Additional Treatment Research Articles

Complete CP-eigen bases of meson-baryon chiral lagrangian up to p5-order

Chiral perturbation theory describes the low energy dynamics of mesons and baryons in terms of the nonlinear Goldstone boson and fermion degrees of freedom. Through the Young tensor technique, we construct the on-shell operator bases for the meson-baryon system up to p5-order, using the chiral dimension power counting and heavy baryon expansion. For the Lorentz structure, additional treatments on off-shell external sources and operators with higher derivatives are necessarily considered, while for the internal structure, the invariant tensor basis is converted into the trace basis equivalently, and Cayley-Hamilton relations are utilized to classify different CP eigen-operators. Finally we present the complete operator set of C+P+, C+P-, C-P+, and C-P- eigen-operators at the p5-order, and obtain the operator counting from the Hilbert series.

Multi-Path Mechanism of Phytoconstituents in Herbal Remedies for Obesity

Obesity, a metabolic disease with multiple manifestations, has become an epidemic around the world, necessitating efficient and long-term solutions. Since there is an extensive list of phytoconstituents and mechanisms for effective conventional herbal remedies, there has been a lot of focus on potential applications for managing obesity. This study focuses on multiple ways that plant-based compounds in various herbal remedies may help combat obesity. The strategies include modifying adipogenesis, ceasing lipogenesis, accelerating lipolysis, regulating appetite, helping insulin respond more effectively, and altering the gut microbiota. We address the function and clinical evidence of key phytoconstituents from plants like bitter oranges (synephrine), green tea (catechins), and Garcinia cambogia (hydroxycitric acid) in maWe also consider potential complications and explore opportunities for investigating and developing herbal weight loss solutions. We may be able to use plant phytoconstituents as additional treatments or prevent overweight and associated problems by understanding their intricate working methods.

Comparison of high-temperature friction and wear behaviours of Ti6Al4V produced by additive manufacturing and casting

Additive manufacturing (AM) methods, especially selective laser melting (SLM), have recently attracted attention because they enable the quick and easy production of complex parts that cannot be produced with traditional manufacturing methods. However, residual stresses in the fabricated components impact their mechanical characteristics and may necessitate additional heat treatments. In this study, SLM-produced Ti6Al4V parts were subjected to a stress relief treatment under argon gas at 790°C for 2 h. The microstructure, microhardness and high-temperature tribological properties were examined comparatively with the traditional casting method. Dry sliding tribological experiments were carried out at different temperatures up to 600°C to compare high-temperature performance. It has been determined that the microstructure of samples produced by casting and SLM comprised β and α phases. The casting sample had 66.02% α grains, whereas the SLM sample had 59.02% α grains. The average microhardness in the SLM sample was marginally higher than that in the casting due to the formation of martensitic α. The results showed that wear rates increased with temperature for each sample. SLM samples exhibited slightly higher wear rates at each test temperature compared to the casting sample, which is attributed to the oxidative wear mechanism. The higher percentage of oxygen in the triboxide layers in the casting sample increased the wear resistance. When examining friction coefficients, an increase in average friction coefficients was observed at a test temperature of 300°C, while a decrease was observed at a test temperature of 600°C.

Expanding Lightweight Design Potential by Hybrid Joining of Aluminum Sheets with Aluminum Casting Through Compound Sand Casting and Induction Heating

Combining light metals like aluminum to produce lightweight structures offers a high weight‐saving and contributes to a circular economy in automotive car body construction. Compound casting is a promising process for producing car body parts. Difficulties arise in creating metallic continuity between insert and casting. Insert coatings are used to remove the oxide layer and thereby improve the wettability of the melt. This study uses a hybrid joining method to improve the metallic bond between insert and casting. Induction heating differently influences the strength properties of age‐ and nonage‐hardenable inserts. Compression shear tests characterize the metallic bond strength. Microscopic images show the influence of the process variables on the compound quality. Reproducible sound metallic bonding with low scattering is achieved by enhancing the compound casting process through induction and no insert coating. Cast wall thicknesses down to 4 mm contribute to further lightweight potential as they have the same strength level as the reference sample. A decisive factor is the insert temperature in the compound zone. Thereby, insert preheating conditions play a crucial role. Additional heat treatment of hardenable compounds leads to a further increase in metallic bond strength.

Advances in Microsurgical Treatment Options to Optimize Autologous Free Flap Breast Reconstruction

Introduction: Reconstructive plastic surgeons have made great strides in the field of breast reconstruction to achieve the best results for patients undergoing treatment for breast cancer. As microsurgical techniques have evolved, these patients can benefit from additional treatment modalities to optimize the results of the reconstruction. Free tissue transfer from alternative donor sites for breast reconstruction is routinely performed, which was not possible in the past. Neurotization is now possible to address the numbness and lack of sensation to the reconstructed breast. For those patients who develop lymphedema of the upper extremity as a result of their breast cancer care, supermicrosurgical options are now available to treat and even to prevent the development of lymphedema. This study presents a narrative review regarding the latest microsurgical advancements in autologous free flap breast reconstruction. Methods: A literature review was performed on PubMed with the key words “autologous free flap breast reconstruction”, “deep inferior epigastric perforator flap”, “transverse upper gracilis flap”, “profunda artery perforator flap”, “superior gluteal artery perforator flap”, “inferior gluteal artery perforator flap”, “lumbar artery perforator flap”, “breast neurotization”, “lymphovenous bypass and anastomosis”, and “vascularized lymph node transfer”. Articles that specifically focused on free flap breast reconstruction, breast neurotization, and lymphedema surgery in the setting of breast cancer were evaluated and included in this literature review. Results: The literature search yielded a total of 4948 articles which were screened. After the initial screening, 413 articles were reviewed to assess the relevance and applicability to the current study. Conclusions: Breast reconstruction has evolved tremendously in recent years to provide the most natural and cosmetically pleasing results for those patients undergoing treatment for breast cancer. As technology and surgical techniques have progressed, breast cancer patients now have many more options, particularly if they are interested in autologous reconstruction. These advancements also provide the possibility of restoring sensibility to the reconstructed breast as well as treating the sequela of lymphedema due to their cancer treatment.

Metabolic adverse drug reactions related to psychotropic drugs

Metabolic adverse drug reactions (mADR) related to psychotropic drugs have significant health-related effects including weight gain, impaired glucose tolerance, diabetes mellitus and dyslipidemia as well as economic relevance. Nearly all antipsychotics (AP) and many antidepressants (AD) and mood stabilisers may induce weight gain. Weight development in the first weeks or months after the beginning of the therapy is the strongest predictor for weight gain related to AP and AD. The most important risk factors for mADR are antagonistic effects at H1-, 5-HT2C- und M3-receptors and antidopaminergic effects. However, several other systems are also relevant. Systematic monitoring of metabolic parameters is recommended in all patients treated with substances that are associated with an increased risk of mADR. Lifestyle modification, dietary measures, exercise therapy, dose reduction, change and discontinuation of the substance, and additional treatment with metformin and topiramate are evidence-based treatment options for AP-associated weight gain. GLP-1 receptor agonists such as liraglutide are also promising.

Fully Synthetic TF-Based Self-Adjuvanting Vaccine Simultaneously Triggers iNKT Cells and Mincle and Protects Mice against Tumor Development.

The Thomsen-Friedenreich (TF) antigen has proven to be a promising target for developing novel therapeutic cancer vaccines. Here, a new strategy that TF antigen covalently coupled with KRN7000 and vizantin was developed. The resulting three-component vaccine KRN7000-TF-vizantin simultaneously triggers invariant natural killer T (iNKT) cells and macrophage-inducible C-type lectin (Mincle) signaling pathways, eliciting much stronger TF-specific immune responses than glycoprotein vaccine TF-KLH/alum and the corresponding two-component conjugate vaccines TF-KRN7000 and TF-vizantin. The analysis of IgG isotypes and the secretion of cytokines revealed that KRN7000-TF-vizantin induced Th1/Th2 mixed immune responses, where Th1 was dominant. In vivo experiments demonstrated that KRN7000-TF-vizantin increased the survival rate and survival time of tumor-challenged mice, and surviving mice rejected further tumor attacks without any additional treatment. This work demonstrates that covalently coupled KRN7000 and vizantin could serve as a promising TF-based vaccine carrier for antitumor immune therapy, and KRN7000-TF-vizantin features great potential to be a vaccine candidate.

Analysis on the Ancient Bronze Cooking Outils Excavated from Historic Site of Anti-Mongolian Struggle in Hangpaduri, Jeju

The microstructure of ancient bronze cooking outil excavated in historic site of anti-Mongolian struggle in Hangpaduri was analyzed to confirm various manufacturing techniques. Bronze spoon and bronze ladles were made by alloying only copper and tin, and the alloy ratio included approximately 22% tin in the copper composition of the forged high tin bronze. The manufacturing process of forged high tin bronze technology, which commonly involves high-temperature forging and final finishing with quenching, was performed. In addition, the sulfide elongated in the longitudinal direction shows that the copper material supplied to the metal may be copper ore containing sulfur such as chalcopyrite and chalcocite. The three bronzewares were made using a binary alloy of copper-tin and a ternary alloy of copper-tin-lead, respectively. Manufacturing techniques using a binary alloy of copper-tin are divided into a forged high tin bronze technique using a hammering and quenching process and a manufacturing technique system of quenching after casting into a shape. Bronze bowl made using a ternary alloy of copper-tin-lead contain 11 wt% tin and 9 wt% lead in the main metal of copper. The lead contained in large quantities is formed in an uneven size within the microstructure, and shows the characteristic of sulfide being distributed around the lead. In addition, there are no traces of additional processing or heat treatment such as quenching. Therefore, it can be seen that the work process was completed by casting the shape. The results of the microstructure analysis show various manufacturing technology systems applied to the bronze cooking outils from historic site of anti-Mongolian struggle in Hangpaduri, Jeju. In particular, through comparison with bronze artifacts utensils excavated from other regions of the Sambyeolcho’s historic site, the possibility of bronze being introduced due to the migration of the Sambyeolcho was confirmed.

Scalable Hypothalamic Arcuate Neuron Differentiation from Human Pluripotent Stem Cells Suitable for Modeling Metabolic and Reproductive Disorders.

The hypothalamus, composed of several nuclei, is essential for maintaining our body's homeostasis. The arcuate nucleus (ARC), located in the mediobasal hypothalamus, contains neuronal populations with eminent roles in energy and glucose homeostasis as well as reproduction. These neuronal populations are of great interest for translational research. To fulfill this promise, we used a robotic cell culture platform to provide a scalable and chemically defined approach for differentiating human pluripotent stem cells (hPSCs) into pro-opiomelanocortin (POMC), somatostatin (SST), tyrosine hydroxylase (TH) and gonadotropin-releasing hormone (GnRH) neuronal subpopulations with an ARC-like signature. This robust approach is reproducible across several distinct hPSC lines and exhibits a stepwise induction of key ventral diencephalon and ARC markers in transcriptomic profiling experiments. This is further corroborated by direct comparison to human fetal hypothalamus, and the enriched expression of genes implicated in obesity and type 2 diabetes (T2D). Genome-wide chromatin accessibility profiling by ATAC-seq identified accessible regulatory regions that can be utilized to predict candidate enhancers related to metabolic disorders and hypothalamic development. In depth molecular, cellular, and functional experiments unveiled the responsiveness of the hPSC-derived hypothalamic neurons to hormonal stimuli, such as insulin, neuropeptides including kisspeptin, and incretin mimetic drugs such as Exendin-4, highlighting their potential utility as physiologically relevant cellular models for disease studies. In addition, differential glucose and insulin treatments uncovered adaptability within the generated ARC neurons in the dynamic regulation of POMC and insulin receptors. In summary, the establishment of this model represents a novel, chemically defined, and scalable platform for manufacturing large numbers of hypothalamic arcuate neurons and serves as a valuable resource for modeling metabolic and reproductive disorders.

Staged strategy of combined rotational atherectomy and intravascular lithotripsy for severely calcified lesions: an evaluation using multimodality intracoronary imaging—a case report

Abstract Background Severely calcified lesions are the most significant challenge for percutaneous coronary intervention, exhibiting poor clinical outcomes. Some severely calcified lesions remain untreatable with conventional balloons or even atherectomy devices. Intravascular lithotripsy is a new option for treating severe calcification. Case summary Herein, we describe a case of ischaemic cardiomyopathy with a thick, circumferential calcified lesion in the proximal and mid-segments of the left anterior descending coronary artery. In the first session, high-pressure balloons, cutting balloons, and rotational atherectomy failed to disrupt the calcification. In the staged additional treatment that was subsequently planned, eight cycles of intravascular lithotripsy created multiple fractures in the deep calcification, resulting in successful stent deployment. The effect of intravascular lithotripsy was observed mainly in calcified areas with lipid components detected using near-infrared spectroscopy-intravascular ultrasound. Discussion Our report suggests the efficacy of employing a combined strategy of rotational atherectomy with small burrs and intravascular lithotripsy in the treatment of severe calcification with a minimal risk of complications. Our study introduces a novel aspect by utilizing near-infrared spectroscopy-intravascular ultrasound to evaluate calcified lesions before performing intravascular lithotripsy. To our knowledge, there have been no similar reports to date. The effect of intravascular lithotripsy on calcified lesions may be related to the distribution of lipid components and/or heterogeneity within the calcification.

Microplastic additions modulate intraspecific variability in root traits and mycorrhizal responses across root‐life history strategies

Abstract Microplastics (MP) are recognized as a major pollutant in terrestrial environments, prompting concerns about their effects on plant–soil dynamics. Despite evidence of MP altering soil physicochemical properties, impacts on belowground root traits and arbuscular mycorrhizal (AM) fungi remain poorly explored. Existing research has mainly centred on a few model plant species, emphasizing root biomass, and often employs single polymer types and addition rates that surpass realistic scenarios. To investigate how environmentally relevant mixtures and concentrations of MPs impact plant growth, root trait expression and AM fungal colonization, we conducted a greenhouse experiment using six plant species chosen for their contrasting root life strategies; three species in the Amaryllidaceae family represented resource conservation root traits (Allium fistulosum (onion), Allium tuberosum (chive), Allium porrum (leek)), and three from the Solanaceae family, represented plants with resource acquisitive root traits (Solanum lycopersicum (tomato), Solanum melongena (eggplant), Capsicum annuum (pepper)). MP treatments consisted of control (0% MP), low (0.1% w/w) and high (1% w/w) MP additions, using an environmentally relevant MP mixture of weathered polymer types and shapes. We measured above and belowground biomass, average root trait expression (specific root length (SRL), average root diameter (D) and root tissue density (RTD)), AM fungal colonization, as well as intraspecific variability across MP addition treatments. We found that responses to environmentally relevant additions of MPs were species specific and not determined by root life‐strategy. MPs increased biomass in leek, eggplant and tomato, while decreasing AM fungal colonization in tomato. MP additions had no discernible impact on average root functional trait expression across species. However, the addition of MPs resulted in altered intraspecific variability in root traits and AM fungal colonization, indicating a mechanism for plant tolerance to MPs. To address the impacts of MPs on plant functioning, research needs to focus on environmentally relevant mixtures of MPs, considering various plant species' capacities to tolerate soil contamination and the potential for tipping points under real‐world conditions. Read the free Plain Language Summary for this article on the Journal blog.

Nutrient recovery from source-separated urine via sorption and a comparative investigation on the improvement of the residual liquid quality

Human urine, a highly saline solution rich in plant-available nutrients, leaves behind significant organic matter after nutrient recovery, necessitating additional treatment for environmental protection. While nutrient recovery from human urine is well-documented in the literature, research on the safe handling of the residual liquid phase is notably lacking. This study investigates nutrient recovery from source-separated human urine using clinoptilolite for the ion exchange/adsorption process and evaluates the safe management of the residual liquid through anaerobic granular sludge and a second-stage of sorption. The results indicated that the ion exchange/adsorption process, using an ammonium loading of 15 mg NH4+/g clinoptilolite, removed the majority of nutrients, achieving 82% ammonium removal and 100% phosphorus removal, along with 30% removal of organic matter. The residual liquid phase from the nutrient removal stage was treated separately with anaerobic digestion and a second-stage of sorption for further processing. Results showed that anaerobic processing removed 68%–84% of organic matter, with no additional nitrogen removal observed as expected, and produced 0.20–0.46 L CH4/L urine. The second-stage of sorption removed 59%–62% of organic matter and nearly all nitrogen. Both processes effectively removed organic matter, with sorption also eliminating nitrogen and anaerobic processing potentially generating biogas, making them recommended for improving the quality of the residual liquid phase before final disposal.

Non-linear response of plant caloric value to N addition and mowing treatments in a meadow steppe

BackgroundCaloric value is an important indicator of grassland ecosystem function, but the response of caloric value to nitrogen (N) addition and mowing is still unclear. We explored the adaptive changes of plant caloric value and energy standing crop along a N addition gradient after six-year NH4NO3 addition and mowing treatments in an Inner Mongolian temperate meadow steppe in northern China.ResultsWe found that the response of plant caloric value to N addition at different organizational levels was diverse. The caloric value of legumes increased linearly with N addition rates. The caloric value of grasses exhibited a non-linear response trend, initially increasing followed by saturation or decrease, with a N response threshold present. Due to the dominance of grass species, the caloric value at the community level followed a similar pattern to that of the grasses along the N addition gradient. Under mowing, the caloric value of plants at each organizational level increased and usually mowing enhanced the N response threshold. Amongst these, the N response threshold of Leymus chinensis increased from 3.302 to 5.443 g N m−2 yr−1, grasses increased from 4.414 to 5.746 g N m−2 yr−1, and community increased from 5.373 to 9.216 g N m−2 yr−1. Under non-mowing treatment, the N response thresholds of the most dominant species, Leymus chinensis, and community energy standing crop were 10.001 and 15.119 g N m−2 yr−1, respectively. Under mowing, the energy standing crops showed a linear increasing trend.ConclusionsN response thresholds of plant caloric value and energy standing crop vary at different organizational levels (community > functional group > species). The results reveal varying regulatory capabilities of plants on the ecological environment at different organizational levels. These findings enhance our understanding of plant-environment interactions in grassland ecosystems under N deposition from an energy perspective, which is of great significance to clarify the response mechanism of grassland ecosystem structure and function to N deposition.

Short-Term Warming Induces Cyanobacterial Blooms and Antibiotic Resistance in Freshwater Lake, as Revealed by Metagenomics Analysis

Climate change threatens freshwater ecosystems, potentially intensifying cyanobacterial blooms and antibiotic resistance. We investigated these risks in Cosseys Reservoir, New Zealand, using short-term warming simulations (22 °C, 24 °C, and 27 °C) with additional oxidative stress treatments. A metagenomic analysis revealed significant community shifts under warming. The cyanobacterial abundance increased from 6.11% to 20.53% at 24 °C, with Microcystaceae and Nostocaceae proliferating considerably. The microcystin synthesis gene (mcy) cluster showed a strong association with cyanobacterial abundance. Cyanobacteria exhibited enhanced nutrient acquisition (pstS gene) and an upregulated nitrogen metabolism under warming. Concurrently, antibiotic resistance genes (ARGs) increased, particularly multidrug resistance genes (50.82% of total ARGs). A co-association network analysis identified the key antibiotic-resistant bacteria (e.g., Streptococcus pneumoniae and Acinetobacter baylyi) and ARGs (e.g., acrB, MexK, rpoB2, and bacA) central to resistance dissemination under warming conditions. Oxidative stress exacerbated both cyanobacterial growth and ARGs’ proliferation, especially efflux pump genes (e.g., acrB, adeJ, ceoB, emrB, MexK, and muxB). This study demonstrated that even modest warming (2–5 °C) could promote both toxic cyanobacteria and antibiotic resistance. These findings underscore the synergistic effects of temperature and oxidative stress posed by climate change on water quality and public health, emphasizing the need for targeted management strategies in freshwater ecosystems. Future research should focus on long-term impacts and potential mitigation measures.

Evaluating the Necessity of Routine Histopathology in Sleeve Gastrectomy Specimens: A Five-Year Analysis.

Laparoscopic sleeve gastrectomy (LSG) is a widely performed bariatric surgery that involves the removal of a portion of the stomach. Routinely, the resected gastric tissue is sent for histopathological examination to screen for malignancies or other significant pathological findings. However, the necessity of this routine practice remains uncertain. This study aims to evaluate the histopathological outcomes of LSG specimens over a five-year period at our institution. We conducted a retrospective analysis of 203 patients who underwent LSG between January 2017 and December 2022 at Heartlands Hospital, University Hospitals Birmingham. Data collected included patient demographics, body mass index (BMI), use of preoperative oesophagogastroduodenoscopy (OGD), and histopathological findings. Patients with incomplete records or those who underwent Roux-en-Y gastric bypass were excluded from the study. Data were extracted for 310 patients, of whom 107 were excluded. The majority of the 203 patients analyzed were female (83%), with a mean age of 45.7 years and a mean BMI of 45.4 ± 7.3. Preoperative OGD was performed in only 0.5% of cases. Histopathological examination revealed that 81.3% (n=165) of patients had normal gastric mucosa, while 14.3% (n=29) had chronic gastritis. Clinically significant findings were rare, with only 1% (n=2) of patients showing gastrointestinal stromal tumors (GISTs) or focal intestinal metaplasia. None of the patients required additional treatment or follow-up based on these histopathological findings. Most LSG specimens in our study showed normal or non-significant histopathological findings, raising questions about the routine use of histopathological examination in LSG procedures. It remains unclear whether histopathology is necessary following sleeve gastrectomy. While no patients in our cohort required further treatment or surveillance, there are reports in the literature where surveillance or further treatment was necessary, though the incidence remains low. Given the low incidence of clinically significant pathology, further studies with larger sample sizes and multi-center data are needed to establish clear guidelines on this issue.

Challenges of a Circular Economy: The Example of Raw Recycled Tyre Steel Fibres Added to Concrete.

This research was conducted to analyse the possibility of using raw, untreated recycled tyre fibres as an effective concrete reinforcement according to circular economy principles. The aim of the article was also to develop a method for dispensing tire fibres on a real scale. Additional treatment and homogenisation of recycled steel fibres entail higher energy consumption, emissions of greenhouse gases, and increased costs. However, obtaining durable and safe concrete effectively reinforced with steel fibres is critical. Finding a balance between environmental friendliness and product durability is a circular economic challenge. Reference concrete with commercial steel fibres (15 kg/m3) and two concretes containing various quantities of non-treated, raw tyre recycled fibres (25 kg/m3 and 45 kg/m3) were industrially produced. Tests were carried out on the properties of the concrete mixture and hardened concrete, such as compressive strength, flexural strength, splitting strength, modulus of elasticity, residual flexural tensile strength, and fibre distribution in concrete. Tests revealed that increasing the amount of raw tyre fibres disturbs the structure and causes air entrainment and the formation of fibre clusters. Smaller quantities of raw tyre fibres turn out an effective concrete reinforcement. The use of non-treated tyre fibres as concrete reinforcement is possible but requires more stringent control of the concrete parameters. Implementation tests on an industrial scale are a novelty in this study, presenting an analysis of the possible dispensing of tyre fibres in a ready-mixed concrete production plant and testing the characteristics of manufactured concrete.

Genetic profiles and clinical features in subcutaneous panniculitis-like T-cell lymphomas.

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare peripheral T-cell lymphomacharacterized by cutaneous lesions and immunologic manifestations. The five-year survival rate of SPTCL has been reported to be over 80%, indicating a favorable prognosis. Recent studies have uncovered recurrent germline variants in HAVCR2, encoding an immunomodulator. In this study, we integrated whole-exome sequencing data from 60 samples collected from 36 SPTCL patients, encompassing six patients of our cohort and 30 patients of publicly available data. We identified 138 somatic mutations in skin tumors of 24 patients and HAVCR2 germline mutations in 23 of 29 patients. HAVCR2 p.Tyr82Cys mutations were identified in four of six Japanese patients. During the clinical courses of four patients, cyclophosphamide, hydroxydaunomycin, vincristine, and prednisone were administered to all patients, but it resulted in incomplete responses in all four patients. However, disease conditions of all patients remained stable with additional treatment, including autologous peripheral blood stem cell transplantation. Over a 7.5-year median follow-up, one patient developed autoimmune-related diseases, while one developed other hematological malignancy, resulting in death. To our knowledge, this is the first report of recurrent HAVCR2 germline mutations in Japanese patients, suggesting the necessity for long-term follow-up.

Phase 1 trial of intraperitoneal paclitaxel in patients with gastric adenocarcinoma and carcinomatosis or positive cytology.

The purpose of this phase 1 trial was to evaluate the safety and toxicity of repeated normothermic intraperitoneal paclitaxel (PTX) for patients with gastric cancer metastatic to the peritoneum. A Bayesian optimal interval design was used to prospectively identify the safety and tolerability of escalating doses of intraperitoneal paclitaxel at weekly treatments for 3 weeks, followed by a 1-week break, and then three additional treatments. The primary objective was to define the maximum tolerated dose. Secondary end points included safety, tolerability, and antitumor activity. A total of 25 patients were treated between January 2020 and April 2023. Five dose-limiting toxicities were observed at 100 mg/m2. Treatment-related grade 3-4 toxicity included leukopenia (32%) and neutropenia (32%). Seven patients required a schedule change to every other week treatments. The maximum tolerated dose for intraperitoneal PTX was 100 mg/m2. The peritoneum post-intraperitoneal PTX demonstrated progression in five (20%), stable disease in five (20%), improvement in 10 (40%), and not evaluable in five (20%). Eight patients (32%) had resolution of their peritoneal disease and seven (28%) underwent attempted resection. The median overall survival (OS) from the diagnosis of metastatic disease was 18.8 months and from the date of treatment initiation was 10.8 months. One-, 2-, and 3-year OS rates from the diagnosis of metastatic disease were 84%, 38%, and 25%, respectively. Paclitaxel may be safely used at intraperitoneal doses of 100 mg/m2. Neutropenia associated with weekly treatments was common. Peritoneal complete clinical response rates with multimodality therapy including PTX were promising.

Worldwide CTEPH Registry: Long-Term Outcomes With Pulmonary Endarterectomy, Balloon Pulmonary Angioplasty, and Medical Therapy.

The European Chronic Thromboembolic Pulmonary Hypertension (CTEPH) registry, conducted between 2007 and 2012, reported the major impact of pulmonary endarterectomy (PEA) on the long-term survival of patients with CTEPH. Since then, 2 additional treatments for inoperable CTEPH have become available: balloon pulmonary angioplasty (BPA), and an approved oral drug therapy with the guanylate cyclase stimulator riociguat. The current registry aimed to evaluate the effect of these new therapeutic approaches in a worldwide context. Participation in this international global registry included 34 centers in 20 countries. Between February 2015 and September 2016, 1009 newly diagnosed, consecutive patients were included and followed until September 2019. Overall, 605 patients (60%) underwent PEA and 185 (18%) underwent BPA; 76% of the 219 remaining patients not receiving mechanical intervention (ie, neither PEA nor BPA) were treated with pulmonary hypertension drugs. Of patients undergoing PEA and BPA, 38% and 78% also received drugs for pulmonary hypertension, respectively. Median age at diagnosis was higher in the BPA and No PEA/BPA groups than in the PEA group: 66 and 69, respectively, versus 60 years. Pulmonary vascular resistance (PVR) was similar in all groups, with an average of 643 dynes.s.cm-5. During the observation period (>3 years; ≤5.6 years), death was reported in 7%, 11%, and 27% of patients treated by PEA and BPA, and those receiving no mechanical intervention (P<0.001). In Kaplan-Meier analysis, 3-year survival was 94%, 92%, and 71% in the 3 groups, respectively. PEA 3-year survival improved by 5% from that observed between 2007 and 2012. There was no survival difference in patients receiving vitamin K antagonists and non-vitamin K oral anticoagulants (P=0.756). In Cox regression, reduced mortality was associated with: PEA and BPA in the global cohort; history of venous thromboembolism and lower PVR in the PEA group; lower right atrial pressure in the BPA group; and use of pulmonary hypertension drugs, oxygen therapy, and lower right atrial pressure, as well as functional class in the group receiving no mechanical intervention. This second international CTEPH registry reveals important improvement in patient survival since the introduction of BPA and an approved drug for pulmonary hypertension. The type of anticoagulation regimen did not influence survival. URL: https://www.clinicaltrials.gov; Unique identifier: NCT02656238.

Production and characterization of geopolymers containing electric arc furnace dust (EAFD) for hazardous metals sequestration

The present research deals with the production and characterization of geopolymers prepared by mixing metakaolin with sodium silicate, sodium hydroxide solution and different amounts of electric arc furnace dust derived from the production of carbon steel, to be used by the construction industry. Specimens with compositions containing 90, 80, 70, 60 and 50 g of metakaolin and respectively 10, 20, 30, 40 and 50g of electric arc furnace dust powder were prepared. A blank composition containing metakaolin, sodium silicate, sodium hydroxide solution and free from electric arc furnace dust were also prepared for comparison. After production and hardening, all samples were characterized regarding compressive strength and water absorption. Hardened samples with compositions containing 10 and 30g of electric arc furnace dust were then submitted to a release test in order to evaluate the heavy metals elution. It has been observed that the addition of electric arc furnace dust worsens the pastes workability during their production in this way limiting the amount of electric arc furnace dust which may be added to the geopolymeric matrix. However, samples containing 90 g of metakaolin and 10 g of electric arc furnace dust still maintain fair compressive strength (about 27 MPa), low water absorption (about 28 %) and display limited elution of heavy metals. An additional thermal treatment of 1h at 700 °C, performed to induce sintering of the geopolymeric composites and therefore to reduce their porosity, did not lead to materials with improved performances.