Which Should Be Used First for ALK-Positive Non-Small-Cell Lung Cancer: Chemotherapy or Targeted Therapy? A Meta-Analysis of Five Randomized Trials

Background and objectives: Targeted therapy is widely used in the era of precision medicine. Whether the sequence in which targeted therapy and chemotherapy are performed matters, is however not known. We examined the impact of the sequential treatment of targeted therapy and chemotherapy among advanced anaplastic lymphoma kinase (ALK), non-small cell lung cancer (NSCLC) patients. Materials and Methods: Randomized controlled trials comparing the use of ALK inhibitors with chemotherapy were included in this meta-analysis. We estimated the hazard ratios (HRs) and 95% confidence intervals (CI), for progression-free survival (PFS) and overall survival (OS) from a random effects model. Two-sided statistical tests were used to determine the significance of these estimates. Results: In five eligible studies (1404 patients), ALK targeted therapy, in comparison with chemotherapy, had a significantly higher PFS (HR = 0.48; 95% CI, 0.42(-)0.55), but not significantly higher OS (HR = 0.88; 95% CI, 0.72(-)1.07). Crossover from chemotherapy to ALK inhibitors was allowed after progression in all trials. The sensitivity analysis of the use of ALK inhibitors as either the first- or second-line treatment, showed improvements in PFS but not in OS. Conclusions: Our results indicate that using targeted therapy first improved PFS, but that the sequence in which the treatments were performed did not cause a significant difference in overall survival

Online Self-Concordant and Relatively Smooth Minimization, With Applications to Online Portfolio Selection and Learning Quantum States

Consider an online convex optimization problem where the loss functions are self-concordant barriers, smooth relative to a convex function $h$, and possibly non-Lipschitz. We analyze the regret of online mirror descent with $h$. Then, based on the result, we prove the following in a unified manner. Denote by $T$ the time horizon and $d$ the parameter dimension. 1. For online portfolio selection, the regret of $\widetilde{\text{EG}}$, a variant of exponentiated gradient due to Helmbold et al., is $\tilde{O} ( T^{2/3} d^{1/3} )$ when $T > 4 d / \log d$. This improves on the original $\tilde{O} ( T^{3/4} d^{1/2} )$ regret bound for $\widetilde{\text{EG}}$. 2. For online portfolio selection, the regret of online mirror descent with the logarithmic barrier is $\tilde{O}(\sqrt{T d})$. The regret bound is the same as that of Soft-Bayes due to Orseau et al. up to logarithmic terms. 3. For online learning quantum states with the logarithmic loss, the regret of online mirror descent with the log-determinant function is also $\tilde{O} ( \sqrt{T d} )$. Its per-iteration time is shorter than all existing algorithms we know.Comment: 19 pages, 1 figur

Controlled Heterogeneous Nucleation and Growth of Germanium Quantum Dots on Nanopatterned Silicon Dioxide and Silicon Nitride Substrates

Controlled heterogeneous nucleation and growth of Ge quantum dots (QDs) are demonstrated on SiO_2/Si_3N_4 substrates by means of a novel fabrication process of thermally oxidizing nanopatterned SiGe layers. The otherwise random self-assembly process for QDs is shown to be strongly influenced by the nanopatterning in determining both the location and size of the QDs. Ostwald ripening processes are observed under further annealing at the oxidation temperature. Both nanopattern oxidation and Ostwald ripening offer additional mechanisms for lithography for controlling the size and placement of the QDs

Synthesis and Morphological Transformation of Conjugated Amphiphilic Diblock Copolymers in Mixed Solvents

The synthesis, morphological transformation, and photophysical properties of a rod-coil block copolymer, poly[2,7-(9,9-dihexylfluorene)]-block-poly(2-vinylpyridine) (PF-b-P2VP), with P2VP coils of various lengths in a mixed methanol/tetrahydrofuran (MeOH/THF) solvent are reported. Various morphological structures of PF-b-P2VP aggregates, including spheres, short worm-like structures, long cylinders, and large compound micelles (LCMs), were observed after varying the coil length of PF-b-P2VP and the selectivity of mixed solvents. These aggregated structures demonstrated considerable variation with regard to optical absorption, fluorescence, and the PL quantum yield of rod-coil copolymers. The degree of hypsochromic spectral shift was enhanced as the length of P2VP coils and the content of poor solvent increased. This study reveals the influence of coil length and selectivity of solvents on the morphology and the optical characteristics of rod-coil amphiphilic copolymers

Preparation, characterization, and application of titanium nano-tube array in dye-sensitized solar cells

The vertically orientated TiO2 nanotube array (TNA) decorated with TiO2 nano-particles was successfully fabricated by electrochemically anodizing titanium (Ti) foils followed by Ti-precursor post-treatment and annealing process. The TNA morphology characterized by SEM and TEM was found to be filled with TiO2 nano-particles interior and exterior of the TiO2 nano-tubes after titanium (IV) n-butoxide (TnB) treatment, whereas TiO2 nano-particles were only found inside of TiO2 nano-tubes upon titanium tetrachloride (TiCl4) treatment. The efficiency in TNA-based DSSCs was improved by both TnB and TiCl4 treatment presumably due to the increase of dye adsorption

Prevalence and Correlates of Depression among Chronic Kidney Disease Patients in Taiwan

Background: Chronic kidney disease (CKD) is a progressive disease that causes a permanent impairment of renal function and premature mortality. The associated prognosis may result in serious psychological distress to the affected individual. However, there are limited data on the psychological correlates, and in particular depression, in Chinese CKD patients. This study aimed to examine the prevalence of depression, as well as the influence of other psychosocial factors on depression, among Taiwanese CKD patients. Methods: We used a cross-sectional research design to recruit 270 CKD patients who were not undergoing dialysis treatment at a hospital in southern Taiwan during 2011. The structured questionnaire used in this study gathered information on respondent demographic and disease characteristics, and information obtained from the Taiwanese Depression Questionnaire. Factors associated with depression were examined by a multiple logistic regression analysis. Results: The crude and age-standardized prevalence of depression were 22.6% and 20.6%, respectively. Those who had sleep disturbances, reported having no religious beliefs, followed no regular exercise regimen, and were diagnosed with stage III or above CKD demonstrated a significantly higher risk of depression. Conclusion: Our findings are beneficial to healthcare providers, as they identify both the prevalence of depression and several of its correlates. By identifying CKD patients with a higher risk of depression, healthcare providers may be better able to ensure the provision of appropriate rehabilitation to this population

Partial Nephrectomy in the Treatment of Localized Renal Cell Carcinoma — Experience of Taichung Veterans General Hospital

BackgroundPartial nephrectomy has been considered an effective and efficient method in the treatment of localized renal cell carcinoma. Herein, we retrospectively review our experience with partial nephrectomy in the treatment of localized renal cell carcinoma and compared it with patients who received radical nephrectomy.MethodsFrom 1982 to 2005, 35 patients who received partial nephrectomy for localized renal cell carcinoma were enrolled in this study. Ten patients were female (28.6%). The median age was 70 years (range, 42–82 years). Sixteen (45.7%) patients had pathologic T1a tumors; 17 (48.6%) patients had pathologic T1b tumors and 2 (5.7%) patients had pathologic T2 tumor (7 cm). In the meantime, 128 patients who had T1N0M0 renal cell carcinoma and who received radical nephrectomy were assigned to a control group. Thirty-nine patients (30.5%) were female in this group. The median age was 62 years (range, 30–83 years). The tumor characteristics, location, surgical techniques and patient survival were subsequently compared.ResultsThe median tumor size in the partial nephrectomy group was 3.9 cm (range, 1.5–7.0 cm), and it was 4.5 cm (range, 1–6.5 cm) in radical nephrectomy group. The tumor size was smaller in the partial nephrectomy group (p = 0.003). The median follow-up period was 4.38 years (range, 0.05–17.99 years) in the partial nephrectomy group and 5.66 years (range, 0.01–22.25 years) in the radical nephrectomy group. There was no local recurrence or distant metastasis in the partial nephrectomy group. The 5-year overall survival was 85.0% compared with 91.4% in the radical nephrectomy group (p = 0.126). The 5-year disease-specific survival in the partial nephrectomy group was 100%. The postoperative serum creatinine level increased to > 2.0 mg/dL in 5 (14.3%) patients in the partial nephrectomy group, but no patient needed hemodialysis during follow-up.ConclusionFrom our review, partial nephrectomy is safe and provides excellent disease control in the treatment of localized renal cell carcinoma in selected patients. Renal function preservation was observed in the partial nephrectomy group, while the operated kidney showed functioning in the follow-up nuclear medicine survey

Pressure Dependence of Fragile-to-Strong Transition and a Possible Second Critical Point in Supercooled Confined Water

By confining water in nano-pores of silica glass, we can bypass the crystallization and study the pressure effect on the dynamical behavior in deeply supercooled state using neutron scattering. We observe a clear evidence of a cusp-like fragile-to-strong (F-S) dynamic transition. Here we show that the transition temperature decreases steadily with an increasing pressure, until it intersects the homogenous nucleation temperature line of bulk water at a pressure of 1600 bar. Above this pressure, it is no longer possible to discern the characteristic feature of the F-S transition. Identification of this end point with the possible second critical point is discussed.Comment: 4 pages, 3 figure