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Lecanemab treatment for Alzheimer's Disease of varying severities and associated plasma biomarkers monitoring: A multi‐center real‐world study in China
INTRODUCTION We investigated real‐world efficacy, safety, and plasma biomarker dynamics of Lecanemab in Chinese patients with Alzheimer's disease (AD). METHODS A multi‐center prospective cohort study enrolled 68 AD patients. Cognitive scales and plasma biomarkers were assessed at baseline (V0), 2.5 months (V1), and 7 months (V2). RESULTS Alzheimer's Disease Assessment Scale‐Cognitive Subscale 14‐item version (ADAS‐cog14) scores improved significantly at both follow‐ups, and plasma p‐tau181 consistently declined. Both p‐tau181 and p‐tau217 correlated with cognition and partially predicted treatment response (area under the curve [AUC] = 0.734 and 0.713). Mixed‐effects modeling confirmed their dynamic association with ADAS‐cog14 scores. Subgroup analyses indicated benefits across sex and apolipoprotein E4 status, while moderate‐to‐severe cases showed limited response. Lecanemab was well tolerated, with asymptomatic amyloid‐related imaging abnormalities in 17.65% and mild infusion reactions in 5.88%. DISCUSSION These findings support the short‐term efficacy and safety of Lecanemab in early AD and highlight plasma biomarkers as a treatment‐responsive biomarker. Highlights Lecanemab improved cognitive function in Chinese patients with mild cognitive impairment due to Alzheimer's disease (AD‐MCI) and mild AD over a short period. Plasma p‐tau181 and p‐tau217 showed significant correlation with cognitive scores, and their baseline level could partially predict the efficacy of lecanemab. Lecanemab showed a favorable safety profile with low, manageable rates of amyloid‐related imaging abnormalities (ARIA) and infusion reactions.
Journal Article
Comparing Outcomes of Moyamoya Disease and Moyamoya Syndrome in a Real‐World Scenario: A Cohort Study
Background Moyamoya disease (MMD) and moyamoya syndrome (MMS) are rare cerebrovascular conditions with unclear distinctions in clinical presentation and prognosis. Aim This study assessed potential differences between MMD and MMS patients using real‐world data on clinical manifestations, surgical outcomes, and stroke risk factors. Methods This multicenter, retrospective cohort study examined patients with MMD or MMS treated at three tertiary academic hospitals in China, with a mean follow‐up of 11.2 ± 3.1 years. Clinical differences were compared between MMD and MMS, and postoperative cerebrovascular events were compared between patients who underwent surgery and those with conservative management. Primary outcomes were postoperative ischemic and hemorrhagic strokes. Risk factors were evaluated via multivariate Cox regression analysis. Results Of the 2565 patients, 2349 had MMD and 216 had MMS. After 1:1 propensity‐score matching, no significant differences were observed between these two cohorts. Surgical patients had fewer cerebrovascular events than those who received conservative treatment (HR, 0.487; 95% CI, 0.334–0.711; p < 0.001). Preadmission modified Rankin scale scores > 2 (HR, 3.139; 95% CI, 1.254–7.857; p = 0.015) and periprocedural complications (HR, 8.666; 95% CI, 3.476–21.604; p < 0.001) were independent stroke risk factors in patients with MMD. Periprocedural complications (HR, 31.807; 95% CI, 10.916–92.684; p < 0.001) increased stroke risk in patients with MMS. Conclusions This real‐world study revealed substantial clinical overlap between MMD and MMS. Both groups derived significant benefits from surgical revascularization, suggesting distinction may not be necessary to guide surgical management decisions. Optimizing preoperative status and preventing periprocedural complications may improve outcomes in these rare cerebrovascular conditions. Trial Registration This study has been registered in the Chinese Clinical trial registry (registration number: ChiCTR2200064160) This real‐world study revealed substantial clinical overlap between MMD and MMS. Both groups derived significant benefits from surgical revascularization, suggesting distinction may not be necessary to guide surgical management decisions. Optimizing preoperative status and preventing periprocedural complications may improve outcomes in these rare cerebrovascular conditions.
Journal Article
Seeking order in anarchy : multilateralism as state strategy
\"Seeking Order in Anarchy offers insights into both the theoretical foundations and the real-world outcomes of multilateralism in world affairs. Recognizing that Tom Keating's theories, though rooted in Canadian foreign policy, have a broader application in international relations, Robert W. Murray has assembled an array of interpretations of multilateralism and case studies examining its practical effects. Drawing from the insights of fourteen noted scholars and featuring an essay from Tom Keating himself, the volume examines the conditions that encourage states to adopt multilateral strategies, and the consequences of doing so in the context of increasingly complex global politics. Seeking Order in Anarchy is an important book for scholars, graduate students, policy makers, and anyone interested in how multilateralism functions in today's world.\"-- Provided by publisher.
Book
World History Teaching in Asia
World History Teaching in Asia is the first broad survey of the content and approaches used to teach world history in secondary schools and colleges in Asia. The collection has been crafted by scholars and educators whose goal was to shed light on the importance of history education and to foster understanding of and between Asian countries.
eBook
The music road : coherence and diversity in music from the Mediterranean to India
'The Music Road' contains contributions on musical cultures from the Mediterranean to India which brings together historical research, philology and ethnographic fieldwork to revive the differentiated voices of this world region. It is here referred to as 'the Music Road', to emphasise the musical traditions in this western half of the 'Silk Road', and the transitional nature of its cultural migrations and coherences.
Book
Real‐world effectiveness and safety of RC48‐ADC alone or in combination with PD‐1 inhibitors for patients with locally advanced or metastatic urothelial carcinoma: A multicenter, retrospective clinical study
Introduction Previous RC48 (Disitamab Vedotin) studies established that the safety and efficacy of RC48‐antibody–drug conjugate (ADC), either alone or combined with toripalimab, for metastatic urothelial carcinoma (mUC) patients exhibiting human epidermal growth factor receptor 2 (HER2)‐positive or even HER2‐negative status after standard chemotherapy failure. Methods With locally advanced or metastatic urothelial carcinoma (la/mUC), patients who received RC48‐ADC monotherapy or a combination with programmed cell death protein 1 (PD‐1) inhibitors between August 2021 and October 2022 were enrolled in this retrospective observational study to evaluate the real‐world antitumor effectiveness and safety. Results Among the 38 enrolled patients (29 males; median age 67.5 years [38–93]), 8 received RC48‐ADC monotherapy, while 30 received combination therapy. Initially, 63.2% (24/38) of the patients had received ≥1 line of prior treatment, and 63.2% (24/38) had visceral metastasis. UC of the bladder represented the majority type in 68.4% (26/38) of cases. By the data cutoff in March 2023, the overall objective response rate (ORR) was 63.2% (95% CI, 47.1%–79.2%), with a disease control rate (DCR) of 89.5% (95% CI, 79.3%–99.7%). Median follow‐up time was 10.6 months. The median progression‐free survival (PFS) was 8.2 months (95% CI, 5.9–10.5), with a 6‐month PFS rate of 63.2% and a 12‐month PFS rate of 34.1%. Median overall survival (OS) was not reached, with a 12‐month OS rate of 76.7%. The median duration of response was 7.3 months (95% CI, 4.6–10.0) among 24 patients evaluated as partial response (PR). The most common treatment‐related adverse events (TRAEs) included anemia (71.1%), anorexia (57.9%), asthenia (52.6%), hypoesthesia (52.6%), bone marrow suppression (47.4%), alopecia (47.4%), nausea (44.7%), proteinuria (36.8%), vomiting (34.2%), and hypoalbuminemia (31.6%). No patient experienced TRAEs of Grade ≥3. One patient had an immune‐related adverse event (irAE) of rash related to toripalimab. Conclusions Both as monotherapy and in combination with PD‐1 inhibitors, RC48‐ADC exhibits promising effectiveness and manageable safety profile for mUC patients in real‐world settings.
Journal Article
Leadership : six studies in world strategy
\"Henry Kissinger, consummate diplomat and statesman, examines the strategies of six great twentieth-century figures and brings to life a unifying theory of leadership and diplomacy \"Leaders,\" writes Henry Kissinger in this compelling book, \"think and act at the intersection of two axes: the first, between the past and the future; the second, between the abiding values and aspirations of those they lead. They must balance what they know, which is necessarily drawn from the past, with what they intuit about the future, which is inherently conjectural and uncertain. It is this intuitive grasp of direction that enables leaders to set objectives and lay down a strategy.\" In Leadership, Kissinger analyses the lives of six extraordinary leaders through the distinctive strategies of statecraft, which he believes they embodied. After the Second World War, Konrad Adenauer brought defeated and morally bankrupt Germany back into the community of nations by what Kissinger calls \"the strategy of humility.\" Charles de Gaulle set France beside the victorious Allies and renewed its historic grandeur by \"the strategy of will.\" During the Cold War, Richard Nixon gave geostrategic advantage to the United States by \"the strategy of equilibrium.\" After twenty-five years of conflict, Anwar Sadat brought a vision of peace to the Middle East by a \"strategy of transcendence.\" Against the odds, Lee Kuan Yew created a powerhouse city-state, Singapore, by \"the strategy of excellence.\" And, though Britain was known as \"the sick man of Europe\" when Margaret Thatcher came to power, she renewed her country's morale and international position by \"the strategy of conviction.\" To each of these studies, Kissinger brings historical perception, public experience and-because he knew each of the subjects and participated in many of the events he describes-personal knowledge. Leadership is enriched by insights and judgements that only Kissinger could make and concludes with his reflections on world order and the indispensability of leadership today\"-- Provided by publisher.
Book
Teacher Education for Sustainable Development and Global Citizenship
This book examines how educators internationally can better understand the role of education as a public good designed to nurture peace, tolerance, sustainable livelihoods and human fulfilment. Bringing together empirical and theoretical perspectives, this insightful text develops new understandings of education for sustainable development and global citizenship (ESD/GC) and illustrates how these might impact on educational research, policy and practice. The text recognizes the ESD/GC as pivotal to the universal ambitions of UNESCO’s Sustainable Development Goals, and focuses on the role of teachers and teacher educators in delivering the appropriate educational response to promote equity and sustainability. Chapters explore factors including curriculum design, values and assessment in teacher education, and consider how each and every learner can be guaranteed an understanding of their role in promoting a just and sustainable global society. This book will be of great interest to academics, researchers, school leaders, practitioners, policy makers and students in the fields of education, teacher education and sustainability.
eBook