Effectiveness Of Treatment Research Articles

Effects of Probiotic Therapy on Periodontal and Peri-implant Treatments: An Umbrella Review.

The effectiveness of nonsurgical periodontal treatment is related to patient- and tooth-related factors. To overcome the limitations of the conventional approach, probiotics are one of the adjunct therapies that have been studied. This umbrella review answered the focused question: in adult patients with periodontal diseases or peri-implant diseases, does the use of probiotic therapy as an adjuvant to nonsurgical periodontal treatment when compared with nonsurgical periodontal treatment alone affect treatment effectiveness and clinical disease parameters? A systematic electronic search to identify systematic reviews according to PICOS criteria, defined a priori, was used, and 5 electronic databases were searched (Medline, LILACS, Cochrane Central Registry of Controlled Trials, Google Scholar, and DANS EASY). Included systematic reviews were rated using quality assessment tools by 2 independent reviewers. Thirty systematic reviews were identified evaluating the effectiveness of probiotics in periodontal and peri-implant disease treatment. A quantitative analysis of the results was not possible due to the high heterogeneity of clinical data. Seventeen of 31 reviews reported clinically relevant benefits of probiotic therapy as an adjuvant to scaling and root planning. Twenty-two reviews had a low risk of bias, 7 had a moderate risk, and 2 had a high risk. The evidence from the available studies is conflicting, which means that no definitive conclusions can be made about the effectiveness of probiotic therapy as an adjuvant to nonsurgical periodontal treatment. High-quality primary research studies are needed that control for known confounding variables. This umbrella review provides some evidence regarding the efficacy of probiotics as an adjunct to nonsurgical periodontal therapy, despite some equivocal findings. However, short-term probiotic use alongside therapy appears to be advantageous; there is currently no evidence supporting their long-term benefits. We have also identified that probiotic research is primarily constrained by its origins in gastrointestinal applications, resulting in a lack of approved probiotics for dental use. This review highlights the need for extensive clinical research to ascertain their effectiveness in the oral environment. Nevertheless, the utilization of probiotics alongside periodontal treatment seems safe, with no reported adverse effects in patients. Thus, further clinical validations in oral health care settings are crucial.

Ion Mobility-Mass Spectrometry Captures the Structural Consequences of Lipid Nanoparticle Encapsulation on Ribonucleic Acid Cargo.

Ribonucleic acids (RNAs) are becoming increasingly significant in our search for improved biotherapeutics. RNA-based treatments offer high specificity, targeted delivery, and potentially lower-cost options for various debilitating human diseases. Despite these benefits, there are still relatively few FDA-approved RNA-based therapies, with the notable exceptions being the mRNA (mRNA) COVID-19 vaccines, which are delivered using lipid nanoparticle (LNP) systems. LNPs are distinctive drug delivery systems (DDSs) because of their ability to target specific cells, their biocompatibility, and their efficiency in merging with cellular membranes to enhance treatment effectiveness. While the biophysical landscapes of RNA structures in solution are relatively well understood, the impact of the LNP environment on RNA remains less clear. This study uses native ion mobility-mass spectrometry (IM-MS) and collision-induced unfolding (CIU) techniques to investigate how LNP encapsulation affects RNA structure and stability. We examine how various factors, such as ionization polarity, cofactor binding, lipid types, and lipid ratios, influence LNP-released RNA cargo. Our findings reveal that LNP DDSs induce significant changes in the structures and stabilities of their RNA cargo. However, the extent of these changes strongly depends on the type and composition of the lipids used. We conclude by discussing how IM-MS and CIU can aid in the continued development of more efficient LNP DDSs and improve DDS selection methodologies overall.

OUTCOME MEASURES FOR CERVICOGENIC DIZZINESS: A META ANALYSIS.

Background: Cervicogenic dizziness (CGD) is a complex condition characterized by dizziness arising from cervical spine disorders. It affects approximately 40% of patients with chronic neck pain and can significantly impact daily activities, quality of life, and mental health. The involvement of cervical structure in vestibular function highlights the need for effective assessment tools. Outcome measures play a crucial role in diagnosing CGD, evaluating treatment effectiveness, and improving patient outcomes. This evolved, focusing on both subjective and objective assessments, including symptom questionnaires, functional scales, and vestibular function tests. Standardized outcome measures are essential for clinical making and guideline development. Objective: The objective of the study is to systematically evaluate and compare the reliability, validity and sensitivity data of various outcome measures of cervicogenic dizziness. Method: The systemic data were searched using PubMed, Scopus, Google scholar, Science direct, PEDro, Cochrane library to identify studies published from the year 2001 up to 2023. Study selection is reported according to PRISMA guidelines. A total of 50 review articles were collected on outcome measures for Cervicogenic Dizziness (CGD). Data extraction included Research, Evidence based study, Literature, Systematic reviews and Meta-analysis articles. Result: This meta-analysis states that outcomes measures for Cervicogenic Dizziness (CGD) show a highly significant difference. Conclusion: After analysis of various articles, it was concluded that diagnosing patients with outcome measures for Cervicogenic Dizziness shows highly significant and improving health care efficiency. This study identified reliable and valid outcome measures for assessing Cervicogenic Dizziness (CGD). Implication: This study findings have significant implication for clinical practice, research, and policy, enhancing diagnosis, treatment and patient outcomes, standardized use of validated outcome measures will inform evidence – based guidelines for Cervicogenic Dizziness.

Comparative Efficacy of Different Pharmacological Treatments for Pityriasis Rosea: A Network Meta-Analysis

Background/Objectives: Pityriasis rosea (PR) is a self-limiting exanthematous disease associated with the endogenous reactivation of human herpesviruses (HHV)-6 and HHV-7. Classically, the lesions gradually resolve, leaving no sequelae. Therefore, the best treatment is reassuring the patient and suggesting a resting period. However, atypical PR cases characterized by extensive, persistent lesions and systemic symptoms may impact the patient’s quality of life, and, therefore, a treatment can be prescribed. There is limited evidence on the comparative effectiveness of pharmacological treatments for PR; therefore, we performed a network meta-analysis to compare these interventions. Methods: Overall, 12 randomized control trials (RCTs) were identified. The outcomes were itch resolution and rash improvement. Results were expressed as risk ratio (RR) and 95% confidence interval (CI). We also calculated the relative ranking of the interventions for achieving the aforementioned outcomes as their surface under the cumulative ranking (SUCRA). Results: On network meta-analysis, only oral steroids and the combination of oral steroids+antihistamine resulted significantly superior to the placebo in terms of itch resolution (RR 0.44, CI 0.27–0.72 and RR 0.47, CI 0.22–0.99). Oral steroids resulted in the best treatment (SUCRA 0.90) for itch resolution. In terms of rash improvement, only acyclovir and erythromycin resulted significantly superior to placebo (RR 2.55, CI 1.81–3.58; and RR 1.69, CI 1.23–2.33), and acyclovir outperformed all the other tested interventions. Consequently, acyclovir ranked as the best intervention (SUCRA score 0.92). Conclusions: Acyclovir represents the best option for patients with PR that have extensive, persistent lesions or systemic symptoms. Steroids and antihistamines seemed the best treatment for itch resolution.

Follicular Dendritic Cell Sarcoma of the Thyroid Gland: A Rare Case Report

Abstract Introduction Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm of antigen-presenting cells within the reticuloendothelial system primarily originating in lymph nodes, but in almost one-third of the patients, extranodal sites are involved including oral cavity, tonsil, gastrointestinal tract, soft tissue, and breast. The thyroid gland is an extremely rare location for FDCS and very few cases are reported in the literature. Case Report Here, we present a 39-year-old man who presented with a swelling in the neck for 3 months and difficulty in breathing for 15 days. Following left hemi-thyroidectomy, histopathologically and immunohistologically, he was diagnosed as FDCS of thyroid arising in Castleman's disease. He received adjuvant radiation treatment. The patient had favorable prognosis with no evidence of disease for 6 years after treatment till date. Conclusion The aim of this report was to present the rare site of FDCS arising in the thyroid gland, the vital role of immunohistochemistry in diagnosis, and effectiveness of multimodality treatment for favorable prognosis.

Integrated Analysis of Remdesivir and Paxlovid in COVID-19 Patients: A Personalized Approach to High-Risk Individuals for Severe Evolution

Background/Objectives: COVID-19 led to a pandemic that has brought misery to millions of people but more so to those with pre-existing conditions. For this infection, several antiviral drugs were employed, including remdesivir (R) and Paxlovid (nirmatrelvir/ritonavir (NR)). Methods: The current study compared the effectiveness of remdesivir and Paxlovid treatment for COVID-19 patients with comorbid conditions. Data from a cohort of 151 adult patients with COVID-19 who also had associated comorbidities were used in this study. These patients were treated with antivirals according to local guidelines. The subjects included 78 case-patients assigned to group R and 73 to group NR. Results: In group NR, a considerable improvement in oxygen saturation was seen in the first 24 h of treatment (p = 0.010), but the levels were significantly higher from the second day of treatment (p < 0.001) in group R of patients. At the end of the 5 days of treatment, the oxygen saturation improved statistically significantly compared to the admission day, but only in the R group (95.11 ± 1.80; 91.76 ± 1.80; p < 0.001). Conclusions: Both drugs can be considered a breakthrough in the current treatment approach to the COVID-19 disease since they provide readily available options that can alleviate the severity of the disease and, hence, the prognosis of patients. That is why their effectiveness relies on the correct administration time and choosing the patient with suitable characteristics regarding the presence of comorbidities and the likelihood of the critical further development of the process.

New Emerging Therapeutic Strategies Based on Manipulation of the Redox Regulation Against Therapy Resistance in Cancer.

Background: Resistance to standard therapeutic methods, including chemotherapy, immunotherapy, and targeted therapy, remains a critical challenge in effective cancer treatment. Redox homeostasis modification has emerged as a promising approach to address medication resistance. Objective: This review aims to explore the mechanisms of redox alterations and signaling pathways contributing to treatment resistance in cancer. Methods: In this study, a comprehensive review of the molecular mechanisms underlying drug resistance governed by redox signaling was conducted. Emphasis was placed on understanding how tumor cells manage increased reactive oxygen species (ROS) levels through upregulated antioxidant systems, enabling resistance across multiple therapeutic pathways. Results: Key mechanisms identified include alterations in drug efflux, target modifications, metabolic changes, enhanced DNA damage repair, stemness preservation, and tumor microenvironment remodeling. These pathways collectively facilitate tumor cells' adaptive response and resistance to various cancer treatments. Conclusion: Developing a detailed understanding of the interrelationships between these redox-regulated mechanisms and therapeutic resistance holds potential to improve treatment effectiveness, offering valuable insights for both fundamental and clinical cancer research. Antioxid. Redox Signal. 00, 000-000.

Effectiveness of long-term bimekizumab treatment and predictive factors for responders in moderate-to-severe psoriasis: A 52-week real-world study.

Psoriasis is a chronic, inflammatory skin disease in which the interleukin (IL)-23/IL-17 axis plays a central role. Bimekizumab is a novel antibody that targets both IL-17A and IL-17F. This retrospective study aimed to assess the long-term effectiveness and safety of 52-week treatment with bimekizumab, and to identify predictive factors for short- (16 weeks) and long-term (52 weeks) responders (i.e., achievers of a Psoriasis Area and Severity Index (PASI) score of 100) to bimekizumab in Japanese patients with psoriasis. The study was conducted on 56 Japanese patients (aged ≥ 15 years) with moderate-to-severe psoriasis treated with bimekizumab from May 2022 to March 2024. The therapeutic effectiveness was evaluated by the transition of PASI scores during treatment. Baseline characteristics and clinical and laboratory indexes were compared between responders and poor responders. Treatment-emergent adverse events (TEAEs) were recorded to assess the safety of the treatment. At week 52, the achievement of PASI 100, static Physician's Global Assessment 0/1, and the Dermatology Life Quality Index 0/1 were 72.4%, 94.7%, and 93.3%, respectively. Short-term responders showed lower baseline values of neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio (MLR), and systemic inflammatory response index compared to poor responders. Long-term responders showed younger age and lower MLR compared to poor responders. TEAEs were mild or moderate, without serious adverse events. Long-term treatment with bimekizumab is effective and safe for psoriasis patients. Lower MLR and younger age might predict long-term response to treatment with bimekizumab, aiding in personalized treatment strategies.

Treatment satisfaction and effectiveness of Lurasidone on quality of life and functioning in adult patients with schizophrenia in the real-world Italian clinical practice: a prospective 3-month observational study.

Although second-generation antipsychotics (SGAs) have proven to be effective therapeutic options for patients with schizophrenia, there is a notable lack of evidence on patients' subjective perspectives regarding their well-being, quality of life, and satisfaction with these medications. This study aimed to evaluate the treatment satisfaction and effectiveness of lurasidone on quality of life and functioning in adult patients with schizophrenia in real-world Italian clinical practice. This was a multicentre, national, non-interventional, single-arm, 3-month prospective study. Patients who were naive to lurasidone treatment and whose treating physician had decided to start them on this medication were enrolled and evaluated over a 3-month period. Eligible patients were adults (≥ 18 years of age) with a primary diagnosis of schizophrenia who were being treated with lurasidone (for the first time [i.e., they were lurasidone naive]) as part of routine clinical practice. Efficacy endpoints were changes in patient/caregiver treatment satisfaction (seven-point Likert scale from the Treatment Satisfaction Questionnaire for Medication), patient quality of life and functioning (QLS), investigator-rated global assessment of functioning (CGI-S, IAQ) after 6 weeks and 3 months of lurasidone, and number of relapses and hospitalizations. Sixty-one patients were enrolled and 59 completed the study. The median dosage of lurasidone at baseline was 37.00mg/day. The median duration of titration was 86.0 days (Min 28; Max 115 days); the median number of dosage changes was 1.0. At the end of 3-month observation period, the median dose of lurasidone was 74.00mg/day. QoL and Functioning Score showed a trend of improvement over time, reaching a mean change from baseline of 9.8 at the end of the study. According to the CGI-S, the percentage of patients who were "markedly or severely ill" showed a continuous decrease from baseline to 3 months, from 62.29% to 8.20%. Patient satisfaction increased over time, with 80.32% of patients reporting that they were somewhat, fairly, or very satisfied (including 63.93% who were completely or very satisfied) at the end of the study. No relapses/hospitalizations for psychiatric reasons were reported. Lurasidone was well tolerated with no safety concerns or discontinuations due to AEs. Lurasidone represents a valid option for the treatment of schizophrenia and positively affects subjective well-being, quality of life and satisfaction. NCT06527885 retrospectively registered (01/08/2024).

Finite element analysis of maxillary orthodontic therapies with variable alveolar bone grafts under occlusal forces in patient with unilateral cleft lip and palate

ObjectiveTo investigate the biomechanical effects of maxillary orthodontic treatment on different alveolar bone grafting positions loaded with occlusal forces in an unilateral cleft lip and palate (UCLP) patient.MethodsFinite element analysis was employed to simulate clinical scenarios more accurately by loading with occlusal forces on 8 bone-grafted models during maxillary orthodontic treatment. Displacement and von Mises stress pattern during maxillary protraction, expansion, and combined protraction and expansion were analyzed.ResultsThe seven bone-grafted models exhibited significantly smaller horizontal displacements at the non-cleft side landmarks during maxillary protraction and expansion compared to non-bone grafted models. Additionally, alveolar cleft bone grafted in the upper 1/3 and middle 1/3 exhibited greater asymmetry displacement and stress under maxillary protraction and expansion.ConclusionThe study highlights the necessity of considering occlusal forces in finite element study on orthodontic therapies for UCLP patients. The upper 1/3 and middle 1/3 bone graft conditions may require secondary bone graft supplementation to ensure the effectiveness of maxillary orthodontic treatment.

Emerging Mechanisms of Physical Exercise Benefits in Adjuvant and Neoadjuvant Cancer Immunotherapy

The primary factors that can be modified in one’s lifestyle are the most influential determinants and significant preventable causes of various types of cancer. Exercise has demonstrated numerous advantages in preventing cancer and aiding in its treatment. However, the precise mechanisms behind these effects are still not fully understood. To contribute to our comprehension of exercise’s impact on cancer immunotherapy and provide recommendations for future research in exercise oncology, we will examine the roles and underlying mechanisms of exercise on immune cells. In addition to reducing the likelihood of developing cancer, exercise can also improve the effectiveness of certain approved anticancer treatments, such as targeted therapy, immunotherapy, and radiotherapy. Exercise is a pivotal modulator of the immune response, and thus, it can play an emerging important role in new immunotherapies. The mechanisms responsible for these effects involve the regulation of intra-tumoral angiogenesis, myokines, adipokines, their associated pathways, cancer metabolism, and anticancer immunity. Our review assesses the potential of physical exercise as an adjuvant/neoadjuvant tool, reducing the burden of cancer relapse, and analyzes emerging molecular mechanisms predicting favorable adjuvanticity effects.

EXPRESS: On the interchangeability of presentation order for cause and effect: Experimental tests of cue and outcome density effects.

Studies of cue-outcome contingency learning demonstrate outcome-density effects: participants typically overestimate contingencies when the outcome event is relatively frequent. Equivalent cue-density effects occur, though these have been examined less often. Few studies have simultaneously examined both those event density effects or have manipulated the presentation order of the events,limiting knowledge of whether these phenomena share underlying principles-. We report three well-powered experiments to address those gaps. Participants judged the effectiveness of a medical treatment after viewing a series of pairings for two events, a cause (treatment given vs. not) and an effect (patient recovered vs. not). Experiment 1 manipulated both event densities independently. We then manipulated the presentation order for the cause and the effect, alongside a manipulation of effect density (Experiment 2a) or cause density (Experiment 2b). Experiment 1 found a large main effect of event-density (η_p^2 =.55), which was qualified by a significant interaction between event type and density level (η_p^2 =.10) whereby effect density had greater impact than cause density. Experiments 2a and 2b found effects for effect-density (η_p^2=.60) and cause-density (η_p^2=.31). The effects of cause-effect presentation order were always small and non-significant. We conclude that effect-density manipulations had substantial impact on contingency judgments, and cause-density manipulations less so. Moreover, it matters little which event (cause or effect) is seen first. These findings have implications for contingency, associative, probabilistic, and causal models of contingency judgment; primarily, that people may be more sensitive to the causal status of events than to their temporal order of presentation.

Surface metamorphosis techniques for sustainable polymers: Optimizing material performance and environmental impact

The transition to sustainable polymers is crucial for reducing the environmental footprint of additive manufacturing, particularly in fused deposition modeling (FDM). This study investigates surface metamorphosis techniques—methods to modify polymer surfaces at micro and nanoscale levels to enhance performance and minimize environmental impact. We explore plasma treatment, chemical etching, and laser texturing on biodegradable and recycled polymers, assessing their effects on surface properties, such as adhesion, roughness, and chemical resistance. Our results demonstrate significant enhancements in mechanical properties. For example, PLA’s tensile strength increased from 55.3 MPa (untreated) to 63.8 MPa (plasma treated), and its elongation improved from 4.2% to 5.1%. PHA showed a similar trend, with tensile strength rising from 45.1 MPa to 52.6 MPa, and elongation increasing from 5.6% to 6.4%. rPET and rPP also exhibited improvements, indicating the effectiveness of these surface treatments. Employing a multi-criteria decision-making approach, we assess and prioritize these techniques based on their mechanical enhancements and sustainability profiles. While this study presents hypothetical results, it establishes a comprehensive framework for optimizing surface metamorphosis processes, guiding future experimental research. Our findings suggest that tailored surface modifications can significantly improve the performance and environmental sustainability of polymers in FDM, offering pathways for integrating eco-friendly materials into advanced manufacturing. This work contributes to the development of green manufacturing technologies by highlighting surface metamorphosis as a key strategy for achieving high-performance and sustainable materials.

Emerging threat of artemisinin partial resistance markers (pfk13 mutations) in Plasmodium falciparum parasite populations in multiple geographical locations in high transmission regions of Uganda

BackgroundArtemisinin-based combination therapy (ACT) is currently recommended for treatment of uncomplicated malaria. However, the emergence and spread of partial artemisinin resistance threatens their effectiveness for malaria treatment in sub-Saharan Africa where the burden of malaria is highest. Early detection and reporting of validated molecular markers (pfk13 mutations) in Plasmodium falciparum is useful for tracking the emergence and spread of partial artemisinin resistance to inform containment efforts.MethodsGenomic surveillance was conducted at 50 surveillance sites across four regions of Uganda in Karamoja, Lango, Acholi and West Nile from June 2021 to August 2023. Symptomatic malaria suspected patients were recruited and screened for presence of parasites. In addition, dried blood spots (DBS) were collected for parasite genomic analysis with PCR and sequencing. Out of 563 available dried blood spots (DBS), a random subset of 240 P. falciparum mono-infections, confirmed by a multiplex PCR were selected and used for detecting the pfk13 mutations by Sanger sequencing using Big Dye Terminator method. Regional variations in the proportions of pfk13 mutations were assessed using the chi square or Fisher’s exact tests while Kruskal–Wallis test was used to compare absolute parasite DNA levels between wild type and mutant parasites.ResultsOverall, 238/240 samples (99.2%) contained sufficient DNA and were successfully sequenced. Three mutations were identified within the sequenced samples; pfk13 C469Y in 32/238 (13.5%) samples, pfk13 A675V in 14/238 (5.9%) and pfk13 S522C in (1/238 (0.42%) samples across the four surveyed regions. The prevalence of pfk13 C469Y mutation was significantly higher in Karamoja region (23.3%) compared to other regions, P = 0.007. The majority of parasite isolates circulating in West Nile are of wild type (98.3), P = 0.002. Relative parasite DNA quantity did not differ in samples carrying the wild type, C469Y and A675V alleles (Kruskal–Wallis test, P = 0.6373).ConclusionDetection of validated molecular markers of artemisinin partial resistance in multiple geographical locations in this setting provides additional evidence of emerging threat of artemisinin partial resistance in Uganda. In view of these findings, periodic genomic surveillance is recommended to detect and monitor levels of pfk13 mutations in other regions in parallel with TES to assess potential implication on delayed parasite clearance and associated treatment failure in this setting. Future studies should consider identification of potential drivers of artemisinin partial resistance in the different malaria transmission settings in Uganda.

Impact of diversion ileostomy on postoperative complications and recovery in the treatment of locally advanced upper-half rectal cancer.

The efficacy of diversion ileostomy followed by radical surgery for locally advanced upper-half rectal cancer remains uncertain. This study seeks to compare the effectiveness of treatment with and without diversion ileostomy in preventing anastomotic leakage (AL) and to identify a subset who may benefit from diversion ileostomy after AL occurs in Chinese patients with stage II and III upper-half rectal cancer. A retrospective study enrolled a total of 809 patients with locally advanced upper-half rectal cancer between 2017 and 2021, with 27.6% (n = 223) treated with diversion ileostomy and 72.4% (n = 586) treated without diversion ileostomy. The Diversion(+) group (n = 172) and Diversion(-) group (n = 172) were compared for perioperative outcomes through 1:1 propensity score matching (PSM). The selection of variables for multivariable logistic regression was determined through bivariate logistic regression analysis. Additionally, optimal cutoff values for risk factors were identified using ROC curve analysis. Within the entire cohort, patients in the Diversion(+) group exhibited a lower distance from the anal verge (DAV) and higher rates of chemoradiotherapy (CRT), diabetes, cN2 stage, mrCRM positivity, EMVI positivity, and CEA elevation compared to those in the Diversion(-) group. Following PSM, a satisfactory balance of baseline variables was achieved between the two groups. There were no statistically significant differences in AL rates (7.0% vs. 5.8%, p = 0.659) or AL grade distribution (Grade A: 0.6% vs. 0%, Grade B: 5.2% vs. 4.1%, Grade C: 1.2% vs. 1.7%, p = 0.691) between the two groups. However, the Diversion(+) group demonstrated a higher incidence of postoperative complications (30.8% vs. 17.4%, p = 0.004), Clavien‒Dindo III-IV complications (2.9% vs. 2.3%, p = 0.013), particularly wound infections (8.1% vs. 1.2%, p = 0.002), and early postoperative inflammatory small bowel obstruction (EPISBO) (8.7% vs. 1.2%, p = 0.001) compared to the Diversion(-) group. Results from multivariate logistic regression analysis revealed that male gender (OR = 2.354, p = 0.014) was the only independent risk factor associated with AL, while the presence of diversion ileostomy (with vs. without, OR = 1.144, p = 0.686) did not show significant associations. In patients with AL, the onset of the AL was observed to occur later in the Diversion(+) group compared to the Diversion(-) group (7.0 ± 3.3 vs. 3.4 ± 1.4 days, p < 0.001), while the recovery time was significantly shorter (11.3 ± 4.7 vs. 20.3 ± 7.2 days, p < 0.001). Similarly, in Grade C AL patients, the occurence time was delayed in the Diversion(+) group compared to the Diversion(-) group (8.7 ± 4.7 vs. 3.2 ± 1.5 days, p = 0.008), with a shorter recovery time (19.3 ± 2.1 vs. 25.7 ± 6.7 days, p = 0.031). A trend was observed indicating a longer interval before ileostomy restoration in the AL patients compared to the non-AL patients (7.6 ± 4.9 months vs. 5.5 ± 2.9 months, p = 0.079). In addition, DAV (OR = 0.078, p = 0.002) was identified as the only independent factor associated with potential-diversion-benefit in patients with AL, with an optimal cutoff point of 8.6cm. The utilization of diversion ileostomy as a preventative measure for AL in cases of locally advanced upper-half rectal cancer is not universally endorsed due to potential complications such as small bowel obstruction and wound infection. Nevertheless, in the occurrence of AL, diversion ileostomy may prove advantageous for patient recuperation. Particularly, male patients with a DAV ranging from 7 to 8.6cm may experience benefits from undergoing diversion ileostomy subsequent to AL in cases of locally advanced upper-half rectal cancer.

Imaging treatment efficacy of repeated photodynamic therapy in glioblastoma using chemical exchange transfer saturation MRI.

To observe the tumor responses during photodynamic therapy in a murine glioblastoma model using chemical exchange saturation transfer (CEST) MRI and to compare the treatment effectiveness between single photodynamic therapy (sPDT) and repeated PDT (rePDT). After tumor cell implantation in NSG mouse brain(n = 27), mice were subjected to four PDT sessions (rePDT), sPDT after the administration of 5-aminolevulinic acid 6 h before each session, and a non-PDT session (control). A 630-nm LED light was used to effectuate PDT. After 24 h for each PDT session, T2-weighted and CEST MRI were performed over 7 days. We observed that rePDT resulted in a continuous suppression of tumors according to T2-weighted images; thus, the tumor volume was the smallest among three groups on Day 7. Both CEST contrasts at 3.5 ppm (amide proton transfer, APT) and 3.5 ppm (relayed nuclear Overhauser enhancement, rNOE) in the rePDT group were significantly lower (p < 0.05) than those in the control group starting from Day 5, which corresponds to lower protein and cellularity in tumors in the rePDT group, respectively. CEST contrast decreased by 17.9% at 3.5 ppm and 11.3% at 3.5 ppm for rePDT group. This was validated by histology, where we observed moderatecorrelations between APTwith cell proliferation (R = 0.730, p < 0.01) and cell apoptosis (R = 0.715, p < 0.05) and moderate correlation between rNOE with cellularity (R = 0.796, p < 0.01). rePDT has a better effect in tumor growth suppression when compared with sPDT, and CEST could be a robust and noninvasive mean to assess the molecular changes related to treatment efficacy.

A Computational Study on Effects of PID Temperature Target and RF Frequency for PID-Controlled Nonablative RF Cosmetic Systems.

Commonly adopted in cosmetic dermatology, nonablative radiofrequency (RF) devices convert high-frequency electromagnetic energy into thermal energy to induce a wound-healing response in skin tissue. However, differences in the electrical properties of different skin layers raise questions about the impact of different RF frequencies and target temperatures on treatment effectiveness. This paper presents a finite element analysis (FEA)-based computational study aimed at simulating and optimizing the effects of a proportional integral derivative (PID)-controlled RF cosmetic devices under different combinations of these two parameters during treatment. A 3D physical model for the application of a nonablative RF device was constructed using COMSOL, which included the human tissue and RF electrodes, electromagnetic and thermal boundary conditions, as well as the PID controller. FEA was performed for each of the twelve models with parameter combinations of three RF frequencies (0.1, 0.5, and 1 MHz) and three PID-controlled target temperatures (60°C, 65°C, and 70°C) plus one group without PID control. Treatment effectiveness was quantitatively assessed using the integration of tissue thermal damage fraction, i.e., thermal damage volume. In the earlier stage of heating (0-10 s), higher RF frequency resulted in a larger thermal damage volume. At 10 s, among models with a temperature target of 70°C, there is a 6.04% difference between the thermal damage volume at RF frequencies of 1.0 and 0.1 MHz. In the later stage of heating(11-80 s), the impact of RF frequency decreases. The difference in thermal damage volume caused by higher temperature targets is more significant, at 80 s, among models with an RF frequency of 1.0 MHz, the 70°C model produces 1.15 and 1.36 times more tissue thermal damage than the 65°C and 60°C models. PID controller has ensured treatment safety and uniformity, in exchange for some efficiency. Among 12 parameter combinations, the one with a temperature of 70°C and RF frequency of 1.0 MHz achieved the highest thermal damage volume, which could potentially result in the best esthetic effect. Considering users' different susceptibility to heat, engineers or physicians can select better temperature targets and RF frequencies to bring the desired cosmetic results based on thermal damage volume curves from this study.

Comprehensive Analysis and Verification of the Prognostic Significance of Cuproptosis-Related Genes in Colon Adenocarcinoma

Colon adenocarcinoma (COAD) is a frequently occurring and lethal cancer. Cuproptosis is an emerging type of cell death, and the underlying pathways involved in this process in COAD remain poorly understood. Transcriptomic and clinical data for COAD patients were collected from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. We investigated alterations in DNA and chromatin of cuproptosis-related genes (CRGs) in COAD. In order to identify predictive differentially expressed genes (DEGs) and various molecular subtypes, we used consensus cluster analysis. Through univariate, multivariate, and Lasso Cox regression analyses, four CRGs were identified. A risk prognostic model for cuproptosis characteristics was constructed based on four CRGs. This study also examined the association between the risk score and the tumor microenvironment (TME), the immune landscape, and drug sensitivity. We distinguished two unique molecular subtypes using consensus clustering analysis. We discovered that the clinical characteristics, prognosis, and TME cell infiltration characteristics of patients with multilayer CRG subtypes were all connected. The internal and external evaluations of the predicted accuracy of the prognostic model built using data derived from a cuproptosis risk score were completed at the same time. A nomogram and a clinical pathological analysis make it more useful in the field of medicine. A significant rise in immunosuppressive cells was observed in the high cuproptosis risk score group, with a correlation identified between the cuproptosis risk score and immune cell infiltration. Despite generally poor prognoses, the patients with a high cuproptosis risk but low tumor mutation burden (TMB), cancer stem cell (CSC) index, or microsatellite instability (MSI) may still benefit from immunotherapy. Furthermore, the cuproptosis risk score positively correlated with immune checkpoint gene expression. Analyzing the potential sensitivity to medications could aid in the development of clinical chemotherapy regimens and decision-making. CRGs are the subject of our in-depth study, which exposed an array of regulatory mechanisms impacting TME. In addition, we performed additional data mining into clinical features, prognosis effectiveness, and possible treatment medications. COAD’s molecular pathways will be better understood, leading to more precise treatment options.

Neurosyphilis-Induced Psychosis in Europe: A Systematic Review of Case Reports

The tertiary stage of syphilis appears to be the most diverse of the three recognized, with a number of cardiovascular, gummatous, neurological and psychiatric symptoms. This systematic review’s aim is to analyze cases of organic psychoses secondary to tertiary syphilis, inspect the diagnostic procedures and assess the effectiveness of treatment. Case studies from Pubmed and MEDLINE Ultimate were sought out with the Boolean expression ‘((neurosyphilis) OR (syphilis) OR (treponema pallidum)) AND (case report) AND ((psychosis) OR (psychotic))’ to later undergo screening for exclusion criteria (according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 guidelines). Each report was accepted independently by two authors. Case reports were later appraised using the JBI Critical Appraisal Checklist for Case Reports. Finally, 11 case reports were included in the study. The most frequently reported psychiatric symptoms were delusions (91%) and hallucinations (81%), disorientation (about 42%) and sleep disturbances and memory loss (36%). Several inconsistencies in diagnostic processes were found in some of the case reports, while treatment procedures were more in line with the guidelines. A disease as complex as neurosyphilis requires great awareness and cooperation between various medical specialties. Despite its mimicry and variability in presentation, the discussed case reports prove that it can be successfully dealt with.

Evidence-Base Update of Psychosocial and Combination Treatments for Child and Adolescent Depression

ABSTRACT Objective This evidence-based update (EBU) builds on three previous reviews (1998, 2008, 2017) sponsored by the Society of Clinical Child and Adolescent Psychology with the aim of evaluating the empirical support for psychosocial interventions for depression in youth. Method In the current review period (2014–2022), 25 randomized controlled trials (RCT) were identified: four in children and 21 in adolescents. Descriptive effect sizes and number-needed-to-treat (NNT) ratios were calculated for primary outcomes. Results were integrated with prior reviews, and cumulative evidence used to classify treatments as well-established, probably efficacious, possibly efficacious, or experimental. Published secondary analyses of predictors, moderators, and mediators were examined. Results For adolescents, cognitive behavioral therapy (CBT), interpersonal psychotherapy (IPT-A), CBT in combination with antidepressant medication, and collaborative care programs were all classified as well-established. The evidence was considerably weaker for children, with no treatments achieving well-established or probably efficacious status. New developments include greater exploration of parent- and family-mediated treatment models and increasing evidence on technology-assisted interventions. Data on predictors, moderators, and mediators continued to be focused on adolescent depression samples and drawn from a limited number of RCT datasets. Conclusion Since the prior EBU, there has been incremental progress in youth depression treatment research. There is an urgent need to: (a) develop innovative approaches to substantially improve on the modest effects seen in most RCTs, (b) expand the evidence base for children and other underserved groups, (c) craft evidence-based guidelines for choosing between interventions when multiple efficacious treatments do exist, and (d) address issues of treatment effectiveness and scalability to ameliorate the wide prevalence and high impact of depression in youth.