Graft-vs-tumor effect in patients with advanced nasopharyngeal cancer treated with nonmyeloablative allogeneic PBSC transplantation

While nonmyeloablative peripheral blood stem cell transplantation (NST) has shown efficacy against several solid tumors, it is untested in nasopharyngeal cancer (NPC). In a phase II clinical trial, 21 patients with pretreated metastatic NPC underwent NST with sibling PBSC allografts, using CY conditioning, thymic irradiation and in vivo T-cell depletion with thymoglobulin. Stable lymphohematopoietic chimerism was achieved in most patients and prophylactic CYA was tapered at a median of day +30. Seven patients (33%) showed partial response and three (14%) achieved stable disease. Four patients were alive at 2 years and three showed prolonged disease control of 344, 525 and 550 days. With a median follow-up of 209 (4–1147) days, the median PFS was 100 days (95% confidence interval (CI), 66–128 days), and median OS was 209 days (95% CI, 128–236 days). Patients with chronic GVHD had better survival—median OS 426 days (95% CI, 194–NE days) vs 143 days (95% CI, 114–226 days) (P=0.010). Thus, NST may induce meaningful clinical responses in patients with advanced NPC

Evaluating the American Heart Association/American College of Cardiology Guideline—Recommended and Contemporary Pretest Probability Models in a Mixed Asian Cohort: The Contribution of Coronary Artery Calcium

BACKGROUND: Most pretest probability (PTP) tools for obstructive coronary artery disease (CAD) were Western -developed. The most appropriate PTP models and the contribution of coronary artery calcium score (CACS) in Asian populations remain unknown. In a mixed Asian cohort, we compare 5 PTP models: local assessment of the heart (LAH), CAD Consortium (CAD2), risk factor-weighted clinical likelihood, the American Heart Association/American College of Cardiology and the European Society of Cardiology PTP and 3 extended versions of these models that incorporated CACS: LAH (CACS), CAD2 (CACS), and the CACS-clinical likelihood. METHODS AND RESULTS: The study cohort included 771 patients referred for stable chest pain. Obstructive CAD prevalence was 27.5%. Calibration, area under the receiver-operating characteristic curves (AUC) and net reclassification index were evaluated. LAH clinical had the best calibration (χ 2 5.8; P=0.12). For CACS models, LAH (CACS) showed least deviation between observed and expected cases (χ 2 37.5; P&lt;0.001). There was no difference in AUCs between the LAH clinical (AUC, 0.73 [95% CI, 0.69-0.77]), CAD2 clinical (AUC, 0.72 [95% CI, 0.68-0.76]), risk factor-weighted clinical likelihood (AUC, 0.73 [95% CI: 0.69-0.76) and European Society of Cardiology PTP (AUC, 0.71 [95% CI, 0.67-0.75]). CACS improved discrimination and reclassification of the LAH (CACS) (AUC, 0.88; net reclassification index, 0.46), CAD2 (CACS) (AUC, 0.87; net reclassification index, 0.29) and CACS-CL (AUC, 0.87; net reclassification index, 0.25). CONCLUSIONS: In a mixed Asian cohort, Asian-derived LAH models had similar discriminatory performance but better calibration and risk categorization for clinically relevant PTP cutoffs. Incorporating CACS improved discrimination and reclassification. These results support the use of population-matched, CACS-inclusive PTP tools for the prediction of obstructive CAD.</p

A bright cadmium-free, hybrid organic/quantum dot white light-emitting diode

We report a bright cadmium-free, InP-based quantum dot light-emitting diode (QD-LED) with efficient green emission. A maximum brightness close to 700 cd/m2 together with a relatively low turn-on voltage of 4.5 V has been achieved. With the design of a loosely packed QD layer resulting in the direct contact of poly[N,N′-bis(4-butylphenyl)-N,N′-bis(phenyl) benzidine] (poly-TPD) and 2,2′,2″-(1,3,5-benzinetriyl)-tris(1- phenyl-1-H-benzimidazole) (TPBi) in the device, a ternary complementary white QD-LED consisting of blue component (poly-TPD), green component (QDs), and red component (exciplex formed at the interface between poly-TPD and TPBi) has been demonstrated. The resulting white QD-LED shows an excellent color rendering index of 95. © 2012 American Institute of Physics

Redox flow desalination based on the temperature difference as a driving force

How to effectively reduce the consumption of electrical energy is a key topic in many studies of electrochemical desalination. In this work, we use the temperature difference to drive a continuous process of dialysis desalination. The system consists of a thermoelectric unit and a desalination unit connected in series. The thermoelectric unit includes a thermoelectric generator (TEG), a heater as heat source and an air-cooled heat sink to generate electricity and for the desalination unit. The desalination unit contains two platinum-coated hydrophobic carbon cloths as current collectors, a mixture of [Fe(CN)6]3-/4- as anolyte and catholyte, concentrated and diluted salt streams with two cationic and one anionic exchange membranes separated configuration (CEM|AEM|CEM). During the charging process driven by temperature difference, chloride and sodium ions in the diluted salt stream move to the concentrated salt stream and cathodic reservoir, respectively. The results show that the concentration of brine drops significantly from 5,000 ppm to 344.3 ppm as the current decreases to 0.06 mA from the initial 1.30 mA when the temperature difference is maintained at 65 K. Concurrently, the average salt removal rate is up to 8.8 μg cm-2 min-1 and average heat consumption is 284.3 MJ mole-1. Moreover, the influences from the temperature difference, salt feeds content and electrolyte concentration are also investigated in detail. This research has the potential application for the freshwater obtainment via the utilization of waste heat, and will be significant in places with the shortage of the electrical energy such as ships, islands and oceans with the temperature differences

Diagnosis of obstructive coronary artery disease using computed tomography angiography in patients with stable chest pain depending on clinical probability and in clinically important subgroups: meta-analysis of individual patient data

OBJECTIVE: To determine whether coronary computed tomography angiography (CTA) should be performed in patients with any clinical probability of coronary artery disease (CAD), and whether the diagnostic performance differs between subgroups of patients. DESIGN: Prospectively designed meta-analysis of individual patient data from prospective diagnostic accuracy studies. DATA SOURCES: Medline, Embase, and Web of Science for published studies. Unpublished studies were identified via direct contact with participating investigators. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Prospective diagnostic accuracy studies that compared coronary CTA with coronary angiography as the reference standard, using at least a 50% diameter reduction as a cutoff value for obstructive CAD. All patients needed to have a clinical indication for coronary angiography due to suspected CAD, and both tests had to be performed in all patients. Results had to be provided using 2×2 or 3×2 cross tabulations for the comparison of CTA with coronary angiography. Primary outcomes were the positive and negative predictive values of CTA as a function of clinical pretest probability of obstructive CAD, analysed by a generalised linear mixed model; calculations were performed including and excluding non-diagnostic CTA results. The no-treat/treat threshold model was used to determine the range of appropriate pretest probabilities for CTA. The threshold model was based on obtained post-test probabilities of less than 15% in case of negative CTA and above 50% in case of positive CTA. Sex, angina pectoris type, age, and number of computed tomography detector rows were used as clinical variables to analyse the diagnostic performance in relevant subgroups. RESULTS: Individual patient data from 5332 patients from 65 prospective diagnostic accuracy studies were retrieved. For a pretest probability range of 7-67%, the treat threshold of more than 50% and the no-treat threshold of less than 15% post-test probability were obtained using CTA. At a pretest probability of 7%, the positive predictive value of CTA was 50.9% (95% confidence interval 43.3% to 57.7%) and the negative predictive value of CTA was 97.8% (96.4% to 98.7%); corresponding values at a pretest probability of 67% were 82.7% (78.3% to 86.2%) and 85.0% (80.2% to 88.9%), respectively. The overall sensitivity of CTA was 95.2% (92.6% to 96.9%) and the specificity was 79.2% (74.9% to 82.9%). CTA using more than 64 detector rows was associated with a higher empirical sensitivity than CTA using up to 64 rows (93.4% v 86.5%, P=0.002) and specificity (84.4% v 72.6%, P<0.001). The area under the receiver-operating-characteristic curve for CTA was 0.897 (0.889 to 0.906), and the diagnostic performance of CTA was slightly lower in women than in with men (area under the curve 0.874 (0.858 to 0.890) v 0.907 (0.897 to 0.916), P<0.001). The diagnostic performance of CTA was slightly lower in patients older than 75 (0.864 (0.834 to 0.894), P=0.018 v all other age groups) and was not significantly influenced by angina pectoris type (typical angina 0.895 (0.873 to 0.917), atypical angina 0.898 (0.884 to 0.913), non-anginal chest pain 0.884 (0.870 to 0.899), other chest discomfort 0.915 (0.897 to 0.934)). CONCLUSIONS: In a no-treat/treat threshold model, the diagnosis of obstructive CAD using coronary CTA in patients with stable chest pain was most accurate when the clinical pretest probability was between 7% and 67%. Performance of CTA was not influenced by the angina pectoris type and was slightly higher in men and lower in older patients. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42012002780

Polygenic risk scores for prediction of breast cancer risk in Asian populations.

PURPOSE: Non-European populations are under-represented in genetics studies, hindering clinical implementation of breast cancer polygenic risk scores (PRSs). We aimed to develop PRSs using the largest available studies of Asian ancestry and to assess the transferability of PRS across ethnic subgroups. METHODS: The development data set comprised 138,309 women from 17 case-control studies. PRSs were generated using a clumping and thresholding method, lasso penalized regression, an Empirical Bayes approach, a Bayesian polygenic prediction approach, or linear combinations of multiple PRSs. These PRSs were evaluated in 89,898 women from 3 prospective studies (1592 incident cases). RESULTS: The best performing PRS (genome-wide set of single-nucleotide variations [formerly single-nucleotide polymorphism]) had a hazard ratio per unit SD of 1.62 (95% CI = 1.46-1.80) and an area under the receiver operating curve of 0.635 (95% CI = 0.622-0.649). Combined Asian and European PRSs (333 single-nucleotide variations) had a hazard ratio per SD of 1.53 (95% CI = 1.37-1.71) and an area under the receiver operating curve of 0.621 (95% CI = 0.608-0.635). The distribution of the latter PRS was different across ethnic subgroups, confirming the importance of population-specific calibration for valid estimation of breast cancer risk. CONCLUSION: PRSs developed in this study, from association data from multiple ancestries, can enhance risk stratification for women of Asian ancestry

Highly flexible, electrically driven, top-emitting, quantum dot light-emitting stickers

Flexible information displays are key elements in future optoelectronic devices. Quantum dot light-emitting diodes (QLEDs) with advantages in color quality, stability, and cost-effectiveness are emerging as a candidate for single-material, full color light sources. Despite the recent advances in QLED technology, making high-performance flexible QLEDs still remains a big challenge due to limited choices of proper materials and device architectures as well as poor mechanical stability. Here, we show highly efficient, large-area QLED tapes emitting in red, green, and blue (RGB) colors with top-emitting design and polyimide tapes as flexible substrates. The brightness and quantum efficiency are 20 000 cd/m2 and 4.03%, respectively, the highest values reported for flexible QLEDs. Besides the excellent electroluminescence performance, these QLED films are highly flexible and mechanically robust to use as electrically driven light-emitting stickers by placing on or removing from any curved surface, facilitating versatile LED applications. Our QLED tapes present a step toward practical quantum dot based platforms for high-performance flexible displays and solid-state lighting. © 2014 American Chemical Society