Green sonochemical synthesis of ZnCo2O4 decorated with carbon nanofibers for enhanced electrochemical detection of bisphenol A in food products.

The facile sonochemical synthesis is reported of zinc cobalt oxide (ZnCo2O4) composited with carbon nanofiber (CNF). Structural, chemical, and morphological were characterized by X-ray diffraction (XRD), X-ray photoluminescent spectroscopy (XPS), field emission scanning electron microscopy (FESEM), and transmittance electron microscopy (TEM), respectively. ZnCo2O4/CNF-modified GCE was applied to the detection of bisphenol A (BPA). The modified GCE shows enhanced sensing performance towards BPA, which includes a linear range (0.2 to 120 µM L-1) alongside a low limit of detection (38.2 nM L-1), low interference, and good stability. Detection of lower concentrations of BPA enables real sample analysis in the food industries (milk, orange juice, yogurt, tap water, and baby feeding bottles). Surprisingly, the BPA was detected in milk 510 nM L-1, orange juice 340 nM L-1, yogurt 1050 nM L-1, and tap water 140 nM L-1. Moreover, an interaction mechanism between the BPA analyte and ZnCo2O4 was discussed.

Development of a nanozyme-based electrochemical catalyst for real-time biomarker sensing of superoxide and nitric oxide anions released from living cells and exogenous donors.

Developing quantitative biosensors of superoxide (O2•-) and nitric oxide (NO) anion is crucial for pathological research. As of today, the main challenge for electrochemical detection is to develop high-selectivity nano-mimetic materials to replace natural enzymes. In this study, the dendritic-like morphological structure of silver organic framework (Ag-MOF) was successfully synthesized via a solvothermal strategy. Owing to the introduction of polymeric composites results in improved electrical conductivity and catalytic activity, which promotes mass transfer and leads to faster electron efficiency. For monitoring the electrochemical signals of O2•- and NO, the Ag-MOF electrode substrate was produced by drop-coating, and composites were designed by cyclic voltammetric potential cycles. The designed electrode substrates demonstrate high sensitivity, wide linear concentrations of 1 nM-1000 µM and 1 nM-850 µM, and low detection limits of 0.27 nM and 0.34 nM (S/N = 3) against O2•- and NO. Aside from that, the sensor successfully monitored the cellular release of O2•-, and NO from HepG2 and RAW 264.7 living cells and has the potential to monitor exogenous NO release from donors of Diethylamine (DEA)-NONOate and sodium nitroprusside (SNP). Additionally, the developed system was applied to the analysis of O2•- and NO in real biological fluid samples, and the results were good satisfactory (94.10-99.57 ± 1.23%). The designed system provides a novel approach to obtaining a good electrochemical biosensor platform that is highly selective, stable, and flexible. Finally, the proposed method provides a quantitative way to follow the dynamic changes in O2•- and NO in biological systems.

CuMoO4/Ti3C2Tx nanocomposite layers perform as an ultrasensitive electrochemical sensor for the detection of antioxidant rutin.

The focus of this paper is laid on synthesizing layered compounds of CuMoO4 and Ti3C2Tx using a simple wet chemical etching method and sonochemical method to enable rapid detection of rutin using an electrochemical sensor. Following structural examinations using XRD, surface morphology analysis using SEM, and chemical composition state analysis using XPS, the obtained CuMoO4/Ti3C2Tx nanocomposite electrocatalyst was confirmed and characterized. By employing cyclic voltammetry and differential pulse voltammetry, the electrochemical properties of rutin on a CuMoO4/Ti3C2Tx modified electrode were examined, including its stability and response to variations in pH, loading, sweep rate, and interference. The CuMoO4/Ti3C2Tx modified electrode demonstrates rapid rutin sensing under optimal conditions and offers a linear range of 1 µΜ to 15 µΜ, thereby improving the minimal detection limit (LOD) to 42.9 nM. According to electrochemical analysis, the CuMoO4/Ti3C2Tx electrode also demonstrated cyclic stability and long-lasting anti-interference capabilities. The CuMoO4/Ti3C2Tx nanocomposite demonstrated acceptable recoveries when used to sense RT in apple and grape samples. In comparison to other interfering sample analytes encountered in the current study, the developed sensor demonstrated high selectivity and anti-interference performance. As a result, our research to design of high-performance electrochemical sensors in the biomedical and therapeutic fields.

Medical students' perceptions of integrating social media into a narrative medicine programme for 5th-year clerkship in Taiwan: a descriptive qualitative study.

BACKGROUND: The growing demands in integrating digital pedagogies in learning (e.g., social media) contribute to disrupting many fields, including the medical humanities education. However, the strengths and barriers behind social media and medical humanities context are blurred and contradictive. We examined the perceptions of integrating social media - Facebook - into a narrative medicine (NM) programme for 5th -year clerkship in Taiwan. METHODS: We used purposive sampling to recruit participants. Sixteen medical students (Female/Male: 7/9) participated in four group interviews. Semi-structured focus group interviews were conducted to explore students' perceptions and experiences of the social media integrated into the NM programme. We analysed the data using a descriptive thematic analysis with a team-based approach. Data were managed and coded using ATLAS.ti version 9.0. RESULTS: We identified six main themes: (1) Positive experiences of social media integration; (2) Negative experiences of social media integration; (3) Barriers on writing and sharing NM stories in social media; (4) Barriers on reading NM stories in social media; (5) Barriers on reacting contents in social media; (6) Suggestions for future improvement. CONCLUSIONS: The study revealed the strengths and barriers from medical students' perceptions, when integrating social media into a NM programme. It is important to match students' experiences, barriers, and perceptions towards learning. Understanding participants' suggestions for future improvement are also crucial. With this knowledge, we might better develop the social media integration systems that achieve our desired outcomes based on the medical humanities education curricula.

Urinary catheter placement and adverse urinary outcomes with a focus on elevated risk in men with indwelling Foley catheters.

BACKGROUND: Prior studies indicated a link between urinary catheter use and urinary complications, highlighting the need for comprehensive, gender-specific investigations. This study explored the association through a national retrospective cohort, emphasizing gender disparities and long-term outcomes. METHODS: Our study utilized data from the entire population covered by Taiwan's National Health Insurance Research Database from 2000 to 2017. We included 148,304 patients who had undergone Foley catheter placement and their propensity-scores matched controls in the study. We evaluated urinary complications, which encompassed urinary tract cancer, urolithiasis, urethral stricture, obstructive uropathy, reflux uropathy, fistula, diverticulum, caruncle, false passage, prolapsed urethral mucosa, urinary tract rupture, and urinary tract infection. These were assessed using the Fine and Gray sub-distribution proportional hazards model to compare between the Foley and non-Foley groups. Sensitivity analyses were conducted with different matching ratios. RESULTS: In the study, the non-Foley group presented a marginally higher mean age (75.24 ± 10.47 years) than the Foley group (74.09 ± 10.47 years). The mean duration of Foley catheterization was 6.1 ± 4.19 years. Men with Foley catheterization exhibited the highest adjusted sub-distribution hazard ratios for urinary tract cancer (6.57, 95% CI: 5.85-7.37), followed by women with Foley catheterization (4.48, 95% CI: 3.98-5.05), and men without catheterization (1.58, 95% CI: 1.39-1.8) in comparison with women without the procedure. Furthermore, men with Foley catheterization were found to be at the greatest risk for complications such as urolithiasis, urethral stricture, obstructive and reflux uropathy, fistula, diverticulum, caruncle, false passage, prolapsed urethral mucosa, and urinary tract rupture. Conversely, women with urinary catheterization were most susceptible to urinary tract infections. CONCLUSIONS: The evidence confirms that urinary catheterization significantly increases urinary complications, particularly among men. Our study underscores the crucial need for healthcare providers to carefully evaluate the necessity of catheterization, aim to shorten its duration whenever feasible, and strictly adhere to established protocols to minimize complications.

Develop and Validate a Prognostic Index With Laboratory Tests to Predict Mortality in Middle-Aged and Older Adults Using Machine Learning Models: A Prospective Cohort Study.

BACKGROUND: Prognostic indices can enhance personalized predictions of health burdens. However, a simple, practical, and reproducible tool is lacking for clinical use. This study aimed to develop a machine learning-based prognostic index for predicting all-cause mortality in community-dwelling older individuals. METHODS: We utilized the Healthy Aging Longitudinal Study in Taiwan (HALST) cohort, encompassing data from 5 663 participants. Over the 5-year follow-up, 447 deaths were confirmed. A machine learning-based routine blood examination prognostic index (MARBE-PI) was developed using common laboratory tests based on machine learning techniques. Participants were grouped into multiple risk categories by stratum-specific likelihood ratio analysis based on their MARBE-PI scores. The MARBE-PI was subsequently externally validated with an independent population-based cohort from Japan. RESULTS: Beyond age, sex, education level, and BMI, 6 laboratory tests (low-density lipoprotein, albumin, aspartate aminotransferase, lymphocyte count, high-sensitivity C-reactive protein, and creatinine) emerged as pivotal predictors via stepwise logistic regression (LR) for 5-year mortality. The area under curves of MARBE-PI constructed by LR were 0.799 (95% confidence interval [95% CI]: 0.778-0.819) and 0.756 (95% CI: 0.694-0.814) for the internal and external validation data sets, and were 0.801 (95% CI: 0.790-0.811) and 0.809 (95% CI: 0.774-0.845) for the extended 10-year mortality in both data sets, respectively. Risk categories stratified by MARBE-PI showed a consistent dose-response association with mortality. The MARBE-PI also performed comparably with indices constructed with clinical health deficits and/or laboratory results. CONCLUSIONS: The MARBE-PI is considered the most applicable measure for risk stratification in busy clinical settings. It holds potential to pinpoint older individuals at elevated mortality risk, thereby aiding clinical decision-making.

Differential prognostic value of tumor and plasma T790M mutations in EGFR TKI-treated advanced NSCLC.

Background: Substitution of methionine for threonine at codon 790 (T790M) of epidermal growth factor receptor (EGFR) represents the major mechanism of resistance to EGFR tyrosine kinase inhibitors (TKIs) in EGFR-mutant non-small-cell lung cancer. We determined the prognostic impact and association of secondary T790M mutations with the outcomes of osimertinib and chemotherapy. Methods: Patients (n = 460) progressing from first-line EGFR-TKI treatment were assessed. Tissue and/or liquid biopsies were used to determine T790M status; post-progression overall survival (OS) was analyzed. Results: Overall, 143 (31.1%) patients were T790M positive, 95 (20.7%) were T790M negative, and 222 (48.2%) had unknown T790M status. T790M status [T790M positive versus T790M negative: hazard ratio (HR) 0.48 (95% confidence interval (CI), 0.32-0.70); p < 0.001, T790M unknown versus T790M negative: HR 1.97 (95% CI, 1.47-2.64); p < 0.001] was significantly associated with post-progression OS. T790M positivity rates were similar for tissue (90/168, 53.6%) and liquid (53/90, 58.9%) biopsies (Fisher's exact test, p = 0.433). Tumor T790M-positive patients had significantly longer post-progression OS than tumor T790M-negative patients (34.1 versus 17.1 months; log-rank test, p = 8 × 10-5). Post-progression OS was similar between plasma T790M-positive and -negative patients (17.4 versus not reached; log-rank test, p = 0.600). In tumor T790M-positive patients, post-progression OS was similar after osimertinib and chemotherapy [34.1 versus 29.1 months; log-rank test, p = 0.900; HR 1.06 (95% CI, 0.44-2.57); p = 0.897]. Conclusion: T790M positivity predicts better post-progression OS than T790M negativity; tumor T790M positivity has a stronger prognostic impact than plasma T790M positivity. Osimertinib and chemotherapy provide similar OS benefits in patients with T790M-positive tumors.

Different prognostic meaning of tumor resistant gene detected from tumor or blood in patients with EGFR-mutant lung cancer The study demonstrates that patients with EGFR-mutant lung cancer who develop resistance due to a secondary T790M mutation, defined by tumor or blood T790M positivity, achieve better survival than patients without secondary T790M mutation; this association was mainly contributed by tumour T790M positivity. Oismertinib and chemotherapy led to similar survival in tumour T790M-positive patients. However, compared to osimertinib, chemotherapy was associated with longer survival in blood T790M-positive patients.

Photochemical decoration of gold nanoparticles on MoS2 nanoflowers grafted onto the flexible carbon cloth as a recyclable SERS sensor for the detection of antibiotic residues on curved surfaces.

Surface-enhanced Raman spectroscopy (SERS)-based flexible substrate has recently been demonstrated to be effective in detecting molecules on curved surfaces, however a suitable method for fabricating the flexible SERS substrate still remains a hurdle. In this paper, we fabricated a flexible SERS substrate by anchoring the plasmonic gold nanoparticles (Au-NPs) onto the hydrothermally grown flower-like molybdenum disulfide (MoS2) grafted onto carbon cloth (CC) via a facile photoreduction route. Benefitting from the abundant hotspots generation of the Au-NPs and photo-induced charge-transfer ability of MoS2, the constructed Au-NPs/MoS2/CC substrate exhibit a superior SERS sensing ability, excellent SERS enhancement factor, high flexibility and mechanical stability towards the nitrofurantoin (NFT) with an ultra-low detection limit of 10-11 M. As a trial for practical applications, the flexible substrate was used to detect NFT (10-4 M) in the curved surfaces of meat samples via swab technique. The ability of the flexible Au-NPs/MoS2/CC substrate to sustain the robust Raman signals of NFT even after recycling up to 4 cycles validated its reusability. The proposed flexible SERS substrate with reusable capability indicates its great potential in practical applications for the detection of target molecules on the curved surfaces.

Brain metastasis, EGFR mutation subtype and generation of EGFR-TKI jointly influence the treatment outcome of patient with EGFR-mutant NSCLC.

Non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutation is brain metastasis (BM)-prone. We determined the impact of this hallmark, along with EGFR subtype and generation of tyrosine kinase inhibitor (TKI) treatment, on patients' outcome. 553 metastatic EGFR-mutant NSCLC patients received front-line EGFR-TKI treatment. Progression-free survival (PFS), overall survival (OS) and secondary T790M rate were analysed. BM was observed in 211 (38.2%) patients. BM (HR 1.20 [95% CI 0.99-1.48]; p = 0.053), ECOG PS 0-1 (HR 0.71 [95% CI 0.54-0.93]; p = 0.014) and afatinib treatment (HR 0.81 [95% CI 0.66-0.99]; p = 0.045) were associated with PFS. Afatinib-treated patients without BM demonstrated a significantly longer PFS (16.3 months) compared to afatinib-treated patients with BM (13.7 months) and to gefitinib/erlotinib-treated patients with (11.1 months) or without BM (14.2 months; p < 0.001). CNS-only progression trended higher in afatinib-treated patients. ECOG PS 0-1 (HR 0.41 [95% CI 0.31-0.56]; p < 0.001) and EGFR L858R mutation (HR 1.46 [95% CI 1.13-1.88]; p = 0.003), but not BM, were the predictors for OS. BM (OR 2.02 [95% CI 1.02-4.08]; p = 0.040), afatinib treatment (OR 0.26 [95% CI 0.12-0.50]; p < 0.001) and EGFR L858R mutation (OR 0.55 [95% CI 0.28-1.05]; p = 0.070) were associated with secondary T790M rate. In BM patients, gefitinib/erlotinib-treated ones with 19 deletion mutation and afatinib-treated ones with L858R mutation had the highest and the lowest T790M rate (94.4% vs. 27.3%, p < 0.001), respectively. BM and generation of EGFR-TKI jointly impact PFS and secondary T790M rate in patients with EGFR-mutant NSCLC, whereas OS was mainly associated with EGFR subtype.

Is moderate resistance training adequate for older adults with sarcopenia? A systematic review and network meta-analysis of RCTs.

BACKGROUND: Resistance training (RT) and nutritional supplementation are recommended for the management of sarcopenia in older adults. However, optimal RT intensity for the treatment of sarcopenia has not been well investigated. METHODS: This network meta-analysis aims to determine the comparative effectiveness of interventions for sarcopenia, taking RT intensity into consideration. RT intensity was classified into light-to-moderate intensity RT(LMRT), moderate intensity RT(MRT), and moderate-to-vigorous intensity RT(MVRT) based on percentage of one repetition maximum (%1RM) and/or rating of perceived exertion. RESULTS: A total of 50 RCTs (N = 4,085) were included after screening 3,485 articles. The results confirmed that RT with or without nutrition was positively associated with improved measures of muscle strength and physical performance. Regarding RT intensity, LMRT only demonstrated positive effects on hand grip (aerobic training + LMRT + nutrition: mean difference [MD] = 2.88; 95% credential intervals [CrI] = 0.43,5.32). MRT provided benefits on improvement in the 30-s chair stand test (repetitions) (MRT: MD = 2.98, 95% CrI = 0.35,5.59), timed up and go test (MRT: MD = -1.74, 95% CrI: = -3.34,-0.56), hand grip (MRT: MD = 2.44; 95% CrI = 0.03,5.70), and leg press (MRT: MD = 8.36; 95% CrI = 1.87,13.4). MVRT also improved chair stand test repetitions (MVRT: MD = 5.64, 95% CrI = 0.14,11.4), gait speed (MVRT + nutrition: MD = 0.21, 95% CrI = 0.003,0.48), appendicular skeletal muscle index (MVRT + nutrition: MD = 0.25, 95% CrI = 0.01,0.5), and leg press (MVRT: MD = 14.7, 95% CrI: 5.96,22.4; MVRT + nutrition: MD = 17.8, 95% CrI: 7.55,28.6). CONCLUSION: MVRT had greater benefits on muscle mass, lower extremity strength, and physical performance compared to MRT. Increasing RT intensity may be recommended for sarcopenic older adults.

Sensitive label-free detection of the biomarker phosphorylated tau-217 protein in Alzheimer's disease using a graphene-based solution-gated field effect transistor.

Alzheimer's disease (AD) is generally diagnosed using advanced imaging, but recent research suggests early screening using biomarkers in peripheral blood is feasible; among them, plasma tau proteins phosphorylated at threonine 231, threonine 181, and threonine 217 (p-tau217) are potential targets. A recent study indicates that the p-tau217 protein is the most efficacious biomarker. However, a clinical study found a pg/ml threshold for AD screening beyond standard detection methods. A biosensor with high sensitivity and specificity p-tau217 detection has not yet been reported. In this study, we developed a label-free solution-gated field effect transistor (SGFET)-based biosensor featuring a graphene oxide/graphene (GO/G) layered composite. The top layer of bilayer graphene grown using chemical vapor deposition was functionalized with oxidative groups serving as active sites for forming covalent bonds with the biorecognition element (antibodies); the bottom G could act as a transducer to respond to the attachment of the target analytes onto the top GO conjugated with the biorecognition element via π-π interactions between the GO and G layers. With this unique atomically layered G composite, we obtained a good linear electrical response in the Dirac point shift to p-tau217 protein concentrations in the range of 10 fg/ml to 100 pg/ml. The biosensor exhibited a high sensitivity of 18.6 mV/decade with a high linearity of 0.991 in phosphate-buffered saline (PBS); in human serum albumin, it showed approximately 90% of the sensitivity (16.7 mV/decade) in PBS, demonstrating high specificity. High stability of the biosensor was also displayed in this study.

Synergetic effects of Mo2C sphere/SCN nanocatalysts interface for nanomolar detection of uric acid and folic acid in presence of interferences.

Till to date, the application of sulfur-doped graphitic carbon nitride supported transition metal carbide interface for electrochemical sensor fabrication was less explored. In this work, we designed a simple synthesis of molybdenum carbide sphere embedded sulfur doped graphitic carbon nitride (Mo2C/SCN) catalyst for the nanomolar electrochemical sensor application. The synthesized Mo2C/SCN nanocatalyst was systematically characterized using X-ray diffraction (XRD) and scanning electron microscopy (SEM) with elemental mapping. The SEM images show that the porous SCN network adhered uniformly on Mo2C, causing a loss of crystallinity in the diffractogram. The corresponding elemental mapping of Mo2C/SCN shows distinct peaks for carbon (41.47%), nitrogen (32.54%), sulfur (1.37%), and molybdenum (24.62%) with no additional impurity peaks, reflecting the successful synthesis. Later, the glassy carbon electrode (GCE) was modified by Mo2C/SCN nanocatalyst for simultaneous sensing of uric acid (UA) and folic acid (FA). The fabricated Mo2C/SCN/GCE is capable of simultaneous and interference free electrochemical detection of UA and FA in a binary mixture. The limit of detection (LOD) calculated at Mo2C/SCN/GCE for UA and FA was 21.5 nM (0.09 - 47.0 µM) and 14.7 nM (0.09 - 167.25 µM) respectively by differential pulse voltammetric (DPV) technique. The presence of interferons has no significant effect on the sensor's performance, making it suitable for real sample analysis. The present method can be extended to fabricate an electrochemical sensor for various molecules.

Image-guided brachytherapy following external-beam radiation therapy for patients with inoperable endometrial cancer.

OBJECTIVE: To investigate the outcomes of definitive external-beam radiation therapy (EBRT) plus image-guided brachytherapy (IGBT) in patients with endometrial cancer (EC) unsuitable for surgery. METHODS: A total of 50 patients with inoperable EC were included. The patients received EBRT in a median dose of 45 Gy to the pelvis over 5 weeks. Thereafter, the patients received brachytherapy using tandem and ovoid applicators. High-risk clinical target volume (HR-CTV) and gross tumor volume in brachytherapy (GTVp) were defined by the assistance of patients' pre-IGBT magnetic resonance imaging. RESULTS: The medical records of the 50 patients were analyzed. The main causes of inoperability were anesthesia contraindications, namely medical comorbidities and obesity. The median cumulative D90s (the minimum dose delivered to 90% of the volume) in EQD2 (equivalent dose in 2-Gy fractions) to the HR-CTV and GTVp were 72.9 Gy10 (range, 64.9 to 80.3) and 166.2 Gy10 (range, 123.0 to 189.8), respectively. Over a median follow-up period of 27 months, 8 of the patients died of cancer. The 2-year overall and cancer-specific survival rates were 75% and 83%, respectively. The cumulative incidences of pelvic and distant failure were 4% (n = 2) and 16% (n = 8), respectively. Gastrointestinal complications of grade 2 or above were noted in 2 patients (4%), and a grade 2 genitourinary complication was noted in one. CONCLUSIONS: For patients with inoperable EC, EBRT followed by IGBT is an effective approach for achieving high local control without a high risk of complications.

The Risk Factors for Radiolucent Nephrolithiasis among Workers in High-Temperature Workplaces in the Steel Industry.

Workers in high-temperature workplaces with inadequate water supply may exhibit symptoms of chronic dehydration and have increased risk of nephrolithiasis. The aim of this study was to investigate the risk of radiolucent stone formation among workers in a high-temperature workplace and the related risk factors associated with the condition. We collected data from 1681 workers in a steel factory in Southern Taiwan who underwent regular health examinations. Radiolucent stones were defined as positive findings on ultrasound with negative radiographic images. The prevalences of nephrolithiasis and radiolucent stones in this study were 12.0% and 5.1%, respectively. Heat exposure and age were two major risk factors influencing the probability of radiolucent stones. We combined the age and heat exposure into four groups (over and under 35 years of age with and without heat exposure) in a logistic regression. For workers younger than 35 years, the odds ratio of radiolucent stones was 2.695 (95% confidence interval: 1.201-6.049) in workers with heat exposure compared to workers without. Our investigation further demonstrated that heat exposure was a main risk factor for radiolucent stone formation. In conclusion, our identification of heat exposure as an independent factor for radiolucent stone development in steel workers highlights the need for attention to be paid to those working in similar environments.

Effect of health literacy and shared decision-making on choice of weight-loss plan among overweight or obese participants receiving a prototype artificial intelligence robot intervention facilitating weight-loss management decisions.

Implementation of artificial intelligence (AI) in medical decision-making is still in early development. We developed an AI robot intervention prototype with a health literacy-friendly interface that uses interactive voice response (IVR) surveying to assist in decision-making for weight loss. The weight-specific health literacy instrument (WSHLI) and Shared Decision-Making Questionnaire (SDMQ) were used to measure factors influencing weight-loss decisions. Factors associated with participants choosing to lose weight were analyzed using logistic regression, and factors influencing the selection of specific weight-loss plans were examined with one-way analysis of variance. Our study recruited 144 overweight or obese adults (69.4% women, 58.3% with body mass index (BMI) ≥ 24). After interacting with the AI robot, 78% of the study population made the decision to lose weight. SDMQ score was a significant factor positively influencing the decision for weight-loss (odds ratio [OR]: 2.16, 95% confidence interval [CI]: 1.09-4.29, p = 0.027). Individuals who selected self-monitored lifestyle modification (mean ± SD: 11.52 ± 1.95) had significantly higher health literacy than those who selected dietician-assisted plan (9.92 ± 2.30) and physician-guided treatment (9.60 ± 1.52) (both p = 0.001). The study results demonstrated that our prototype AI robot can effectively encourage individuals to make decisions regarding weight management and that both WSHLI and SDMQ scores affect the choice of weight-loss plans.

A chemiresistive biosensor for detection of cancer biomarker in biological fluids using CVD-grown bilayer graphene.

A chemiresistive biosensor is described for simple and selective detection of miRNA-21. We developed chemical vapor deposition (CVD) and low-damage plasma treatment (LDPT)-treated bilayer graphene composite of graphene oxide/graphene (GO/GR) for the determination of a reliable biomarker. We have successfully overcome the self-limiting growth mechanism by using CVD method to grow more than one layer of graphene on copper foil. In addition, LDPT can be used to form GO/GR structures for chemiresistive biosensor applications. Due to the direct formation of BLGR (bilayer graphene), the coupling between graphene layers is theoretically superior to that of stacked BLGR, which is also confirmed by the blue shift of the characteristic peak of graphene in Raman spectroscopy. The shift is about double compared with that of stacked BLGR. Based on the results, the limit of detection for the target miRNA-21 was calculated to be 5.20 fM and detection rage is calculated as 100 fM to 10 nM, which is obviously better performance. Compared with previous work, this chemiresistive biosensor has good selectivity, and stability towards detection of miRNA-21. The ability to detect miRNA-21 in different biological fluids was almost identical to that in pH 7.4 phosphate-buffered saline (PBS). Thus, the proposed bilayer GO/GR of modified chemiresistive biosensor may potentially be applied to detect cancer cells in clinical examinations.

Nanohollow Titanium Oxide Structures on Ti/FTO Glass Formed by Step-Bias Anodic Oxidation for Photoelectrochemical Enhancement.

In this study, a new anodic oxidation with a step-bias increment is proposed to evaluate oxidized titanium (Ti) nanostructures on transparent fluorine-doped tin oxide (FTO) on glass. The optimal Ti thickness was determined to be 130 nm. Compared to the use of a conventional constant bias of 25 V, a bias ranging from 5 V to 20 V with a step size of 5 V for 3 min per period can be used to prepare a titanium oxide (TiOx) layer with nanohollows that shows a large increase in current of 142% under UV illumination provided by a 365 nm LED at a power of 83 mW. Based on AFM and SEM, the TiOx grains formed in the step-bias anodic oxidation were found to lead to nanohollow generation. Results obtained from EDS mapping, HR-TEM and XPS all verified the TiOx composition and supported nanohollow formation. The nanohollows formed in a thin TiOx layer can lead to a high surface roughness and photon absorbance for photocurrent generation. With this step-bias anodic oxidation methodology, TiOx with nanohollows can be obtained easily without any extra cost for realizing a high current under photoelectrochemical measurements that shows potential for electrochemical-based sensing applications.

Tumor Volume Reduction Rate to Induction Chemotherapy is a Prognostic Factor for Locally Advanced Head and Neck Squamous Cell Carcinoma: A Retrospective Cohort Study.

Introduction: Aim of this retrospective cohort study is to evaluate the prognostic value of tumor volume reduction rate status post-induction chemotherapy in locally advanced head and neck squamous cell carcinoma. Methods: Patients newly diagnosed from year 2007 to 2016 at a single center were included in this retrospective study. All patients had received induction Taxotere, Platinum, Fluorouracil followed by daily definitive intensity-modulated radiotherapy for 70 Gy in 35 fractions concurrent with or without cisplatin-based chemotherapy. Tumor volume reduction rate was measured and calculated by contrast-enhanced computed tomography images at diagnosis, and after at least 1 cycle of induction chemotherapy, and analyzed though a univariate and multivariate Cox regression model. Results: Ninety patients of the primary cancer sites at hypopharynx (31/90, 34.4%), oropharynx (29/90, 32.2%), oral cavity (19/90, 21.1%), and larynx (11/90, 12.2%) were included in this study, with a median follow-up time interval of 3.9 years. In multivariate Cox regression analysis, the tumor volume reduction rate of the primary tumor (TVRR-T) was also an independently significant prognostic factor for disease-free survival (DFS) (hazard ratio 0.77, 95% confidence interval 0.62-0.97; P-value = .02). Other factors including patient's age at diagnosis, the primary cancer site, and RECIST (Response Evaluation Criteria in Solid Tumors), were not significantly related. At a cutoff value using 50% in Kaplan-Meier survival analysis, the DFS was higher with TVRR-T ≥ 50% group (log-rank test, P = .024), and a trend of improved overall survival. (log-rank test, P = .069). Conclusion: TVRR-T is a probable prognostic factor for DFS. With a cut-off point of 50%, TVRR-T may indicate better DFS.

Comparative safety of immune checkpoint inhibitors and chemotherapy in advanced non-small cell lung cancer: A systematic review and network meta-analysis.

BACKGROUNDS: Immune checkpoint inhibitors (ICIs) alone or in combination with chemotherapy (CT) are the standard of care for first-line therapy in metastatic non-small cell lung cancer (NSCLC) patients without actionable mutations. The safety ranking of different ICI and CT combination regimens has not been investigated. This study was aimed to provide a toxicity profile and safety ranking of different ICI and CT combination regimens. METHODS: We performed comprehensive searches of phase 2 and 3 randomized clinical trials (RCTs) comparing different ICI regimens (alone or combination) or CT for the first-line treatment of advanced NSCLC. Outcomes of interest were the cumulative incidence of any treatment-related adverse events (TRAEs), grade 3-5 TRAEs (grade 3-5), any immune-related adverse events (irAEs), and grade 3-5 irAEs (grade 3-5). Odds ratios and 95% credible intervals were calculated as summary statistics to quantify the effect of different ICI combination regimens. RESULTS: We included 21 RCTs from 2016 to 2021 with a total of 12,626 patients. The incidence of any TRAEs and grade 3-5 TRAEs ranked from high to low were ICI-CT (probability: 88.3% and 87.1%), ICI-ICI-CT (66.2% and 73.9%), CT alone (77.7% and 86.6%), ICI-ICI (98.9% and 99.2%), and ICI monotherapy (99.7% and 100%). Adding CT to ICI regimens resulted in a higher incidence of any grade or grade 3-5 TRAEs compared to ICI-ICI combinations or ICI monotherapy. However, ICI-ICI-CT combinations did not result in a higher incidence of TRAEs than ICI-CT combinations. For any irAEs and grade 3-5 irAEs, the ranking was ICI-ICI (probability: 97.6% and 99.8%), ICI monotherapy (97.2% and 99.8%), ICI-CT (99.5% and 99.9%), and CT alone (99.9% and 100%). Notably, the incidence of any grade and grade 3-5 irAEs was lower when adding CT to ICI monotherapy. CONCLUSION: Lack of head-to-head comparisons, these findings provide evidence for clinical decision-making when considering different ICI combination regimens for advanced NSCLC patients.

Colloidal synthesis of perovskite-type lanthanum aluminate incorporated graphene oxide composites: Electrochemical detection of nitrite in meat extract and drinking water.

A novel electrochemical method has been developed for determination of nitrite using La-based perovskite-type lanthanum aluminate nanorod-incorporated graphene oxide nanosheets (LaAlO3@GO). Morphological and structural analyses of the prepared perovskite-type electrocatalyst, with and without a glassy carbon electrode (GCE) surface, were performed using various techniques, including transmission electron microscopy, energy-dispersive X-ray spectroscopy, X-ray diffractometry, Raman spectroscopy, and electrochemical impedance spectroscopy. Under optimal conditions, the LaAlO3@GO composite-modified GCE (LaAlO3@GO/GCE) exhibited excellent electrocatalytic performance toward the electrooxidation of nitrite (pH = 7.0), with a significant increase in anodic peak currents compared with the bare GCE. Using amperometry, the fabricated sensor exhibited a wide nitrite determination range from 0.01 to 1540.5 µM, with a detection limit of 0.0041 µM. Notably, the proposed LaAlO3@GO/GCE electrode demonstrated a good nitrite detection performance in different meat and water samples. In addition, the LaAlO3@GO/GCE electrode displayed excellent selectivity, repeatability, reproducibility, storage, and operational stability toward nitrite detection.