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The detection of driver gene mutations can determine appropriate treatment strategies for non-small cell lung cancer (NSCLC) by identifying the presence of an effective druggable target. Mutations in the gene encoding the epidermal growth factor receptor (EGFR) are common driver mutations in NSCLC that can be effectively targeted by the use of EGFR tyrosine kinase inhibitors (EGFR-TKIs). However, without the detection of driver mutations, appropriate therapeutic decisions cannot be made. The most commonly applied methods for detecting driver gene mutations are assays based on polymerase chain reaction (PCR). However, the underlying mechanism of PCR-based assays limits the detection of rare mutations. Therefore, patients harboring rare mutations may not receive optimal treatment. We report a heavily-treated patient with NSCLC who harbored a T751_I759delinsN mutation in exon 19 of EGFR that was not detected by real-time PCR but was successfully detected by next-generation sequencing (NGS). The detection of a driver mutation using NGS resulted in the administration of targeted therapy, leading to favorable progression-free survival for the patient. Our report highlights the importance and potential of routine NGS testing among NSCLC patients for whom traditional assays fail to detect driver mutations when determining treatment options.

Background This study investigated the relationship between inflammatory biomarkers (lymphocyte ratio [NLR], monocyte‐to‐lymphocyte ratio [MLR], and platelet‐to‐lymphocyte ratio [PLR]) and the treatment outcomes of patients with non‐small cell lung cancer (NSCLC) treated with afatinib. Methods The patients with NSCLC treated with afatinib between June 2014 and February 2018 were retrospectively reviewed. Their inflammatory biomarkers and clinical outcomes (progression‐free survival [PFS] and tumor response) were explored using univariate and multivariate analyses. Results Among 325 patients, those with an NLR >2.18, MLR >0.19, and PLR >177.73 had significantly worse PFS than those with lower values. After adjusting for performance status, stage, and liver metastasis, the PFS was still unfavorable for a baseline NLR >2.18, MLR >0.19, or PLR > 177.73. Among 188 patients with paired inflammatory values, those whose NLR decreased by >29.5%, MLR decreased by >57.9%, and PLR increased by <18.8% had significantly better PFS. After adjusting for performance status, stage, and liver metastasis, the PFS was significantly unfavorable for an NLR decrease of <29.5% and MLR decrease of <57.9%. Among the patients with tumor response, NLR, MLR, and PLR significantly decreased after treatment (all p < 0.05). Conclusions Our study presented the NLR, MLR, and PLR as prognostic factors for patients with NSCLC treated with afatinib. Further investigation into these markers representing the tumor microenvironment and their association with cancer status is crucial for evaluating prognosis and clinical outcomes in patients with NSCLC. EGFRm NSCLC patients (n = 325). EGFRm NSCLC patients (n = 188). Afatinib for 1–3 months. Unfavorable prognostic factors for PFS. Baseline inflammatory values. NLR >2.18, MLR >0.19. PLR >177.73. Changes of inflammatory values. NLR decrease of <29.5%. MLR decrease of <57.9%.

The detection of driver gene mutations can determine appropriate treatment strategies for non-small cell lung cancer (NSCLC) by identifying the presence of an effective druggable target. Mutations in the gene encoding the epidermal growth factor receptor (EGFR) are common driver mutations in NSCLC that can be effectively targeted by the use of EGFR tyrosine kinase inhibitors (EGFR-TKIs). However, without the detection of driver mutations, appropriate therapeutic decisions cannot be made. The most commonly applied methods for detecting driver gene mutations are assays based on polymerase chain reaction (PCR). However, the underlying mechanism of PCR-based assays limits the detection of rare mutations. Therefore, patients harboring rare mutations may not receive optimal treatment. We report a heavily-treated patient with NSCLC who harbored a T751_I759delinsN mutation in exon 19 of EGFR that was not detected by real-time PCR but was successfully detected by next-generation sequencing (NGS). The detection of a driver mutation using NGS resulted in the administration of targeted therapy, leading to favorable progression-free survival for the patient. Our report highlights the importance and potential of routine NGS testing among NSCLC patients for whom traditional assays fail to detect driver mutations when determining treatment options.

SnPb solder was widely used in electronic packaging for aerospace devices due to its high reliability. However, its creep resistance is poor and can be improved by adding alloying elements. The effects of Sb content on the microstructure, tensile, and creep properties of eutectic SnPb solder were investigated. Sb addition effectively improved the mechanical properties of the SnPb solder. When Sb content exceeds 1.7 wt.%, SbSn intermetallic compounds (IMCs) occurred. And increasing the Sb content increased the tensile strength. Furthermore, Sb addition decreased the steady-state creep rate and increased the stress exponent n, suggesting that the creep resistance had been enhanced, which may be attributed to the hindrance of dislocation movement by SbSn IMCs, as well as the reduction in phase boundaries, which consequently reduced grain boundary sliding.

An axion insulator is a three-dimensional (3D) topological insulator (TI), in which the bulk maintains the time-reversal symmetry or inversion symmetry but the surface states are gapped by surface magnetization. The axion insulator state has been observed in molecular beam epitaxy (MBE)-grown magnetically doped TI sandwiches and exfoliated intrinsic magnetic TI MnBi 2 Te 4 flakes with an even number layer. All these samples have a thickness of ~ 10 nm, near the 2D-to-3D boundary. The coupling between the top and bottom surface states in thin samples may hinder the observation of quantized topological magnetoelectric response. Here, we employ MBE to synthesize magnetic TI sandwich heterostructures and find that the axion insulator state persists in a 3D sample with a thickness of ~ 106 nm. Our transport results show that the axion insulator state starts to emerge when the thickness of the middle undoped TI layer is greater than ~ 3 nm. The 3D hundred-nanometer-thick axion insulator provides a promising platform for the exploration of the topological magnetoelectric effect and other emergent magnetic topological states, such as the high-order TI phase. A zero Hall conductance plateau has been taken as evidence of the axion insulator state in magnetically doped topological insulator heterostructures, but it can also originate from surface state hybridization. Here the authors establish such a state in a ~106 nm thick sample, where hybridization is negligible.

The antioxidant effect of salidroside has been proven, but its role in liver injury is poorly understood. In this study, we aimed to evaluate the protective effects and mechanism of salidroside on liver injury induced by carbon tetrachloride (CCl4) in vivo. Mice were pretreated with salidroside (60 mg/kg, intraperitoneally injected, i.p.) once per day for 14 consecutive days and then administered with CCl4 (15.95 g/kg, i.p.) for 24 h to produce a liver injury model. Salidroside attenuated hepatic transaminase elevation in serum and ameliorated liver steatosis and necrosis, thereby suggesting its protective effect on the liver. Salidroside antagonized CCl4-induced toxicity by equilibrating antioxidation system, thereby inhibiting reactive oxygen species accumulation, and restoring mitochondrial structure and function. Salidroside exerts antioxidant and liver-protective effects by selectively inhibiting the activation of genes, including growth arrest and DNA -damage-inducible 45 α (Gadd45a), mitogen-activated protein kinase 7 (Mapk7), and related RAS viral oncogene homolog 2 (Rras2), which induce oxidative stress in the mitogen-activated protein kinase pathway. These results revealed that salidroside can protect the liver from CCl4-induced injury by resisting oxidative stress and protecting mitochondrial function.

Abstract Background Taiwan's Long-Term Care (LTC) Plans 1.0 and 2.0 aimed to provide accessible LTC services since 2007. Currently, >40% of the people needing LTC are covered by these plans. Past studies have indicated that high unmet needs among LTC users may lead to adverse outcomes. Thus, whether the LTC services meet the needs of both the care recipients and their family caregivers merits further study. The purpose of this study was to develop a suitable \"unmet needs appraisal scale (UNAS) for long-term care service users\" and pilot test this tool on older Taiwanese adults. Methods The tool was developed through a systematic literature review. The tool underwent two rounds of the Delphi method with 26 experts, and the tool reached a high consensus among the experts. The UNAS includes 11 items assessing activities that need more assistance, including daily activities, psychological health, and spiritual health. We pilot tested the tool in older Taiwanese adults and examined the tool properties, including reliability and validity. We included short-form 8 as a concurrent validity measure. Result: The survey was conducted in 6 counties, and 255 service user questionnaires were collected. The overall Cronbach's α value was 0.91, indicating good internal consistency. Our confirmatory factor analysis also showed good construct validity [χ2 = 146.514, p < 0.001, CFI = 0.98, RMSEA = 0.06, SRMR = 0.02]. The UNAS scores showed a moderate negative correlation with quality of life scores (r = -0.452, p < 0.001), demonstrating good concurrent validity of the unmet needs scale.

In this paper, we start from the study on the packaging efficiency of the phosphor-converted white LED via a new way to measure and calculate the blue light from the blue die to the encapsulation lens. Then we try to estimate the limit of luminous efficacy of a pcW-LED with Type VII structure. In the calculation, with the EQE of 81% of the blue die and Stokes loss, we obtain the optimal limit of luminous efficacy. The largest one reaches 300 lm/W, and occurs for green-white light with CCT from 4000K to 5000K. More practical limit is calculated in considering phosphor quantum loss and geometry loss, and the practical limit of luminous for CRI around 60 is around 210 lm/W, and for CRI larger than 80 is around 175 lm/W. Luminous efficacy will be sacrificed to obtain higher CRI. In order to know the real optical flux on the illuminated target, we introduce the optical utilization factor (OUF). Three application cases are discussed. The OUFs for light bulb, automotive head lamp, and street light are 90%, 60% and 45%, respectively. In considering human factors, it is interesting to find that a light source with lower luminous efficacy can perform higher illumination luminous efficacy (ILE). Therefore it is important to use ILE rather than LE when a light source is practically applied to lighting.

To analyze the clinical characteristics, results of treatment, and prognostic factors of patients diagnosed as primary ovarian non-Hodgkin’s lymphoma (PONHL). Fourteen cases of PONHL treated in Fudan University Cancer Center during a 10-year period were retrospectively reviewed, and the clinical data of the patients were analyzed for correlation between KPS, clinical stage, tumor size, IPI, ovary involvement, treatment and prognosis. The median age was 45 years, and thirteen patients were diagnosed of diffuse large B-cell lymphoma and one patient lymphoblastic lymphoma. Four patients were stage IE, three stage IIE, and seven stage IVE. The median tumor size was 8 cm (range, 4.0–15.0 cm). The median overall survival (OS) of the 14 patients was 23.0 months (range 11.5–71.2 months). Thirty-six percentage of patients with bilateral ovary involvement had a shorter survival time than those with unilateral ovary involvement (median OS: 19.0 vs. 37.2 months, P  = 0.014). The OS of Stage IVE was worse than stage IE and stage IIE (median OS: 18.75 vs. 37.5 months, P  = 0.047). Patients with IPI >2 had worse prognosis than those with IPI ≤2 (median OS: 19.0 vs. 42.1 months, P  = 0.03). PONHL patient with larger tumor mass had worse prognosis (median OS: 19.1 vs. 37.2 months, P  = 0.019). R-CHOP regimens had a tendency to improve the OS but was not shown to be statistically significant (median OS: 22.4 vs. 37.2 months, P  = 0.436). The management of PONHL should be based on multi-modality treatment including surgery and chemotherapy. The significant prognostic factors of survival are tumor size, Ann Arbor staging, and IPI.

Recently, gate-defined Josephson junctions based on magic-angle twisted bilayer graphene (MATBG) have been fabricated. In such a junction, local electrostatic gating can create two superconducting regions connected by an interaction-driven valley-polarized state as the weak link. Due to the spontaneous time-reversal and inversion symmetry breaking of the valley-polarized state, novel phenomena such as the Josephson diode effect have been observed without applying external fields. Importantly, when the so-called nonreciprocity efficiency (which measures the sign and strength of the Josephson effect) changes sign, the energy-phase relation of the junction is approximate \\(F(\\phi) \\approx \\cos(2\\phi)\\) where \\(F\\) is the free energy and \\(\\phi\\) is the phase difference of the two superconductors. In this work, we show that such a MATBG-based Josephson junction, when shunted by a capacitor, can be used to realize the long-sought-after \\(0\\)-\\(\\pi\\) qubits which are protected from local perturbation-induced decoherence. Interestingly, by changing the junction parameters, transmon-like qubits with large anharmonicity can also be realized. In short, by utilizing the novel interaction-driven valley-polarized state in MATBG, a single gate-defined Josephson junction can be used to replace complicated superconducting circuits for realizing qubits that are protected from local perturbations.