Ambulatory prescriptions with short-acting nifedipine as a PRN (pro re nata) order in Taiwan, 1997–2011 (0.2% sampling).

<p>Ambulatory prescriptions with short-acting nifedipine as a PRN (pro re nata) order in Taiwan, 1997–2011 (0.2% sampling).</p

Characteristics of ambulatory visits in Taiwan, 1997–2011 (0.2% sampling).

a<p>CCBs: calcium channel blockers.</p>b<p>PRN: pro re nata.</p

Additional file 1 of Comparative cardiovascular safety of LABA/LAMA FDC versus LABA/ICS FDC in patients with chronic obstructive pulmonary disease: a population-based cohort study with a target trial emulation framework

Additional file 1: Table S1. Specification and emulation of a target trial of LABA/LAMA FDC versus LABAICS FDC among patients with COPD using real-world data from Taiwan NHIRD. Table S2. International Classification of Diseases, 9th or 10th Revision, Clinical Modification diagnosis codes used to identify patients with COPD. Table S3. Anatomical Therapeutic Chemical classification system codes used to identify use of LABA/LAMA FDC or LABA/ICS FDC. Table S4. International Classification of Diseases, 9th or 10th Revision, Clinical Modification diagnosis codes used to identify outcomes of interest and the positive control outcome. Table S5. International Classification of Diseases, 9th or 10th Revision, Clinical Modification diagnosis or procedure codes or Taiwan health insurance service claims codes used to identify comorbidities and measures of healthcare services at baseline. Table S6. Anatomical Therapeutic Chemical classification system codes used to identify medication use at baseline. Table S7. Measurement of the 11 clinical parameters at baseline. Table S8. Summary of subgroup analyses. Table S9. Patient characteristics of the eligible cohort before and after PS matching. Table S10. Number of patients and events, follow-up duration, incidence rate, and risk of pneumonia comparing LABA/LAMA FDC with LABA/ICS FDC before and after PS matching. Table S11. Number of patients and events, follow-up duration, incidence rate, and risk of composite cardiovascular events comparing LABA/LAMA FDC with LABA/ICS FDC before and after PS matching, by intention-to-treat approach. Table S12. Availability of the clinical parameters at baseline in the eligible cohort. Table S13. Clinical parameters of the imputed cohort before and after PS matching. Table S14. Number of patients, number of events, and risk of composite cardiovascular events comparing LABA/LAMA FDC versus LABA/ICS FDC before and after PS matching, by patient characteristic. Table S15. Number of patients, number of events, and risk of composite cardiovascular events comparing LABA/LAMA FDC versus LABA/ICS FDC before and after PS score matching, by individual LABA/LAMA FDC and LABA/ICS FDC. Table S16. Number of patients, number of events, and risk of composite cardiovascular events comparing LABA/LAMA FDC versus LABA/ICS FDC before and after PS matching, by treatment duration. Table S17. Selected patient characteristics at baseline and cardiovascular outcomes during follow-up of three substantial efficacy trials and our study. Figure S1. Study cohort assembly. Figure S2. Distributions of propensity score by study drug before and after PS matching. Figure S3. Cumulative incidence plots of composite cardiovascular events by study FDC treatment before and after PS matching derived from complement of the Kaplan-Meier survival function. Figure S4. Cumulative incidence plots of composite cardiovascular events by study FDC treatment before and after PS matching accounting for the influence of competing risk from overall death

Data_Sheet_1_Letrozole as premedication of high intensity focused ultrasound treatment of uterine fibroids: A retrospective observation study.docx

BackgroundNo reports on Letrozole as a pretreatment before ablation of uterine fibroid with high intensity focused ultrasound (HIFU), so a retrospective observation study was performed to evaluate the response of different pre-HIFU medication.MethodsWe collected patients with single uterine fibroid receiving HIFU ablation from January 2018 to April 2021. All enrolled patients were classified into three group: group A (no pre-HIFU medication use), group B (Pre-HIFU letrozole use), group C (pre-HIFU gonadotrophin releasing hormone analog, GnRHa). Further associated clinical data and treatment response after HIFU treatment were reviewed and evaluated.ResultsA total of 39 patients including 21, 7, and 11 in group A, B, and C were collected respectively. After pre-HIFU medication, no difference of fibroid volume was found (A: 251.4, B: 360.6, C: 409.4 cm3, p = 0.250), and GnRHa group had significantly larger volume reduction than Letrozole users (38.6% vs. 16.4%, p = 0.007). The incidence of hypoestrogenic symptoms was higher in GnRHa group than in letrozole users (27.3% vs. 0, p = 0.170). GnRHa group had more sonication time (p = 0.001), treatment duration (p = 0.002), and ablated energy (p = 0.001) than group A and B. The treatment efficiency was higher in letrozole group than that in other 2 groups (4.52 vs. 2.39 vs. 2.34 cm3/min, p = 0.050). For patients with fibroid over 10 cm in diameter, letrozole group had even better energy efficiency (p = 0.067), treatment speed (p = 0.007), treatment efficiency (p = 0.001), NPV per energy (p = 0.005), and NPV per sonication (p = 0.004) than other 2 groups.ConclusionLetrozole as a pretreatment medication before HIFU treatment might increase the energy efficiency and treatment efficiency of its ablation of uterine leiomyoma, especially for fibroid over 10 cm. Future study of larger patient number is needed to confirm our results.</p

Tubular graphene architectures at the macroscopic scale: fabrication and properties

<p>Specific graphene architectures at the macroscopic scale are paramount for exploring new functions and practical uses of graphene. In this study, macroscopic, freestanding, and tubular graphene (TG) architectures were successfully fabricated through a versatile and robust process based on the annealing of cellulose acetate (CA) on Ni templates. These TG architectures can be obtained as woven tubes with diameters of approximately 50 μm; they possess high graphitic crystallinity, strong electrical conductivity, and favorable corrosion resistance. The effects of processing parameters, such as annealing temperature, annealing time, and amount of CA, on the graphene properties of these architectures were investigated and are discussed in this paper. The graphene properties were characterized through field emission scanning electron microscopy, high-resolution transmission electron microscopy, atomic force microscopy, Raman spectroscopy, four-point probe resistivity, and electrochemical measurements.</p

Biophysical Regulations of Epigenetic State and Notch Signaling in Neural Development Using Microgroove Substrates

A number of studies have recently shown how surface topography can alter the behavior and differentiation patterns of different types of stem cells. Although the exact mechanisms and molecular pathways involved remain unclear, a consistent portion of the literature points to epigenetic changes induced by nuclear remodeling. In this study, we investigate the behavior of clinically relevant neural populations derived from human pluripotent stem cells when cultured on polydimethylsiloxane microgrooves (3 and 10 μm depth grooves) to investigate what mechanisms are responsible for their differentiation capacity and functional behavior. Our results show that microgrooves enhance cell alignment, modify nuclear geometry, and significantly increase cellular stiffness, which we were able to measure at high resolution with a combination of light and electron microscopy, scanning ion conductance microscopy (SICM), and atomic force microscopy (AFM) coupled with quantitative image analysis. The microgrooves promoted significant changes in the epigenetic landscape, as revealed by the expression of key histone modification markers. The main behavioral change of neural stem cells on microgrooves was an increase of neuronal differentiation under basal conditions on the microgrooves. Through measurements of cleaved Notch1 levels, we found that microgrooves downregulate Notch signaling. We in fact propose that microgroove topography affects the differentiation potential of neural stem cells by indirectly altering Notch signaling through geometric segregation and that this mechanism in parallel with topography-dependent epigenetic modulations acts in concert to enhance stem cell neuronal differentiation

Association between Physician Specialty and Risk of Prescribing Inappropriate Pill Splitting

<div><p>Background</p><p>Prescription errors that occur due to the process of pill splitting are a common medication problem; however, available prescription information involving inappropriate pill splitting and its associated factors is lacking.</p><p>Methods</p><p>We retrospectively evaluated a cohort of ambulatory prescriptions involving extended-release or enteric-coated formulations in a Taiwan medical center during a 5-month period in 2010. For this study, those pill splitting prescriptions involving special oral formulations were defined as inappropriate prescriptions. Information obtained included patient demographics, prescriber specialty and prescription details, which were assessed to identify factors associated with inappropriate pill splitting.</p><p>Results</p><p>There were 1,252 inappropriate prescriptions identified in this cohort study, representing a prescription frequency for inappropriate pill splitting of 1.0% among 124,300 prescriptions with special oral formulations. Among 35 drugs with special oral formulations in our study, 20 different drugs (57.1%, 20/35) had ever been prescribed to split. Anti-diabetic agents, cardiovascular agents and central nervous system agents were the most common drug classes involved in inappropriate splitting. The rate of inappropriate pill splitting was higher in older (over 65 years of age) patients (1.1%, 832/75,387). Eighty-seven percent (1089/1252) of inappropriate prescriptions were prescribed by internists. The rate of inappropriate pill splitting was highest from endocrinologists (3.4%, 429/12,477), nephrologists (1.3%, 81/6,028) and cardiologists (1.3%, 297/23,531). Multivariate logistic regression analysis revealed that the strongest factor associated with individual specific drug of inappropriate splitting was particular physician specialties.</p><p>Conclusion</p><p>This study provides important insights into the inappropriate prescription of special oral formulation related to pill splitting, and helps to aggregate information that can assist medical professionals in creating processes for reducing inappropriate pill splitting in the future.</p></div

Characteristics of ambulatory prescribed drug items with oral extended-release or enteric-coated formulations that should not be split over the study period.

a<p>Top 10 drugs which most frequently triggered warnings during the intervention period.</p>b<p>Drugs were classified by the American Hospital Formulary Service (AHFS) Pharmacologic-Therapeutic Classification System.</p><p>Characteristics of ambulatory prescribed drug items with oral extended-release or enteric-coated formulations that should not be split over the study period.</p

Impact of Excitation Intensity-Dependent Fluorescence Intensity Ratio of Upconversion Nanoparticles on Wide-Field Thermal Imaging

Erbium ion (Er3+)-doped upconversion nanoparticles (UCNPs) are frequently used for nanothermometry because their fluorescence intensity ratio (FIR) between two green emission bands at ∼525 and ∼545 nm is sensitive to temperature variation. One of the prerequisites for nanothermometry is that the FIR be independent of excitation intensity at constant temperature. In this work, the effect of excitation intensity on the FIR of core–double-shell NaYF4:Yb3+,Er3+@NaYF4:Yb3+,Nd3+@NaYF4 UCNPs was investigated in two environments. The first environment is in aqueous solution, and the second is a monolayer of UCNPs on top of a silica–silicon substrate in air. The experimental results showed that the FIR decreases with the excitation intensity at constant temperature in each case. We further found that the excitation intensity-dependent FIR indeed deteriorated the thermal images acquired by wide-field upconversion fluorescence microscopy, in which a Gaussian laser beam was used to excite UCNPs uniformly coated on a silica–silicon substrate. The nonuniform excitation intensity of the incident laser beam resulted in thermal images that showed nonuniform temperature distributions in a 100 μm range field of view, even though the whole sample was maintained at constant temperature in air. To tackle this problem, we first measured the excitation intensity and temperature dependence of the FIR and the excitation laser intensity distribution on the sample. We then developed a correction scheme to correct the thermal images. With our correction process, the temperature distribution on the sample can be accurately mapped even with nonuniform illumination