A Review on the Relationship between SGLT2 Inhibitors and Cancer

Risk of increasing breast and bladder cancer remains a safety issue of SGLT2 (sodium glucose cotransporter type 2) inhibitors, a novel class of antidiabetic agent. We reviewed related papers published before January 29, 2014, through Pubmed search. Dapagliflozin and canagliflozin are the first two approved SGLT2 inhibitors for diabetes therapy. Although preclinical animal toxicology did not suggest a cancer risk of dapagliflozin and overall tumor did not increase, excess numbers of female breast cancer and male bladder cancer were noted in preclinical trials (without statistical significance). This concern of cancer risk hindered its approval by the US FDA in January, 2012. New clinical data suggested that the imbalance of bladder and breast cancer might be due to early diagnosis rather than a real increase of cancer incidence. No increased risk of overall bladder or breast cancer was noted for canagliflozin. Therefore, the imbalance observed with dapagliflozin treatment should not be considered as a class effect of SGLT2 inhibitors and the relationship with cancer for each specific SGLT2 inhibitor should be examined individually. Relationship between SGLT2 inhibition and cancer formation is still inconclusive and studies with larger sample size, longer exposure duration, and different ethnicities are warranted

An Investigation on Network Relationship of Elderly Nursing Home

All developed countries have been facing the trend of aging population and view it as an importance social policy which has to plan care and nurse senior citizens. The elderly caring and nursing organizations are obligated to provide more comfortable and suitable environment for a high quality life of elders. Based upon Maslow’s Hierarchy of Needs Theory, there is a hierarchy of five needs within each individual, including physiological needs, safety needs, belongingness and love Needs, self-esteem needs and self-actualization needs. Individuals would acquire emotional support, materiality and service through social network. This study investigates two main issues related to network relationship of elderly nursing home. First, this study demonstrates the network relationship between elderly nursing home and other related groups, including family and friends of elderly resident, exclusive volunteers, neighborhood community centre, religion groups and other welfare associations. Second, this study investigates what the network relationships would influence the satisfaction of five elderly residents’ needs. To better understanding the real connection among groups related to nursing home, this study uses case study with the perceptions of social network to know the network relationship in the nursing home and what it influences their residents’ needs

Effects of manual lymphatic drainage on breast cancer-related lymphedema: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND: Lymphedema is a common complication of axillary dissection for breast cancer. We investigated whether manual lymphatic drainage (MLD) could prevent or manage limb edema in women after breast-cancer surgery. METHODS: We performed a systematic review and meta-analysis of published randomized controlled trials (RCTs) to evaluate the effectiveness of MLD in the prevention and treatment of breast-cancer-related lymphedema. The PubMed, EMBASE, CINAHL, Physiotherapy Evidence Database (PEDro), SCOPUS, and Cochrane Central Register of Controlled Trials electronic databases were searched for articles on MLD published before December 2012, with no language restrictions. The primary outcome for prevention was the incidence of postoperative lymphedema. The outcome for management of lymphedema was a reduction in edema volume. RESULTS: In total, 10 RCTs with 566 patients were identified. Two studies evaluating the preventive outcome of MLD found no significant difference in the incidence of lymphedema between the MLD and standard treatment groups, with a risk ratio of 0.63 and a 95% confidence interval (CI) of 0.14 to 2.82. Seven studies assessed the reduction in arm volume, and found no significant difference between the MLD and standard treatment groups, with a weighted mean difference of 75.12 (95% CI, −9.34 to 159.58). CONCLUSIONS: The current evidence from RCTs does not support the use of MLD in preventing or treating lymphedema. However, clinical and statistical inconsistencies between the various studies confounded our evaluation of the effect of MLD on breast-cancer-related lymphedema

Look, the World is Watching How We Treat Migrants! The Making of the Anti-Trafficking Legislation during the Ma Administration

Employing the spiral model, this research analyses how anti-human trafficking legislation was promulgated during the Ma Ying-jeou (Ma Yingjiu) presidency. This research found that the gov- ernment of Taiwan was just as accountable for the violation of mi- grants’ human rights as the exploitive placement agencies and abusive employers. This research argues that, given its reliance on the United States for political and security support, Taiwan has made great ef- forts to improve its human rights records and meet US standards for protecting human rights. The reform was a result of multilevel inputs, including US pressure and collaboration between transnational and domestic advocacy groups. A major contribution of this research is to challenge the belief that human rights protection is intrinsic to dem- ocracy. In the same light, this research also cautions against Taiwan’s subscription to US norms since the reform was achieved at the cost of stereotyping trafficking victimhood, legitimising state surveillance, and further marginalising sex workers

The mediating effect of green innovation on the relationship between green supply chain management and environmental performance

The emerging environmental awareness of the public, as well as the implementation of governmental regulations, force organisations to employ corporate environmental practices such as green supply chain management (GSCM) and green innovation. Accordingly, both practices are crucial to achieve professional improvement in the environmental performance of these organisations. However, research on the relationship of GSCM, green innovation, and environmental performance is relatively rare. Therefore, this study is aimed to provide empirical evidence showing that GSCM and green innovation practices significantly improve environmental performance in order to encourage organisations to implement these practices. In addition, this study investigates the relationship between GSCM and green innovation practices and the influence of these practices on the environmental performance in 123 manufacturing organisations with ISO 14001 certification. The results of PLS-SEM revealed that there is a significant and positive relationship between GSCM and green innovation, and the environmental performance. Moreover, green innovation had a positive effect on the environmental performance. Furthermore, green innovation had a mediating relationship between GSCM and environmental performance. Therefore, the present paper confirmed the significant influence of GSCM on boosting the green innovation of organisations and on the manufacturing establishments, which eventually improve the environment. In brief, the outcomes of this study provide enhanced understanding about the significant role of green innovation in the manufacturers for improving their GSCM and organisational environmental performance

A preliminary study on the dynamic friction behavior of a one-third scale-down vertical cylindrical cask

In Taiwan, the capacities of spent fuel pools for temporary storage in nuclear power plant will reach depletion soon, and the site of final disposal facility is still to be decided. Therefore, the installation of dry-type interim storage facilities is urgent. The dry storage systems in Taiwan utilize a freestanding cask and design to non-anchored to the foundation pad. It is necessary to establish the simulation techniques for the non-anchored structure, such as the dry storage cask, for the reasonable assessment of its seismic behavior when the earthquake hit. This study is cast a 1/3 scale-down pedestal specimen of the INER-dry storage cask system, which were conducted to acquire the actual friction coefficient at the cask/pad interface as well as the effect of normal stress and sliding rate on it. Based on the results of cyclic loading testing, the cyclic frequency almost had no influence on the friction coefficient but the friction coefficient increased with the normal stress increased. Apparent rocking of the cask was induced at a higher friction coefficient, while sliding dominated the cask motion at a lower one. In addition, the cast motions were almost purely sliding and the range of the friction coefficient was between 0.60 and 0.73 under various compositions of dry storage cask system

Predicting the Severity and Prognosis of Trismus after Intensity-Modulated Radiation Therapy for Oral Cancer Patients by Magnetic Resonance Imaging

To develop magnetic resonance imaging (MRI) indicators to predict trismus outcome for post-operative oral cavity cancer patients who received adjuvant intensity-modulated radiation therapy (IMRT), 22 patients with oral cancer treated with IMRT were studied over a two-year period. Signal abnormality scores (SA scores) were computed from Likert-type ratings of the abnormalities of nine masticator structures and compared with the Mann-Whitney U-test and Kruskal–Wallis one-way ANOVA test between groups. Seventeen patients (77.3%) experienced different degrees of trismus during the two-year follow-up period. The SA score correlated with the trismus grade (r = 0.52, p<0.005). Patients having progressive trismus had higher mean doses of radiation to multiple structures, including the masticator and lateral pterygoid muscles, and the parotid gland (p<0.05). In addition, this group also had higher SA-masticator muscle dose product at 6 months and SA scores at 12 months (p<0.05). At the optimum cut-off points of 0.38 for the propensity score, the sensitivity was 100% and the specificity was 93% for predicting the prognosis of the trismus patients. The SA score, as determined using MRI, can reflect the radiation injury and correlate to trismus severity. Together with the radiation dose, it could serve as a useful biomarker to predict the outcome and guide the management of trismus following radiation therapy