Search

Proteinuria is a common adverse event arising from treatment with bevacizumab, requiring diagnostic testing via 24-h urine collection. However, this method is cumbersome. We assessed urine screenings in gynecologic cancer patients from February 2021 to May 2022. Along with a simple urine dipstick (UD), the urine microalbumin, total protein, and creatinine were measured and calculated as the urine albumin to creatinine ratio (UACR) and the urine protein to creatinine ratio (UPCR), which were further adjusted through the Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration equations to be estimated and correlated with 24-h urine total protein content. The incremental cost-effectiveness ratio was used for cost analysis. There were 129 urine samples from 36 patients. The sensitivity and specificity for the UACR were 0.56 and 0.97, and for the UPCR, 0.71 and 0.88, respectively. The 24-h TP correlated strongly with the UACR (r = 0.75; p < 0.001) and UPCR (r = 0.79; p < 0.001) and fair for the simple UD (r = 0.35; p < 0.001). The UPCR saves one unnecessary 24-h urine test for less than a dollar compared to a simple UD. The results indicate that using the UPCR could enhance diagnostic accuracy, lower costs, and reduce unnecessary 24-h urine sampling.

Objective: To demonstrate a successful surgical treatment and reconstruction in a case of malignant mucosal vulvar melanoma. Case report: A 52-year-old woman had stage II bulky malignant mucosal vulvar melanoma and received wide surgical excision with partial vulvectomy. She underwent 2-steps reconstructive vulvoplasty and vaginoplasty with skin grafting 1 year after initial surgical treatment. There was no evidence of recurrence after 3 years of follow-up. Conclusion: Vulvar melanoma is a rare malignant neoplasm. Wide local excision with reconstruction can relieve pelvic discomfort and restore local function after the surgery.

Abstract Background Ovarian clear cell carcinoma (OCCC) is the most common endometriosis-associated ovarian cancer. Ovarian endometriosis may present with atypical or malignant sonographic features and interfere with clinical judgment about whether definitive surgical intervention is required. Objective To compare the characteristics of endometrioma with atypical features and OCCC. Methods This study enrolled patients with pathologic diagnoses of either endometrioma or OCCC. For patients with endometrioma, only those with atypical features, defined as the presence of at least one of the following sonographic characteristics: cyst diameter of 10 ± 1 cm, multi-cystic lesions, any solid component or papillary structure, and blood flow of any degree, were included. Results Sixty-three patients had endometriomas with atypical features, while 57 patients had OCCC. Patients with endometriomas were younger (39.33 ± 7.04 years vs. 53.11 ± 9.28 years, P 47.5 years), large cysts (> 11.55 cm), large solid components (size > 1.37 cm), and loss of ground-glass echogenicity were independent factors suggestive of malignancy. Conclusion Advanced age, larger cyst sizes, larger solid component sizes, and loss of ground-glass echogenicity are major factors differentiating endometriomas from malignancies. For women in menopausal transition who have finished childbearing who present with endometrioma with atypical features, removal of the adnexa intact could be considered.

Abstract Women who underwent vaginal pelvic reconstructive surgery with or without mesh consecutively between 2004 and 2018 were retrospectively analyzed to determine the learning curve in vaginal pelvic reconstructive surgery. With cumulative summation (CUSUM) analysis of surgical failure and operation time, we assessed the learning curve of vaginal pelvic reconstructive surgery, including sacrospinous ligament fixation, anterior colporrhaphy, posterior colporrhaphy, and optional vaginal hysterectomy with or without mesh placement. The study is based on two individual surgeons who performed vaginal pelvic reconstructive surgery with or without mesh. Two hundred and sixty-four women with stage III or IV pelvic organ prolapse underwent vaginal pelvic reconstructive surgery by surgeons A or B. The median follow-up time of 44 months ranged from 24 to 120 months. Surgical proficiency was achieved in 32–33 vaginal pelvic reconstructive surgery procedures without mesh and 37–47 procedures in the same surgery with mesh. The total surgical success rates for surgeons A and B were 82.2% and 94.1%, with median follow-up times of 60 and 33 months, respectively. More procedures were needed for the learning curve of vaginal pelvic reconstructive surgery with mesh. Having crossed the proficiency boundary, the surgical success rate and operation time were improved.

The functional interleukin 6 (IL-6) signaling complex is a hexameric structure composed of IL-6, IL-6Rα, and the signaling receptor gp130. There are three different modes of IL-6 signaling, classic signaling, trans-signaling, and trans-presentation, which are not functionally redundant and mediate pleiotropic effects on both physiological and pathophysiological states. Monoclonal antibodies against IL-6 or IL-6Rα have been successfully developed for clinical application. However, designing therapeutic interventions that block specific modes of IL-6 signaling in a pathologically relevant manner remains a great challenge. Here, we constructed a fusion protein Hyper-IL-6 (HyIL-6) composed of human IL-6 and IL-6Rα to develop specific blocking antibodies against the IL-6/IL-6Rα complex. We successfully screened the monoclonal antibody C14mab, which can bind to HyIL-6 with the binding constant 2.86 × 10−10 and significantly inhibit IL-6/IL-6Rα/gp130 complex formation. In vitro, C14mab effectively inhibited HyIL-6-stimulated signal transducer and activator of transcription 3 (STAT3) activation and related vascular endothelial growth factor (VEGF) induction. Moreover, C14mab efficaciously suppressed HyIL-6-induced acute phase response in vivo. Our data from hydrogen-deuterium exchange mass spectrometry demonstrate that C14mab mainly binds to site IIIa of IL-6 and blocks the final step in the interaction between gp130 and IL-6/IL-6Rα complex. Additionally, data from enzyme-linked immunosorbent assays and kinetics assays indicate that C14mab interacts simultaneously with IL-6 and IL-6Rα, while it does not interact with IL-6Rα alone. The unique features of C14mab may offer a novel alternative for IL-6 blockade and illuminate a better therapeutic intervention targeting IL-6.

Fluorescence spectroscopy has been demonstrated to non-invasively detect changes related to precursors of epithelial cancers, which include decreased fluorescence emission from collagen crosslinks in the connective tissue and increased fluorescence emission from reduced nicotinamide adenine dinucleotide (NADH) in the epithelial tissue. We implemented two-layer forward Monte Carlo models to predict diffuse reflectance and fluorescence intensities at the surface of cervical mucosa given tissue absorption, scattering, and fluorescence properties. The absorption and scattering coefficients of the upper epithelial layer and underlying connective tissue, as well as the epithelial thickness, were estimated from diffuse reflectance spectra using iterative curve fitting. The estimated parameters were used by the fluorescence forward model to obtain quantities needed to relate the intrinsic fluorescence of tissue fluorophores to measured fluorescence intensity. The emission spectra of tissue fluorophores were modeled by skew normal functions, and together with the efficiency of the fluorophores were extracted by fitting the modeled fluorescence spectra to measured spectra using the genetic algorithm. Compared to conventional one-layer forward models, the proposed two-layer models showed significantly smaller errors both in tissue properties estimated from simulated spectra, and in spectral errors of fitting to in-vivo data. Results of a preliminary in-vivo study showed that in seven of eight subjects with histopathologically confirmed dysplasia, the NADH-to-collagen intrinsic fluorescence ratio estimated from the biopsied site was at least two times greater than that estimated from the normal site on the same subject. The ability to more accurately estimate layer-specific intrinsic fluorescence from cervical mucosa could aid the detection of precancers in the cervix as well as other sites including oral and esophageal mucosae.

Uterine sarcoma is a very aggressive and highly lethal disease. Even after a comprehensive staging surgery or en block cytoreduction surgery followed by multimodality therapy (often chemotherapy and/or radiation therapy), many patients relapse or present with distant metastases, and finally die of diseases. The worst outcome of uterine sarcomas is partly because of their rarity, unknown etiology, and highly divergent genetic aberration. Uterine sarcomas are often classified into four distinct subtypes, including uterine leiomyosarcoma, low-grade uterine endometrial stromal sarcoma, high-grade uterine endometrial stromal sarcoma, and undifferentiated uterine sarcoma. Currently, evidence from tumor biology found that these tumors showed alternation and/or mutation of genomes and the intracellular signal pathway. In addition, some preclinical studies showed promising results for targeting receptor tyrosine kinase signaling, phosphatidylinositol 3-kinase/AKT/mammalian target of rapamycin pathway, various kinds of growth factor pathways, Wnt/beta-catenin signaling pathway, transforming growth factor β/bone morphogenetic protein signal pathway, aurora kinase A, MDM2 proto-oncogene, histone deacetylases, sex hormone receptors, certain types of oncoproteins, and/or loss of tumor suppressor genes. The current review is attempted to summarize the recurrent advance of targeted therapy for uterine sarcomas.

Uterine fibroids (leiomyomas) are the most common benign tumours in women during their reproductive age. Hyperplasia of uterine smooth muscle cells and abnormal deposition of extracellular matrix (ECM) are responsible for the development of uterine fibroids. Studies have shown that food rich in phytochemicals can prevent or treat leiomyoma. Therefore, the purpose of this study is to demonstrate the inhibitory effects of resveratrol on uterine fibroid cell growth and ECM-associated protein expression. We found that resveratrol inhibited the proliferation of leiomyoma cell line (ELT3) and uterine smooth muscle cell line (UtSMC) and affected the cell morphology of both cell lines, induced cell cycle arrest at S and G2/M phase, regulated cell apoptosis associated protein expression and induced cell apoptosis, and affected ECM-associated mRNA and protein expression. Our results suggest that resveratrol is potentially effective in preventing the hyperplasia of leiomyoma and uterine smooth muscle cells.

Objective: Pelvic tuberculosis is rare, but is problematic for differential diagnosis. In this communication, we report a case series of pelvic tuberculosis clinically presenting as ovarian malignancy. Case Series: Over the past 10 years in our hospital, six cases of pelvic tuberculosis were seen. Five were thought to be ovarian malignancies, presenting either with ascites, an elevation of serum CA-125, or an adnexal tumor. Four patients underwent exploratory laparotomy and one received only peritoneoscopic biopsy. Extensive peritoneal seedings and omental thickening were discovered in all cases. Caseating granuloma on histopathologic examination was found in all of the patients. Four out of five patients received a complete course of combined anti-tuberculous treatment. All remain free of disease. Conclusion: Pelvic tuberculosis should be taken into account, especially in premenopausal women who manifest with massive ascites and adnexal tumors. Tumor markers such as CA-125 give limited information for the differential diagnosis of pelvic tuberculosis and ovarian carcinoma. We suggest exploratory laparotomy and intraoperative frozen pathology for the diagnosis of pelvic tuberculosis. New insight needs to be applied to tuberculosis.

Oral cancer, which is the fourth most common cancer in Taiwanese men, is associated with environmental carcinogens. The possibility that genetic predisposition in nuclear factor-kappa B (NF-κB)-signaling pathways activation is linked to the development of oral squamous cell carcinoma (OSCC) requires investigation. The current study examines associations between polymorphisms within promoter regions of NFKB1 encoding NF-κB1 and NFKBIA encoding IkappaBalpha (IκBα) with both the susceptibility to develop OSCC and the clinicopathological characteristics of the tumors.Genetic polymorphisms of NFKB1 and NFKBIA were analyzed by a real-time polymerase chain reaction (real-time PCR) for 462 patients with oral cancer and 520 non-cancer controls. We found that NFKB1 -94 ATGG1/ATGG2, -94 ATGG2/ATGG2, and the combination of -94 ATGG1/ATGG2 and ATGG2/ATGG2 genotypes NFKBIA -826 T (CT+TT) and -881 G (AG+GG) allelic carriages, were more prevalent in OSCC patients than in non-cancer participants. Moreover, we found that NFKB1 or NFKBIA gene polymorphisms seem to be related to susceptibility to develop oral cancer linked to betel nut and tobacco consumption. Finally, patients with oral cancer who had at least one -519 T allele of the NFKBIA gene were at higher risk for developing distant metastasis (P

In Taiwan, oral cancer has causally been associated with environmental carcinogens. Carbonic anhydrase 9 (CA9) is reportedly overexpressed in several types of carcinomas and is generally considered a marker of malignancy. The current study explored the combined effect of CA9 gene polymorphisms and exposure to environmental carcinogens on the susceptibility of developing oral squamous cell carcinoma (OSCC) and the clinicopathological characteristics of the tumors.Four single-nucleotide polymorphisms (SNPs) of the CA9 gene from 462 patients with oral cancer and 519 non-cancer controls were analyzed by a real-time polymerase chain reaction (PCR). While the studied SNPs (CA9 rs2071676, rs3829078, rs1048638 and +376 Del) were not associated with susceptibility to oral cancer, the GAA haplotype of 3 CA9 SNPs (rs2071676, rs3829078, and rs1048638) was related to a higher risk of oral cancer. Moreover, the four CA9 SNPs combined with betel quid chewing and/or tobacco consumption could robustly elevate susceptibility to oral cancer. Finally, patients with oral cancer who had at least one G allele of CA9 rs2071676 were at higher risk for developing lymph-node metastasis (p = 0.022), compared to those patients homozygous for AA.Our results suggest that the haplotype of rs2071676, rs3829078, and rs1048638 combined has potential predictive significance in oral carcinogenesis. Gene-environment interactions of CA9 polymorphisms, smoking, and betel-quid chewing might alter oral cancer susceptibility and metastasis.

Purpose: Hydrochlorothiazide (HCTZ) exposure has been linked to increased skin cancer in Caucasian (white) populations, especially squamous cell carcinoma (SCC), but not basal cell carcinoma (BCC). This study aimed to evaluate and compare skin cancer risks associated with HCTZ‐ and other antihypertensives use. Methods: This retrospective cohort study utilized Taiwan's National Health Insurance Research Database. We identified patients aged 20 years and older, newly receiving antihypertensive medications between 2004 and 2015. We calculated the medication possession ratio (MPR) for the first 2 years of treatment to determine patient eligibility and treatment classification, whereby only patients with MPR above 80% were included. These were subsequently categorized by the type of antihypertensives they received, namely HCTZ, other thiazide diuretics, non‐thiazide diuretics or non‐diuretic antihypertensives. Cox proportional hazards model was used to evaluate skin cancer risks, and these were then classified as SCC or BCC. Results: Our study included 41 086, 27 402, 19 613, and 856 782 patients receiving HCTZ, other thiazide diuretics, non‐thiazide diuretics, and non‐diuretic antihypertensives, respectively. We found BCC risks were similar when comparing HCTZ with other thiazides (adjusted hazard ratio: 0.84; 95% CI: 0.54–1.33), non‐thiazide diuretics (0.93; 0.51–1.67), and non‐diuretic antihypertensives (0.91; 0.66–1.26). We observed a higher SCC risk in the HCTZ group, compared to other thiazides (1.24; 0.74–2.08), non‐thiazide diuretics (1.32; 0.70–2.51), and non‐diuretic antihypertensives (1.23; 0.87–1.73), although the confidence intervals (CIs) were wide and crossed the null. Conclusions: We concluded that skin cancer need not be of major concern to physicians when prescribing antihypertensives for an Asian population. [ABSTRACT FROM AUTHOR]

This article explores whether a learning community can affect students' learning achievement and engagement. Besides, this study also analyzed whether degree centralities of peer interaction affect learning achievement and learning engagement based on social network analysis. While the experimental group combined the English learning system with the online learning community, the control group was simply using the English learning system. The results indicated that the students' engagement from the online learning community were higher than the ones who used the English learning system only, although the learning achievement is not significant difference between these two groups. Moreover, higher interaction learners from the online learning community revealed better performance in learning achievement and student engagement. Other than that, the learners who played the "Center" emerged with a higher learning achievement as well as the students' engagement than the "Periphery" ones. The research provides suggestions for online learning with learning communications as well.

Several guidelines do not recommend beta-blocker as the first-line treatment for hypertension because of its inferior efficacy in stroke prevention. Combination therapy with beta-blocker is commonly used for blood pressure control. We compared the clinical outcomes in patients treated with amlodipine plus bisoprolol (A + B), a ß1-selective beta-blocker and amlodipine plus valsartan (A + V). A population-based cohort study was performed using data from the Taiwan National Health Insurance Research Database. From 2012 to 2019, newly diagnosed adult hypertensive patients who received initial amlodipine monotherapy and then switched to A + V or A + B were included. The efficacy outcomes included all-cause death, atherosclerotic cardiovascular disease (ASCVD) event (cardiovascular death, myocardial infarction, ischemic stroke, and coronary revascularization), hemorrhagic stroke, and heart failure. Multivariable Cox proportional hazards model was used to evaluate the relationship between outcomes and different treatments. Overall, 4311 patients in A + B group and 10980 patients in A + V group were included. After a mean follow-up of 4.34 ± 1.79 years, the efficacy outcomes were similar between the A + V and A + B groups regarding all-cause death (adjusted hazard ratio [aHR] 0.99, 95% confidence interval [CI] 0.83–1.18), ASCVD event (aHR 0.97, 95% CI 0.84–1.12), and heart failure (aHR 1.06, 95% CI 0.87–1.30). The risk of hemorrhagic stroke was lower in A + B group (aHR 0.70, 95% CI 0.52–0.94). The result was similar when taking death into consideration in competing risk analysis. The safety outcomes were similar between the 2 groups. There was no difference of all-cause death, ASCVD event, and heart failure in A + B vs. A + V users. But A + B users had a lower risk of hemorrhagic stroke. [ABSTRACT FROM AUTHOR]

Master–slave teleoperation systems with haptic feedback enable human operators to interact with objects or perform tasks in remote environments. This paper presents a sliding-mode control scheme tailored for bilateral teleoperation systems operating in the presence of unknown uncertainties and time-varying delays. To address unknown but bounded uncertainties, adaptive laws are derived alongside controller design. Additionally, a linear matrix inequality is solved to determine the allowable bound of delays. Stability of the closed-loop system is ensured through Lyapunov–Krasovskii functional analysis. Two-degree-of-freedom mechanisms are self-built as haptic devices. Free-motion and force-perception scenarios are examined, with experimental results validating and comparing performances. The proposed adaptive-sliding-control method increases the position performance from 58.48% to 82.55% and the force performance from 83.48% to 99.77%. The proposed control scheme demonstrates enhanced position tracking and force perception in bilateral teleoperation systems. [ABSTRACT FROM AUTHOR]

This paper focuses on the development of an improved Generative Adversarial Network (GAN) specifically designed for generating color portraits from sketches. The construction of the system involves using a GPU (Graphics Processing Unit) computing host as the primary unit for model training. The tasks that require high-performance calculations are handed over to the GPU host, while the user host only needs to perform simple image processing and use the model trained by the GPU host to generate images. This arrangement reduces the computer specification requirements for the user. This paper will conduct a comparative analysis of various types of generative networks which will serve as a reference point for the development of the proposed Generative Adversarial Network. The application part of the paper focuses on the practical implementation and utilization of the developed Generative Adversarial Network for the generation of multi-skin tone portraits. By constructing a face dataset specifically designed to incorporate information about ethnicity and skin color, this approach can overcome a limitation associated with traditional generation networks, which typically generate only a single skin color. [ABSTRACT FROM AUTHOR]

This paper aims to investigate the feasibility of using system power consumption as a factor to improve laptop heat dissipation. The problems due to the CPU overheating are addressed. Based on the Taguchi method, the laptop fan parameters can be optimized with firmware adjustments only. In the Taguchi analysis, the fan speed, system power, and debounce time are considered as control factors, while the Cinebench point is utilized to evaluate the CPU performance. Experimental results demonstrate that the proposed heat dissipation scheme effectively reduces the idle time of a laptop fan. The improvement in heat dissipation can reduce CPU performance degradation because of overheating. According to the best combination of control factors, there is approximately a 5% increase in CPU performance despite a 0.35% increment in power consumption. This paper highlights the effectiveness of optimizing laptop fan parameters through firmware adjustments to improve heat dissipation and mitigate CPU overheating issues. Moreover, the study highlights the delicate balance between power consumption and performance gains. While there may be a slight increase in power consumption associated with the optimized heat dissipation scheme, the observed improvements in CPU performance outweigh this incremental power usage. [ABSTRACT FROM AUTHOR]

This paper aims to establish a predictive model for battery lifetime using data analysis. The procedure of model establishment is illustrated in detail, including the data pre-processing, modeling, and prediction. The characteristics of lithium-ion batteries are introduced. In this study, data analysis is performed with MATLAB, and the open-source battery data are provided by NASA. The addressed models include the decision tree, nonlinear autoregression, recurrent neural network, and long short-term memory network. In the part of model training, the root-mean-square error, integral of the squared error, and integral of the absolute error are considered for the cost functions. Based on the defined health indicator, the remaining useful life of lithium-ion batteries can be predicted. The confidence interval can be used to describe the level of confidence for each prediction. According to the test results, the long short-term memory network provides the best performance among all addressed models. [ABSTRACT FROM AUTHOR]