Clinical impacts of the concomitant use of L-asparaginase and total parenteral nutrition containing L-aspartic acid in patients with acute lymphoblastic leukemia

IntroductionL-asparaginase (ASNase) depletes L-asparagine and causes the death of leukemic cells, making it a mainstay for the treatment of acute lymphoblastic leukemia (ALL). However, ASNase's activity can be inhibited by L-aspartic acid (Asp), which competes for the same substrate and reduces the drug's efficacy. While many commercially used total parenteral nutrition (TPN) products contain Asp, it is unclear how the concomitant use of TPNs containing Asp (Asp-TPN) affects ALL patients treated with ASNase. This propensity-matched retrospective cohort study evaluated the clinical effects of the interaction between ASNase and Asp-TPN.MethodsThe study population included newly diagnosed adult Korean ALL patients who received VPDL induction therapy consisting of vincristine, prednisolone, daunorubicin, and Escherichia coli L-asparaginase between 2004 and 2021. Patients were divided into two groups based on their exposure to Asp-TPN: (1) Asp-TPN group and (2) control group. Data, including baseline characteristics, disease information, medication information, and laboratory data, were collected retrospectively. The primary outcomes for the effectiveness were overall and complete response rates. Relapse-free survival at six months and one year of treatment were also evaluated. The safety of both TPN and ASNase was evaluated by comparing liver function test levels between groups. A 1:1 propensity score matching analysis was conducted to minimize potential selection bias.ResultsThe analysis included a total of 112 ALL patients, and 34 of whom received Asp-TPN and ASNase concomitantly. After propensity score matching, 30 patients remained in each group. The concomitant use of Asp-TPN and ASNase did not affect the overall response rate (odds ratio [OR] 0.53; 95% confidence interval [CI] = 0.17–1.62) or the complete response rate (OR 0.86; 95% CI = 0.29–2.59) of the ASNase-including induction therapy. The concomitant use of Asp-TPN and ASNase also did not impact relapse-free survival (RFS) at six months and one year of treatment (OR 1.00; 95% CI = 0.36–2.78 and OR 1.24; 95% CI, 0.50–3.12, respectively). The peak levels of each liver function test (LFT) and the frequency of LFT elevations were evaluated during induction therapy and showed no difference between the two groups.ConclusionThere is no clear rationale for avoiding Asp-TPN in ASNase-treated patients

Efficient fiber-shaped perovskite photovoltaics using silver nanowires as top electrode

Methylammonium lead iodide (CH3NH3PbI3) perovskite solar cell in a flexible fiber shape is developed via a fully dipping process with a mixed solvent of N, N-dimethylformamide (DMF) and N-methyl-2-pyrrolidone (NMP) followed by toluene dipping. We introduce the first-ever effective n-type compact layer through facile anodizing of titanium wire, achieving a considerable power conversion efficiency of 3.85%, which remains stable during bending; spray-deposited silver nanowires (Ag NWs) are used as the top electrode instead of gold. The ease of fabrication, low cost of materials, and all-solid-state structures result in a simple approach to developing electronic textiles for harvesting solar energy and blazes a new trail in the field of fiber-shaped photovoltaicsclose

Graphene modified vanadium pentoxide nanobelts as an efficient counter electrode for dye-sensitized solar cells

Efficient dye-sensitized solar cells (DSSCs) were fabricated using graphene modified vanadium pentoxide nanobelts (GVNBs) as a cost-effective counter electrodes (CEs). GVNBs were synthesized by facile one-step hydrothermal method without using any reducing agent and harmful solvents. These novel nanocomposite have been tested as a counter electrode in DSSCs for the first time, which showed high solar to electrical energy conversion efficiency. The GVNBs showed the excellent electrocatalytic activity for the reduction of triiodide to iodide due to the synergetic effect between one-dimensional shape of vanadium pentoxide nanobelts and reduced graphene oxide. The DSSCs based on the GVNBs CEs have reached a high power conversion efficiency of 6.17%, which is comparable to that (7.98%) of the conventional platinum (Pt)-based CEs. This result indicate that GVNBs can be used as an alternative to conventional Pt-based CEs for the highly efficient DSSCs.clos

Current globalization of drug interventional clinical trials: characteristics and associated factors, 2011–2013

Abstracts Background Clinical trial globalization is a major trend for industry-sponsored clinical trials. There has been a shift in clinical trial sites towards emerging regions of Eastern Europe, Latin America, Asia, the Middle East, and Africa. Our study objectives were to evaluate the current characteristics of clinical trials and to find out the associated multiple factors which could explain clinical trial globalization and its implications for clinical trial globalization in 2011–2013. Methods The data elements of “phase,” “recruitment status,” “type of sponsor,” “age groups,” and “design of trial” from 30 countries were extracted from the ClinicalTrials.gov website. Ten continental representative countries including the USA were selected and the design elements were compared to those of the USA. Factors associated with trial site distribution were chosen for a multilinear regression analysis. Results The USA, Germany, France, Canada, and United Kingdom were the “top five” countries which frequently held clinical trials. The design elements from nine continental representative countries were quite different from those of the USA; phase 1 trials were more prevalent in India (OR 1.517, p < 0.001) while phase 3 trials were much more prevalent in all nine representative countries than in the USA. A larger number of “child” age group trials was performed in Poland (OR 1.852, p < 0.001), Israel (OR 1.546, p = 0.005), and South Africa (OR 1.963, p < 0.001) than in the USA. Multivariate analysis showed that health care expenditure per capita, Economic Freedom Index, Human Capital Index, and Intellectual Property Rights Index could explain the variance of regional distribution of clinical trials by 63.6%. Conclusions The globalization of clinical trials in the emerging regions of Asia, South Africa, and Eastern Europe developed in parallel with the factors of economic drive, population for recruitment, and regulatory constraints

Additional file 3: of Current globalization of drug interventional clinical trials: characteristics and associated factors, 2011–2013

Number values of associated factors (explanatory variables) considered in regression analysis on clinical trial site distribution. (DOCX 16 kb

Additional file 2: of Current globalization of drug interventional clinical trials: characteristics and associated factors, 2011–2013

The geographical distribution and characteristics of drug interventional clinical trial in the top 30 countries worldwide, 2011–2013. (DOCX 29 kb