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Squamous and anaplastic thyroid cancers are the most aggressive and life‐threatening cancer types in humans, with the involvement of lymph nodes in 59% of cases and distant metastases in 26% of cases of all thyroid cancers. The median survival of squamous thyroid cancer patients is

IntroductionThe aim of this study was to develop and validate a new diabetes distress scale suitable for Chinese and Taiwanese culture.MethodsThis study collected the current diabetes distress measurement tools, re-organized current definitions about the domains of diabetes distress, and then developed a new tool. Three hundred and ninety-five participants from four hospitals in northern Taiwan were recruited by cluster randomized sampling for validity test.ResultsWe found the new diabetes distress scale had appropriate reliability and validity, including an acceptable model fit for the 12-item scale.ConclusionsThis new diabetes distress scale might be more directly related to emotional distress issues blood glucose control, improve the clinical conspicuity of diabetes distress, and even benefit the overall care of diabetic patients in Taiwan. Further studies about the validity and reliability of this new tool in a nationwide setting are needed.

Introduction: The aim of this study was to explore the impact of diabetes self-management and HbA1c affected by the COVID-19 pandemic and the epidemic prevention work.Methods: This quasi-experimental study collected a pooled data from a randomized-control study between February and May 2020 in which 114 participants who presented type 2 diabetes were recruited. The intervention group had health coaching and usual care, whereas the control had usual care only. The main outcome variables of this observation study were the change of HbA1c, physical activity, and eating out behavior within this time interval.Results: We found that the eating out behavior of both groups had decreased, and if a health coach helped the patients set physical activity goals in the two groups, the physical activity behavior will not be impacted due to the pandemic.Conclusions: While every country is focusing on COVID-19 pandemic prevention, especially when strict home quarantine measures and social distancing are adopted, reminding and assisting chronic patients to maintain good self-management behavior may lessen the social and medical system burdens caused by the deterioration of chronic conditions due to the excessive risk prevention behavior and the epidemic prevention work.Trial Registration:www.isrctn.com, identifier number: ISRCTN14167790, date: 12 July, 2019.

Aims/Introduction To investigate the clinical outcomes of patients with type 2 diabetes mellitus (T2DM) who initiated dapagliflozin in real-world practice in Taiwan. Materials and Methods In this multicenter retrospective study, adult patients with T2DM who initiated dapagliflozin after May 1st 2016 either as add-on or switch therapy were included. Changes in clinical and laboratory parameters were evaluated at 3 and 6 months. Baseline factors associated with dapagliflozin response in glycated hemoglobin (HbA1c) were analyzed by univariate and multivariate logistic regression. Results A total of 1,960 patients were eligible. At 6 months, significant changes were observed: HbA1c by −0.73% (95% confidence interval [CI] −0.80, −0.67), body weight was -1.61 kg (95% CI −1.79, −1.42), and systolic/diastolic blood pressure by −3.6/−1.4 mmHg. Add-on dapagliflozin showed significantly greater HbA1c reduction (−0.82%) than switched therapy (−0.66%) (p = 0.002). The proportion of patients achieving HbA1c

Introduction: The aim of this study was to explore the effectiveness in HbA1c lowering and self-efficacy of diabetes self-management of a 6 months coaching intervention.Methods: This paper was a two-armed coaching intervention study in which 116 participants who presented type 2 diabetes were recruited at a medical center. The intervention group had health coaching and usual care for 6 months, whereas the control had usual care only. The main outcome variables were HbA1c level and self-efficacy of diabetes self-management, in followed-up measure at 3 and 6 months.Results: We found that an approximate 0.68% (CI = 0.40 to 0.96) reduction in HbA1c was achieved after a 6-month health coaching. Both physical activity and self-efficacy of diabetes self-management were shown to benefit by health coaching.Conclusions: Health coaching might be an effective strategy to enhance self-management for diabetes patients in Taiwan where “Diabetes Shared Care Network” had been implemented for over 20 years. Consider limitations of this study, more studies with designs that yield higher quality evidence for the role of health coaching in diabetic patients are needed.Clinical Trial Registration:www.isrctn.com (ID number: ISRCTN52454940, date: 10 May, 2018, retrospectively registered).

Triple-negative breast cancer (TNBC) subtype is associated with poor prognosis and a high risk of recurrence-related death in women. Despite the aggressiveness of TNBCs, targeted TNBC therapy is not yet available in the clinic. To overcome this challenge, we generated highly metastatic TNBC cells (LM) derived from metastasized lung cells via a serial spontaneous pulmonary metastasis animal model to identify targetable molecules for attenuating the progression of TNBC metastasis. Gene analysis of primary tumor (P), first-round (1LM) and second-round (2LM) metastasized lung cells revealed that mesenchymal-related genes were significantly expressed in LM cells, especially in 2LM cells. Interestingly, α9-nAChR gene expression was also dramatically induced in LM cells, confirming our previous finding that α9-nAChR plays important roles in receptor-mediated carcinogenic signals in human breast cancer development. Using α9-nAChR as a biomarker, we transfected 2LM cells with CRISPR/Cas9 lentivirus targeting the α9-nAChR genomic region (2LM-α9-nAChR-null), showing that mesenchymal markers and the migration and invasion abilities of 2LM cells were significantly attenuated in 2LM-α9-nAChR-null cells both in vitro and in vivo. In addition, the high efficiency of editing the α9-nAChR gene using a CRISPR/Cas9 lentivirus was demonstrated by gene sequencing, genomic indel frequency and protein expression analyses. Collectively, these results confirmed those of our previous study that advanced-stage breast tumors are associated with substantially higher levels of α9-nAChR gene expression, indicating that α9-nAChR expression is essential for mediating TNBC metastasis during cancer development and may potentially act as a biomarker for targeted therapy in clinical investigations.

The risks of surgery and its clinical outcome are of great importance for both patients and physicians when choosing coronary artery bypass (CABG) surgery for coronary artery disease. The purpose of the current study was to clarify the relationship between serum B-type natriuretic peptide (BNP) and patient clinical outcome. Seventy-six eligible patients who underwent CABG were enrolled into the prospective study. Venous blood samples were drawn for serum BNP and N-terminal (NT)-proBNP levels measurement on preoperative Day 1, postoperative Day 1, and postoperative Day 7. Clinical end points were: (1) intensive care unit (ICU) stay longer than 4 days postoperatively and/or hospital stay longer than 13 days postoperatively; (2) major complications and poor outcomes. Patients who had prolonged ICU stay and hospitalization had significantly higher postoperative Day 1 BNP and postoperative Day 1 NT-proBNP level (p = 0.02 and 0.005, respectively). Age was significantly older in patients with prolonged ICU stay and hospitalization than those without prolonged ICU stay and hospitalization (p = 0.03). Serum creatinine level was also significantly increased in patients with prolonged ICU stay and hospitalization (p = 0.009). However, age was the only remaining factor that correlated with prolonged ICU stay and hospitalization in the multivariate logistic regression model. These results suggest that research using BNP and NT-proBNP for predicting ICU stay and hospitalization in patients who have undergone CABG must adjust risk factors to present a more appropriate estimation of its clinical outcome.

Nonylphenol (NP) has been proven as an endocrine disrupter and had the ability to interfere with the endocrine system. Though the health effects of NP on pregnant women and their fetuses are sustained, these negative associations related to the mechanisms of regulation for estrogen during pregnancy need to be further clarified. The objective of this study is to explore the association between maternal NP and hormonal levels, such as estradiol, testosterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH), and progesterone.A pregnant women cohort was established in North Taiwan between March and December 2010. Maternal urine and blood samples from the first, second, and third trimesters of gestation were collected. Urinary NP concentration was measured by high-performance liquid chromatography coupled with fluorescent detection. A mixed-effects model using a generalised estimating equation (GEE) was applied to assess the associations between maternal NP concentration and plasma hormones throughout the three trimesters.In total, 162 singleton pregnant women completed this study through delivery. The geometric mean of creatinine-adjusted urinary NP concentrations were 4.27, 4.21, and 4.10 µg/g cre. in the first, second, and third trimesters respectively. A natural log-transformation of urinary NP concentrations were significantly associated with LH in the GEE model (β = -0.23 mIU/ml, p

Thyroid cancer is the most commonly diagnosed endocrine cancer. Anaplastic thyroid cancer (ATC) is the most aggressive type of thyroid cancer and has a poor prognosis. Loss of p53 function has been reported to lead to poorly differentiated thyroid tumors; therefore, mutant p53 protein can be considered a crucial therapeutic target in patients with ATC. Sorafenib, a multi-kinase inhibitor, has been approved for the treatment of metastatic and differentiated thyroid cancer. Combined targeted therapy, including sorafenib, may be clinically significant for patients with ATC harboring p53 mutations. In the present study, CP-31398, a p53-restoring agent, was used to improve the therapeutic efficacy of sorafenib in SW579 cells, an ATC cell line harboring p53 mutations. The molecular function of CP-31398 was evaluated using western blot analysis and a luciferase reporter assay. The decreased viability of SW579 cells, following CP-31398 treatment, was augmented by sorafenib, and CP-31398 enhanced the antimitogenic effect of sorafenib; thus, sorafenib and CP-31398 synergistically inhibited the growth of SW579 cells. These results indicate a potential clinical application of CP-31398 for patients with ATC harboring p53 abnormalities, since these individuals generally respond poorly to sorafenib alone. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the pregnancy outcome of pregnant women in whom the 100-g oral glucose tolerance test (OGTT) met the criteria of Carpenter and Coustan (C&C) but not those of the National Diabetes Data Group (NDDG) for diagnosis of gestational diabetes mellitus (GDM). Methods: The medical records of 10,990 singleton pregnancies, delivered at Cathay General Hospital, Taiwan, between 2001 and 2008, were reviewed retrospectively. All pregnant women followed the two-step diagnostic algorithm for GDM; that is, women with a positive (≥140 mg/dL) 50-g glucose challenge test (GCT) underwent a 100-g OGTT at 24–28 weeks of gestation. The pregnancies were classified as follows: group 1, women without GDM; group 2, women with GDM meeting the C&C criteria but not the NDDG criteria; and group 3, women with GDM diagnosed by NDDG criteria. Results: Of the pregnancies, 10,116 (92%), 489 (4.4%), and 385 (3.5%) were classified into groups 1, 2, and 3, respectively. Women with GDM by the C&C criteria but not by the NDDG criteria had an increase in macrosomia compared with women without GDM, 22 (4.5%) infants vs. 236 (2.3%) infants, respectively ( p < 0.05); however, there were no associated adverse complications. If the C&C criteria were used, the incidence of GDM increased to 874 (7.9%) pregnancies. GDM as defined by either NDDG or C&C criteria identified pregnancies complicated by macrosomia, cesarean section, and gestational hypertension compared with the healthy population ( p < 0.05). Conclusions: In a Taiwanese population, using C&C criteria has no added advantages over using NDDG criteria. [ABSTRACT FROM AUTHOR]