an innovative approach for designing simple and efficient photocatalytic materials composed of MXene co-catalysts and TiO2for efficient water electrolysis on semiconductors.

Proton Pump Inhibitors Increases Longitudinal Risk of Mortality, Decompensation, and Infection in Cirrhosis: A Meta-Analysis.

BACKGROUND/AIMS: Proton pump inhibitors (PPIs) are frequently prescribed to cirrhotic patients, but there is limited longitudinal evidence regarding their effects. This study aimed to assess the impact of PPIs on adverse events in cirrhotic patients. METHODS: A comprehensive search was conducted using the Medline and Embase databases to identify relevant articles. Pooled hazard ratios (HRs) using DerSimonian and Laird random-effects model were calculated to evaluate the risk of adverse events such as long-term mortality, hepatic decompensation, hepatic encephalopathy (HE), spontaneous bacterial peritonitis (SBP), and overall infection in cirrhotic patients with PPI use. RESULTS: The analysis included 28 studies with 260,854 cirrhotic patients. The prevalence of PPI use among cirrhotic patients was 55.93%. The use of PPIs was not significantly associated with short-term mortality in cirrhotic patients. However, long-term mortality (HR 1.321, 95% CI 1.103-1.581, P = 0.002), decompensation (HR 1.646, 95% CI 1.477-1.835, P < 0.001), HE (HR 1.968, 95% CI 1.372-2.822, P < 0.001), SBP (HR 1.751, 95% CI 1.649-1.859, P < 0.001), and infection (HR 1.370, 95% CI 1.148-1.634, P < 0.001) were significantly associated with PPI use. Sensitivity analysis with prospective studies yielded similar results. CONCLUSION: PPIs should be reserved for appropriate indications at lowest effective dose for cirrhotic patients due to the potential harm.

Physical fitness levels and trends of kindergarteners in Hong Kong during the COVID-19 pandemic.

Background/objectives: The study aimed to examine the physical fitness and activity levels of kindergarteners in Hong Kong during the coronavirus disease 2019 pandemic. Methods: A total of 2052 kindergarteners (48% girls; 32.9% Grade 1, 34% Grade 2, and 33.1% Grade 3) were recruited from July 2020 to November 2021. Participants completed the physical fitness tests, including body composition, flexibility, lower-limb muscle strength, upper-limb muscle strength, lower-limb muscle endurance, and agility. Children's physical activity and overall well-being were examined using parental proxy reports. Parents also reported their physical activity and parental support to children's physical activity engagement, as well as their perception of children's kindergarten physical activity environment. Fitness differences by age and gender were analyzed using one-way ANOVA and ANCOVA measuring effect size with partial eta-squared. Additionally, correlations assessed the relationship between children's fitness and parents' proxy reports. Results: The results of the physical fitness tests were higher than those in previous studies conducted by the Physical Fitness Association of Hong Kong in 2015-2018. Gender-based differences were observed in most tests for children aged 4 years and older, with boys showing higher scores in the standing long jump, shot put, and balance tests, while girls had higher scores in the sit-and-reach test. Parents' proxy questionnaire answers indicated that children's continuous jump test performances were significantly related to their frequency of physical activity per week (r = 0.19, p < 0.001), and that children's health was significantly and positively correlated with their fitness level (r = 0.179, p < 0.009). Inadequate school physical activity was associated with poor upper-limb strength (r = 0.078, p < 0.005). Moreover, a high level of parental support for their children's participation in physical activity was correlated with a high level of parental participation in vigorous-intensity physical activities (r = 0.167, p < 0.005). Conclusion: The physical fitness of children in Hong Kong was less affected by the epidemic. Parents' healthy behaviors and support were related to children's participation in PA. Efforts to improve children's physical fitness and motor development should include parent education and physical activity involvement.

Betainization of Polydopamine/Polyethylenimine Coating for Universal Zwitterionization.

Biofoulants can adhere to multiple surfaces, degrading the performance of medical devices and industrial facilities and/or causing nosocomial infection. The surface immobilization of zwitterionic materials can prevent the initial attachment of the foulants but lacks extensive implementation. Herein, we propose a facile, universal, two-step surface modification strategy to improve fouling resistance. In the first step, the substrates were immersed in a codeposition solution containing dopamine and branched polyethylenimine (PEI) to form a "primer" layer (PDA/PEI). In the second step, the primer layers were treated with 1,3-propane sultone to betainize primary/secondary/tertiary amine moieties of PEI, generating zwitterions on substrates. After betainization, PS-grafted PDA/PEI (PDA/PEI/S) via a ring-opening alkylation reaction manifested changes in wettability. X-ray photoelectron spectroscopy revealed the presence of zwitterionic moieties on the PDA/PEI/S surfaces. Further investigations using ellipsometry and atomic force microscopy were conducted to scrutinize the relation among the PEI content, film thickness, primer stability, and betainization. As a result, zwitterion-decorated substrates prepared under optimal conditions can exhibit high resistance against bacterial fouling, achieving a 98.5% reduction in bacterial attachment. In addition, the method shows a substrate-independent property, capable of successfully applying it on organic and inorganic substrates. Finally, the newly developed approach shows excellent biocompatibility, displaying no significant difference compared with blank control samples. Overall, we envision that the facile surface modification strategy can further promote the preparation of zwitterion-decorated materials in the future.

The effects of walking on frailty, cognitive function and quality of life among inactive older adults in Saudi Arabia: a study protocol of randomized control trial by comparing supervised group-based intervention and non-supervised individual-based intervention.

BACKGROUND: Kingdom of Saudi Arabia (KSA) demographics are also changing with the increase in life expectancy in the country and the rise in the number of older Saudi Arabians. Saudi Arabia has a higher rate of physically inactive people, and most of them are between the ages of 55-64. Walking is one of the most prevalent forms of physical activity in Saudi Arabia and the study showed that most people prefer walking for recreational and health benefits. Therefore, the purpose of the proposed study is to compare the effects of supervised group-based walking and non-supervised individual-based walking interventions on frailty, cognitive function and quality of life among inactive older adults in Saudi Arabia. METHOD: This study will apply a three-group (2 intervention groups and 1 control group), double-blinded, randomized controlled trial (RCT) to examine the effect of different forms of walking interventions on Saudi Arabia older adults' frailty, cognitive function and quality of life immediately after a 16-week intervention, as well as the residual effects 12 weeks after completion of the interventions. DISCUSSION: This study aims to determine whether supervised group walking and non-supervised individual walking lead to different effects. Given the limited evidence in the literature regarding Saudi Arabia older adults' physical fitness and health, it is worthwhile to explore the effect of walking, as well as the forms of walking on improving the overall physical fitness and psychological status of older adults in Saudi Arabia. The findings of the current study could also create awareness of the government and the general public in Saudi Arabia of the ageing problems and the effective ways of achieving better intervention results. TRIAL REGISTRATION: The trial is registered at the ClinicalTrials.gov PRS (Trial ID: NCT05151575; Date of first posted: 12/07/2021).

Safety and efficacy of irinotecan, oxaliplatin, and capecitabine (XELOXIRI) regimen with or without targeted drugs in patients with metastatic colorectal cancer: a retrospective cohort study.

BACKGROUND: Five-fluorouracil, folinic acid, oxaliplatin and irinotecan (FOLFOXIRI) regimen is used as the first-line treatment for metastatic colorectal cancer (mCRC). The use of capecitabine, an oral fluoropyrimidine pro-drug, is feasible and safe; hence, it provides an interesting alternative to 5-fluorouracil in the abovementioned regimen. This study aimed to evaluate the efficacy and safety of capecitabine, oxaliplatin, and irinotecan (XELOXIRI) regimen use with or without targeted drugs in Chinese patients with mCRC. METHODS: We conducted a retrospective, longitudinal cohort study of patients with mCRC who received XELOXIRI regimen with or without targeted drugs (bevacizumab or cetuximab) every 2 weeks between January 2017 and November 2019 at the National Cancer Center/Cancer Hospital, the Chinese Academy of Medical Sciences, and Peking Union Medical College. Treatment efficacy was assessed by investigators by evaluating the objective response rate (ORR) and disease control rate (DCR). Overall survival (OS) was assessed using Cox proportional hazards models. The adverse events were also analyzed. RESULTS: Sixty-one consecutive patients were examined and followed up for survival. As of November 8, 2021, the median follow-up time was 35.4 months. Disease progression and death occurred in 50 (82%) and 38 (62%) patients, respectively. The median treatment duration of XELOXIRI with or without bevacizumab or cetuximab was 10 cycles (range, 1-12 cycles). The median OS and PFS were 32.2 months (95%CI [24.8-39.6]) and 9.3 months (95% CI [8.1-10.5]), respectively. The ORR of 48 patients with measurable lesions was 70.8%, and the DCR was 89.6%. RAS/BRAF wild-type (HR 0.39; 95% CI [0.16-0.96], p = 0.04) and metastatic organs > 2 (HR 3.25; 95% CI [1.34-7.87], p = 0.009) were independent prognostic factors for OS. The incidence of any grade of adverse events (AEs) was 96.7% (59/61). Grade ≥ 3 AEs included neutropenia (19.7%), leukopenia (9.8%), diarrhea (3.3%), vomiting (3.3%), febrile neutropenia (1.6%), and thrombocytopenia (1.6%). No treatment-related death occurred. CONCLUSION: The use of the XELOXIRI regimen with or without a targeted drug was effective, with a manageable toxicity profile in Chinese patients with mCRC.

Tunable and polarization-sensitive perfect absorber with a phase-gradient heterojunction metasurface in the mid-infrared.

Inspired by the growing family of Van der Waals materials, hBN supported phonon polaritons have attracted much attention due to their inherent hyperbolic dispersion properties in the mid-infrared. However, the lack of tunability imposes a severe restriction on the diversified, functional and integrated applications. Here, we propose a phase-gradient heterostructure metasurface to realize a dynamically tunable and polarization-sensitive perfect absorber in the mid-infrared through combining hBN and phase change VO2. Narrow-band perfect absorption at 7.2 µm can be switched to broadband around 11.2 µm through controlling the temperature of VO2. The governed physics of the bandwidth and absorption differences are demonstrated. Phonon polaritons in hBN phase-gradient configurations and plasmon polaritons in periodic VO2 blocks are respectively excited. We also investigate the absorption dependence on the polarization states of designed absorber. The method of engineering the absorption through controlling the temperature and polarization states opens up a new avenue for tunable applications such as data storage and integrated optical circuits.

Tunable phase change polaritonic perfect absorber in the mid-infrared region.

Realizing tunable light-polaritons interaction, such as perfect absorption in a controllable and compact manner holds great promise in nanophotonic systems. In this work, we engineer the hyperbolic surface phonon polaritons and surface plasmons polaritons to dynamically tune the perfect absorption in mid-infrared by combing the two van der Waals materials: the natural hyperbolic material hBN and phase change material VO2. Two spectrally separated and physically distinct perfect absorption peaks are alternatively observed and can be tuned through changing the temperature. The absorption in the resonant wavelengths can reach around 100%. We also demonstrate the flexibility of the absorber by investigating the absorption dependence on the polarization state and angle of incidence. The structural parameters sweep also confirms the robustness of our design. Our findings may open new possibilities to many versatile minimized applications such as optical modulators, optical switching, and temperature control system.

Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas harboring KRAS and BRCA mutations: case report and whole exome sequencing analysis.

BACKGROUND: Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGC) is an extremely uncommon pancreatic neoplasm that comprises less than 1% of all exocrine pancreatic tumors. To date, cases and data from whole-exome sequencing (WES) analysis have been reported by specific studies. We report a case of pancreatic UC-OGC with a literature review, and provide novel insights into the molecular characteristics of this tumor entity. CASE PRESENTATION: A 31-year-old male presented with intermittent abdominal pain for several months, and positron emission tomography (PET) showed isolated high metabolic nodules during the pancreatic uncinate process that were likely to be malignant disease. Pathological examination after radical excision revealed UC-OGC associated with poorly differentiated adenocarcinoma at the head of the pancreas. The disease recurred 7.4 months after radical surgery. The KRAS p.G12D (c.35G > A) and somatic BRCA2 p.R2896C (c.8686C > T) mutations were detected by subsequent WES analysis. The patient showed no response to platinum-based systemic chemotherapy, and his condition quickly worsened. He finally died, with an overall survival of 1 year. CONCLUSIONS: As an extremely uncommon tumor entity, UC-OGC is really a unique variant of conventional pancreatic ductal adenocarcinoma due to its similarities, as shown by genomic WES analysis. Clinical examination and molecular analysis by WES could further indicate potential treatment strategies for UC-OGC.

Broadband polarization resolving based on dielectric metalenses in the near-infrared.

We demonstrate a novel polarization-resolved device (PRD) with the ability to accurately resolve the polarization states via a simple measurement process. The PRD is composed of two elaborately designed metalenses, which are capable of focusing the two circularly polarized (CP) lights. Therefore, for an arbitrary polarized light (treated as a combination of the two CP lights), a discrepancy is exhibited on focusing efficiency, which inversely provides a way to calculate the ellipticity. With such a strategy, the generalized form for polarization resolving is derived, with which the ellipticity of the incident polarized light can be calculated (through just measuring the efficiencies of the two spots). This process is accomplished by utilizing the numerical simulations and theoretical analysis. Moreover, resolving the polarization states can be achieved within a wavelength range of 400nm, due to the broadband effect of the designed metalenses. With the merits of compact configuration, broadband and compatibility with the existing semiconductor technology, the designed PRD holds potential applications in characterizing the polarization states.

Chaperone in breast examination: a comprehensive systematic review of patient and clinician perspectives, and documentation.

BACKGROUND: The General Medical Council (GMC) has made it mandatory to have a chaperone present during intimate examinations, including breast exams, highlighting the importance of medicolegal protection for both patients and clinicians. AIMS: The use of chaperones during breast examinations is logical, especially in an increasingly litigious society. This review aims to summarize current information regarding patients' and clinicians' perspectives on chaperone use in breast examination. METHODS: A PRISMA-compliant search was conducted in electronic databases from inception until April 2023 for qualitative literature on patients' and clinicians' perspectives on chaperone use in breast examination. The inclusion criteria focused on studies related to breast examinations, excluding other intimate examinations. An inductive thematic analysis was performed in three domains: physician-associated factors, patient-associated factors, and chaperone documentation. RESULTS: Ten studies were included after screening 939 articles. For breast examination, the presence of male and older surgeons, nurse availability, rural settings, and patients' psychiatric comorbidities increased the likelihood of chaperone use during consultations. Medico-legal concerns were prominent for male physicians, while female physicians highlighted the need for technical support. Logistical issues were a common hindrance. The gender of physicians was important for patients, but there was conflicting evidence regarding patient preferences for chaperones and their purpose. Poor documentation was generally observed despite quality improvement projects. CONCLUSION: This study emphasizes the vital role of chaperones in clinical practice, urging a precise definition and targeted resolution for implementation challenges. Patient preferences highlight the need for a personalized approach, and increased awareness among healthcare professionals is essential.

Multifunctional Meta-Devices for Full-Polarization Rotation and Focusing in the Near-Infrared.

The creation of multi-channel focused beams with arbitrary polarization states and their corresponding optical torques finds effective applications in the field of optical manipulation at the micro-nanoscale. The existing metasurface-based technologies for polarization rotation have made some progress, but they have been limited to single functions and have not yet achieved the generation of full polarization. In this work, we propose a multi-channel and spatial-multiplexing interference strategy for the generation of multi-channel focusing beams with arbitrary polarization rotation based on all-dielectric birefringent metasurfaces via simultaneously regulating the propagation phase and the geometric phase and independently controlling the wavefronts at different circular polarizations. For the proof of concept, we demonstrate highly efficient multi-channel polarization rotation meta-devices. The meta-devices demonstrate ultra-high polarization extinction ratios and high focusing efficiencies at each polarization channel. Our work provides a compact and versatile wavefront-shaping methodology for full-polarization control, paving a new path for planar multifunctional meta-optical devices in optical manipulation at micro-nano dimensions.

Perception of Patients, Physicians, and Chaperones Regarding the Use of Chaperones During Patient Examinations for Plastic Surgery: A Systematic Review.

In this systematic review, we searched electronic databases for literature addressing physician use of chaperones during examinations of patients undergoing plastic surgery from the perspective of the patient, physician, and chaperone from inception of the database until April 2023. After screening 939 articles, we included seven studies in a systematic review. We conducted an inductive thematic analysis of four domains (physician perspective, patient perspective, chaperone perspective, and chaperone documentation). The results of the analysis showed that surgeons who are experienced, are men, or have received education related to using chaperones are more likely to provide chaperones during patient examinations for medicolegal protection and patient comfort. A small percentage of surgeons have faced accusations from patients of inappropriate behavior. Most of these incidents have occurred without a chaperone present. Patients who have long associations with a particular plastic surgery practice are less likely to want a chaperone. When physicians examine nonsensitive areas, most patients prefer having no chaperone. However, young patients and patients undergoing reconstructive procedures are more likely to request chaperones. Patients prefer having family members or friends serve as chaperones. Notably, despite the presence of a chaperone, we found that documentation of the presence of a chaperone was inadequate. Using a chaperone helps establish trust and ensure patient comfort. Further research, including qualitative studies and multinational approaches, is warranted to gain deeper insights and develop comprehensive guidelines for chaperone use that empowers both patients and health care providers.

Construction of an immune-related gene signature for overall survival prediction and immune infiltration in gastric cancer.

BACKGROUND: Treatment options for patients with gastric cancer (GC) continue to improve, but the overall prognosis is poor. The use of PD-1 inhibitors has also brought benefits to patients with advanced GC and has gradually become the new standard treatment option at present, and there is an urgent need to identify valuable biomarkers to classify patients with different characteristics into subgroups. AIM: To determined the effects of differentially expressed immune-related genes (DEIRGs) on the development, prognosis, tumor microenvironment (TME), and treatment response among GC patients with the expectation of providing new biomarkers for personalized treatment of GC populations. METHODS: Gene expression data and clinical pathologic information were downloaded from The Cancer Genome Atlas (TCGA), and immune-related genes (IRGs) were searched from ImmPort. DEIRGs were extracted from the intersection of the differentially-expressed genes (DEGs) and IRGs lists. The enrichment pathways of key genes were obtained by analyzing the Kyoto Encyclopedia of Genes and Genomes (KEGGs) and Gene Ontology (GO) databases. To identify genes associated with prognosis, a tumor risk score model based on DEIRGs was constructed using Least Absolute Shrinkage and Selection Operator and multivariate Cox regression. The tumor risk score was divided into high- and low-risk groups. The entire cohort was randomly divided into a 2:1 training cohort and a test cohort for internal validation to assess the feasibility of the risk model. The infiltration of immune cells was obtained using 'CIBERSORT,' and the infiltration of immune subgroups in high- and low-risk groups was analyzed. The GC immune score data were obtained and the difference in immune scores between the two groups was analyzed. RESULTS: We collected 412 GC and 36 adjacent tissue samples, and identified 3627 DEGs and 1311 IRGs. A total of 482 DEIRGs were obtained. GO analysis showed that DEIRGs were mainly distributed in immunoglobulin complexes, receptor ligand activity, and signaling receptor activators. KEGG pathway analysis showed that the top three DEIRGs enrichment types were cytokine-cytokine receptors, neuroactive ligand receptor interactions, and viral protein interactions. We ultimately obtained an immune-related signature based on 10 genes, including 9 risk genes (LCN1, LEAP2, TMSB15A mRNA, DEFB126, PI15, IGHD3-16, IGLV3-22, CGB5, and GLP2R) and 1 protective gene (LGR6). Kaplan-Meier survival analysis, receiver operating characteristic curve analysis, and risk curves confirmed that the risk model had good predictive ability. Multivariate COX analysis showed that age, stage, and risk score were independent prognostic factors for patients with GC. Meanwhile, patients in the low-risk group had higher tumor mutation burden and immunophenotype, which can be used to predict the immune checkpoint inhibitor response. Both cytotoxic T lymphocyte antigen4+ and programmed death 1+ patients with lower risk scores were more sensitive to immunotherapy. CONCLUSION: In this study a new prognostic model consisting of 10 DEIRGs was constructed based on the TME. By providing risk factor analysis and prognostic information, our risk model can provide new directions for immunotherapy in GC patients.

Multimodal Attention Network for Dementia Prediction.

The early identification of an individual's dementia risk is crucial for disease prevention and the design of insurance products in an aging society. This study aims to accurately predict the future incidence risk of dementia in individuals by leveraging the advantages of neural networks. This is, however, complicated by the high dimensionality and sparsity of the International Classification of Diseases (ICD) codes when utilizing data from Taiwan's National Health Insurance, which includes individual profiles and medical records. Inspired by the click-through rate (CTR) problem in recommendation systems, where future user behavior is predicted based on their past consumption records, we address these challenges with a multimodal attention network for dementia (MAND), which incorporates an ICD code embedding layer and multihead self-attention to encode ICD codes and capture interactions among diseases. Additionally, we investigate the applicability of several CTR methods to the dementia prediction problem. MAND achieves an AUC of 0.9010, surpassing traditional CTR models and demonstrating its effectiveness. The highly flexible pipelined design allows for module replacement to meet specific requirements. Furthermore, the analysis of attention scores reveals diseases highly correlated with dementia, aligning with prior research and emphasizing the interpretability of the model. This research deepens our understanding of the diseases associated with dementia, and the accurate prediction provided can serve as an early warning for dementia occurrence, aiding in its prevention.

Significant effect of posterior line treatment of HER2 positive advanced gastric cancer: A case report.

At present, there are few options for third line and above treatment of advanced gastric cancer and the single drug effect is poor. HER2 positive gastric cancer is an important subtype of gastric cancer and has certain immune characteristics. The combination of HER2 inhibitor and PD-1 inhibitor has a synergistic effect, and anti-tumor drugs targeting HER2 can play an anti-angiogenesis role by downregulating VEGF. We report a patient with HER2-positive gastric cancer who developed post-operative tumor recurrence and metastasis after adjuvant chemotherapy and radiotherapy. Trastuzumab combined with albumin paclitaxel was used as second-line treatment with progression-free survival for 9 months. In third line treatment, we retained trastuzumab and combined it with camrelizumab and apatinib. During the treatment period, although the patient stopped taking the drugs due to the side effects of camrelizumab and apatinib, he achieved a PFS of 10.4 months. Considering the good effect of the third line treatment, we added another PD-1 inhibitor and continued to combine trastuzumab treatment. We found that the patient still benefited from the treatment and continued to survive for another 4 months. At present, the patient is treated with DisitamabVedotin (HER2-ADC) combined with PD-1 inhibitor, and no overall survival outcome has been observed.

Human epidermal growth factor receptor 2 expression level and combined positive score can evaluate efficacy of advanced gastric cancer.

BACKGROUND: Although treatment options for gastric cancer (GC) continue to advance, the overall prognosis for patients with GC remains poor. At present, the predictors of treatment efficacy remain controversial except for high microsatellite instability. AIM: To develop methods to identify groups of patients with GC who would benefit the most from receiving the combination of a programmed cell death protein 1 (PD-1) inhibitor and chemotherapy. METHODS: We acquired data from 63 patients with human epidermal growth factor receptor 2 (HER2)-negative GC with a histological diagnosis of GC at the Cancer Hospital, Chinese Academy of Medical Sciences between November 2020 and October 2022. All of the patients screened received a PD-1 inhibitor combined with chemotherapy as the first-line treatment. RESULTS: As of July 1, 2023, the objective response rate was 61.9%, and the disease control rate was 96.8%. The median progression-free survival (mPFS) for all patients was 6.3 months. The median overall survival was not achieved. Survival analysis showed that patients with a combined positive score (CPS) ≥ 1 exhibited an extended trend in progression-free survival (PFS) when compared to patients with a CPS of 0 after receiving a PD-1 inhibitor combined with oxaliplatin and tegafur as the first-line treatment. PFS exhibited a trend for prolongation as the expression level of HER2 increased. Based on PFS, we divided patients into two groups: A treatment group with excellent efficacy and a treatment group with poor efficacy. The mPFS of the excellent efficacy group was 8 months, with a mPFS of 9.1 months after excluding a cohort of patients who received interrupted therapy due to surgery. The mPFS was 4.5 months in patients in the group with poor efficacy who did not receive surgery. Using good/poor efficacy as the endpoint of our study, univariate analysis revealed that both CPS score (P = 0.004) and HER2 expression level (P = 0.015) were both factors that exerted significant influence on the efficacy of treatment the combination of a PD-1 inhibitor and chemotherapy in patients with advanced GC (AGC). Finally, multivariate analysis confirmed that CPS score was a significant influencing factor. CONCLUSION: CPS score and HER2 expression both impacted the efficacy of immunotherapy combined with chemotherapy in AGC patients who were non-positive for HER2.

Investigating and promoting health behaviors reactivity among Hong Kong older adults in the post-COVID-19 Era: An exploratory network analysis.

BACKGROUND: Physical distance has increased the risk of developing a variety of health problems, especially among older people. During the COVID-19 lockdown period, physical activity decreased, screen time increased, food consumption increased, as well as exposure to unhealthy behaviour, leading to poorer sleep quality and more negative emotions, which ultimately led to poorer physical health, mental health, and subjective vitality among older adults. Although there were numerous research studies on changes in health behaviours during COVID-19, only a few were targeted at older adults, and none were conducted in Asian countries. METHOD: The current study is aiming to identify the changes in health behaviours, as well as their associations with older adults' mental health as a result of the COVID-19 pandemic among Hong Kong older adults, using exploratory network analysis. In this study, a random tele-survey was conducted among older adults. RESULTS: A total of 664 participants have been involved in the telephone survey, with 213 males and 451 females, of which mean age was 74.37. The explored network showed strong centrality and edge stability, thus enabling to reveal an overview of the associations between health behaviours and mental well-being of older adults. The lavaan model has also demonstrated the casual paths within the explored network, which indicated the significant impact of sleeping quality, eating habits and social networking on resilience. CONCLUSION: The outcomes of the study were able to identify the lifestyle changes of Hong Kong older adults due to COVID-19. Although the present study is not regarded as novel internationally, it may be representative of the Hong Kong community. In order to facilitate active aging during the pandemic, a user-friendly electronic platform for healthy living should include older adults in the future.

Advanced pancreatic cancer with KRAS wild-type and EGFR-sensitive mutation respond favorably to furmonertinib: A case report.

Pancreatic cancer is the leading cause of cancer death, and treatment options are limited and mostly ineffective. The patient we report had an EGFR exon 19 deletion and had disease progression in the short term after receiving three front-line treatment regimens. We administered furmonertinib and observed tumor shrinkage, decreased CA19-9. The progression-free survival (PFS) of furmonertinib was 4.7 months, and no adverse effects were observed. However, the patient did not benefit from subsequent nimotuzumab-based therapy. Targeted therapy driven by the detection of genetic signatures in this patient shows potential clinical benefit in refractory advanced pancreatic cancer.

Real-World Results of Raltitrexed Combined with S-1 and Bevacizumab in Heavily Pretreated Metastatic Colorectal Cancer.

Purpose: Treatment options for refractory metastatic colorectal cancer (CRC) are scarce. This retrospective study aimed to evaluate the efficacy and safety of raltitrexed combined with S-1 and bevacizumab in patients with heavily pretreated metastatic CRC in a clinical real-world setting. Patients and Methods: Records of patients with metastatic CRC refractory to standard therapies who initiated raltitrexed plus S-1 and bevacizumab from October 2017 to December 2021 were retrospectively reviewed at our institution. The study endpoints included median overall survival (OS), overall response rate (ORR), progression-free survival (PFS), disease control rate (DCR), and adverse events (AEs). Results: Forty-four patients with metastatic CRC, who had previously undergone standard chemotherapy received the regimen comprising raltitrexed plus S-1 and bevacizumab. As of March 2022, the median follow-up was 23.2 months (95% confidence interval 15.8-30.6). The median OS and median PFS were 13.5 (95% CI 9.9-17.1) and 4.7 months (95% CI 3.6-5.8), respectively, with a 16-week PFS rate of 60.9%. Among 43 patients with measurable lesions, the ORR and DCR were 7.0% (3/43) and 65.1% (28/43), respectively. Patients without peritoneal metastases (P = 0.003, hazard ratio 0.160, 95% CI 0.048-0.531), lower carcinoembryonic antigen level (≤42.8 ng/mL) (P = 0.039, HR 0.382, 95% CI 0.153-0.952), and no previous treatment with both vascular endothelial growth factor inhibitors (VEGF) and S-1 (P = 0.020, HR 0.215, 95% CI 0.059-0.785) had better OS. The incidence of any grade of treatment-related AEs was 88.6%, most of which were mild to moderate, and no treatment-related deaths occurred. Conclusion: Raltitrexed combined with S-1 and bevacizumab shows promising antitumor activity and safety and could be an alternative for patients with metastatic CRC who are refractory or intolerant to standard therapy.