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    青銅器時代早期愛琴海運輸罐的來源與技術研究:以阿提卡半島的Kontopigado遺址為例
    (考古人類學刊, 2023-06) ;
    Konstantina Kaza-Papageorgiou
    ;
    David E. Wilson
    ;
    Peter M. Day
    西元前第三千紀的中後期是愛琴海地區社會政治轉型的時期,一般認為此轉變與冶金工藝的出現有關。在青銅器時代早期的第二階段(EB II),在考古學的脈絡中可見到金屬物品的消費和陳設,而這與陶製餐具的引入和當時社會強調社交宴飲等活動是同時相伴出現的。一系列被認為是作為運輸的大型領口型陶罐的出現及其在愛琴海諸島的廣泛分佈,並伴隨有套裝、精美的傾注器皿,顯示了區域間有著頻繁的互動與交換貿易。這些被解釋為運輸罐的陶器遺留,其中一類型為阿提卡式領口型陶罐,在多個關鍵性的愛琴海沿海遺址都有出土,並具有一致的砂質摻合料和器表施有白色泥釉的特點,但它們的來源過去卻一直未知。本文藉由對阿提卡半島Kontopigado遺址青銅器時代早期第一階段(EB I)與第二階段(EB II)出土的陶器進行岩象分析,揭示了此遺址即為阿提卡式領口型陶罐的主要生產中心,並顯示了有機商品(最可能是指葡萄酒)在愛琴海地區的分佈以及擴展的交換網絡。另外,Kontopigado遺址的製陶技術在青銅器時代早期第二階段發生顯著的改變,顯示出人群對陶器燒成溫度和燒成氣氛之控制技術複雜度的增加,更加展現陶器在這時期角色的改變。
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    Physical symptoms distress and demoralization among haemodialysis patients; the mediating effect of spirituality and self-compassion. A cross-sectional questionnaire survey.
    (2025-06)
    Lin, Chia-Hui
    ;
    Chiang, Yi-Chien
    ;
    ;
    Chu, Tsung-Lan
    ;
    Hsiao, Ya-Chu
    Background: Long-term haemodialysis patients often experience physical symptom distress (PSD) and varying levels of demoralization. Spirituality and self-compassion can help patients to cope these challenges. However, the interrelations between these variables remain underexplored, necessitating further investigation. Objectives: To examine the effect of PSD on demoralization among haemodialysis patients and to determine whether spirituality and self-compassion mediate these relationships. Design: A cross-sectional correlational study. Settings: A convenience sample was used to recruit from two haemodialysis clinics. Methods: Self-report questionnaires were the Physical Symptom Distress Scale, Demoralization Scale, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-12, and Self-Compassion Scale. Relationships and mediators were examined with Pearson's correlations and multiple linear regression analysis, respectively. Results: A total of 156 participants participated. Mean age of participants was 61.3 years (SD = 11.3). Most participants were male (66 %) and had received dialysis for ≥ 5 years (61.5 %). Pearson's correlation indicated higher scores for PSD were significantly associated with lower levels of spirituality and self-compassion and higher levels of demoralization. There was a significant total and direct effect of PSD on demoralization. Mediation analysis indicated that the relationship between PSD and demoralization was partially and significantly mediated by spirituality and self-compassion. Demoralization can be explained by 46.83 % variance accounted by these predictors in the mediation model. Conclusion: Long-term haemodialysis can cause chronic symptom distress and feelings of demoralization. The mediating effects of spirituality and self-compassion on PSD and demoralization suggest that these qualities may act as emotional regulators that enable haemodialysis patients to be more accepting of symptom distress, which results in lower levels of demoralization. Our findings imply that developing strategies to increase spirituality and self-compassion could help patients manage chronic symptom distress associated with haemodialysis, reduce demoralization, and ultimately improve their quality of life.
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    Impact of Membranous Nectin-4 on Outcomes of Platinum-Based Chemotherapy in Metastatic Urothelial Carcinoma.
    (2025-02) ;
    Wang, Chung-Chieh
    ;
    Chueh, Shih-Chieh
    ;
    Guo, Jhe-Cyuan
    ;
    Metastatic urothelial carcinoma (mUC) is a highly aggressive malignancy [...].
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    Autonomic modulation by SGLT2i or DPP4i in patients with diabetes favors cardiovascular outcomes as revealed by skin sympathetic nerve activity.
    (2024)
    Chen, Jien-Jiun
    ;
    Lin, Chen
    ;
    Lo, Men-Tzung
    ;
    ;
    Chang, Hsiang-Chih
    ;
    Liu, Geng-Chi
    Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and dipeptidyl peptidase-4 inhibitors (DPP4i) are important second-line treatments for patients with type 2 diabetes mellitus (T2DM). Patients taking SGLT2i have favorable cardiovascular outcomes via various mechanisms, including autonomic nervous system (ANS) modulation. This study aimed to use neuro-electrocardiography (neuECG) to test the effects of SGLT2i or DPP4i on the ANS. Patients with T2DM, who did not reach target hemoglobin (Hb)A1C levels despite metformin treatment, were enrolled. SGLT2i or DPP4i were prescribed randomly unless a compelling indication was present. NeuECG and heart rate were recorded for 10 min before and after a 3-month treatment. The patients were treated according to standard practice and the obtained data for skin sympathetic nerve activity (SKNA) and ANS entropy were analyzed offline. We enrolled 96 patients, of which 49 received SGLT2i and 47 received DPP4i. The baseline parameters were similar between the groups. No adverse event was seen during the study period. In the burst analysis of SKNA at baseline, all parameters were similar. After the 3-month treatment, the firing frequency was higher in SGLT2i group (0.104 ± 0.045 vs 0.083 ± 0.033 burst/min, p < 0.05), with increased long firing duration (7.34 ± 3.66 vs 5.906 ± 2.921, p < 0.05) in 3-s aSKNA scale; the other parameters did not show any significant change. By symbolic entropy, the most complex patterns (Rank 3) were found to be significantly higher in SGLT2i-treated patients than in DDP4i-treated group (0.084 ± 0.028 vs 0.07 ± 0.024, p = 0.01) and the direction of change in Rank 3, after SGLT2i treatment, was opposite to that observed in the DDP4i group (0.012 ± 0.036 vs. -0.005 ± 0.037, p = 0.024). Our findings demonstrated the favorable autonomic modulation by SGLTi and the detrimental effects of DPP4i on ANS. We demonstrated the autonomic modulation by SGLTi and DPP4i using SKNA in patients with DM, which might provide insights into the favorable outcomes of SGLT2i. Furthermore, we refined the analytical methods of neuECG, which uses SKNA to evaluate autonomic function.
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    Rebiopsy Enhances Survival with Afatinib vs. Osimertinib in EGFR Exon 19 Deletion Non-Small Cell Lung Cancer: A Multicenter Study in Taiwan.
    (2025-01-10)
    Kuo, Jerry Shu-Hung
    ;
    Chang, Cheng-Yu
    ;
    Chang, Shih-Chieh
    ;
    Wei, Yu-Feng
    ;
    Background: Afatinib and Osimertinib are first-line treatments for EGFR-mutated advanced non-small cell lung cancer (NSCLC), but their comparative efficacies and the patient groups that benefit the most remain unclear. This multicenter retrospective study evaluated the efficacy of first-line Afatinib and Osimertinib in NSCLC patients with EGFR 19del and no brain metastases at diagnosis. Methods: The primary endpoints were time on treatment (ToT) and overall survival (OS). Survival analyses were performed for three groups: Afatinib followed by Osimertinib, Afatinib followed by other therapies, and Osimertinib (alone or followed by other therapies). Rebiopsy practices, including T790M mutation detection, were also analyzed in patients with disease progression on Afatinib. Results: Among 97 Afatinib-treated and 60 Osimertinib-treated patients, Osimertinib showed a significantly longer ToT (23.3 vs. 16.5 months; p = 0.007). Median OS was numerically higher for Afatinib with sequential Osimertinib (40.5 vs. 34.6 months for Osimertinib; p = 0.473). Osimertinib demonstrated advantages, with fewer brain metastases upon progression and fewer adverse effects. In the Afatinib group, 64% of patients with disease progression underwent rebiopsy, with 39% testing positive for T790M mutation and subsequently receiving Osimertinib. Rebiopsy was most frequently performed on the lung parenchyma using non-surgical methods. Conclusions: In this real-world study, Osimertinib achieved a significantly longer ToT compared to Afatinib in NSCLC patients with EGFR 19del and no brain metastases. The sequential use of Afatinib followed by Osimertinib showed a trend toward improved OS, highlighting the importance of rebiopsy for identifying T790M mutations to guide subsequent therapy.
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