Stage Group Research Articles

Overall survival, disease-free survival and quality of life in patients affected by HPV mediated p16+ oropharyngeal squamous cell carcinoma treated with upfront trans-oral robotic surgery vs radiotherapy or chemoradiotherapy.

Treatment de-intensification for p16 + oropharyngeal squamous cell carcinoma (OPSCC) is an area of active research to reduce the side effects and improve patients' quality of life (QoL). In this paper we evaluated the Overall Survival (OS), the Disease-Free Survival (DFS) and the QoL of patients affected by p16 + OPSCC according to their prognostic stage group (PSG) and different treatments. Patients were selected retrospectively through our Electronic Tumor Board Database according to prespecified inclusion criteria. Basic data of eligible patients were recorded and analyzed. Then, OS and DFS were evaluated according to the PSG and the treatments performed. Patients alive completed three questionnaires: the QoL Questionnaire Core 30 (QLQ-C30), the QoL Questionnaire Head & Neck 43 (QLQ-HN43) and the MD Anderson Dysphagia Inventory (MDADI) questionnaire. Sixty-one patients were included in this study. Eight patients died from the disease and the remaining 53 patients completed the 3 questionnaires. Fifteen (25%) patients were treated with upfront surgery, 6 (10%) patients with definitive radiotherapy and 40 (65%) patients with concomitant chemoradiotherapy. Comparing the DFS and the OS of PSG I patients by the different treatments performed, no statistically significant difference was identified. Patients treated with upfront surgery showed better outcomes in some aspects of their QoL. For p16 + OPSCC PSG I patients, upfront surgery can be considered a valid alternative to radiotherapy or chemoradiotherapy while maintaining a comparable DFS and OS and giving patients better results in terms of specific aspects of their QoL.

Modeling energy partition patterns of growing pigs fed diets with different net energy levels based on machine learning.

The objectives of this study were to evaluate the energy partition patterns of growing pigs fed diets with different net energy (NE) levels based on machine learning methods, and to develop prediction models for the NE requirement of growing pigs. Twenty-four Duroc × Landrace × Yorkshire crossbred barrows with an initial body weight of 24.90 ± 0.46kg were randomly assigned to 3 dietary treatments, including the low NE group (2,325 kcal/kg), the medium NE group (2,475 kcal/kg), and the high NE group (2,625 kcal/kg). The total feces and urine produced from each pig during each period were collected, to calculate the NE intake, NE retained as protein (NEp), and NE retained as lipid (NEl). A total of 240 sets of data on the energy partition patterns of each pig were collected, 75% of the data in the dataset was randomly selected as the training dataset, and the remaining 25% was set as the testing dataset. Prediction models for the NE requirement of growing pigs were developed using algorithms including multiple linear regression (MR), artificial neural networks (ANN), k-nearest neighbor (KNN), and random forest (RF), and the prediction performance of these models was compared on the testing dataset. The results showed pigs in the low NE group showed a lower average daily gain, lower average daily feed intake, lower NE intake, but greater feed conversion ratio compared to pigs in the high NE group in most growth stages. In addition, pigs in the 3 treatment groups did not show a significant difference in NEp in all growth stages, while pigs in the medium and high NE groups showed greater NEl compared to pig in the low NE group in growth stages from 25 to 55kg (P < 0.05). Among the developed prediction models for NE intake, NEp, and NEl, the ANN models demonstrated the most optimal prediction performance with the smallest root mean square error (RMSE) and the largest R2, while the RF models had the worst prediction performance with the largest RMSE and the smallest R2. In conclusion, diets with varied NE concentrations within a certain range did not affect the NEp of growing pigs, and the models developed with the ANN algorithm could accurately achieve the NE requirement prediction in growing pigs.

Prognosis and Adjusting Factors in Elderly Patients With Triple-Negative Breast Cancer: Comparing With Young and Middle Age Groups

PurposeProper breast cancer screening and treatment should be considered in the elderly population; however, some tend to be less proactive. Our study aimed to investigate the impact of old age on treatment and prognosis in triple-negative breast cancer (TNBC). MethodThe study included patients with primary TNBC stage I-III diagnosed from 2002 to 2019 in single institution and retrospectively analyzed. We defined young (< 40 years), middle and old (> 70 years) groups. Clinicopathological factors, treatment, and prognosis were analyzed according to age group of TNBC patients. ResultTNBC patients aged 70 and above were 3.3 times more likely (P = .019) to have lymph node metastasis at the time of diagnosis compared to younger patients, but were found to be 0.24 times less likely to receive chemotherapy. (P = .003) Old TNBC patients have an expected likelihood 2.2 times higher of undergoing mastectomy rather than breast-conserving surgery. (P = .042) The 5-year prognosis is poorer in young and old group. (61%, 86%, and 65% in young, middle, and old groups). (P < .001). In subanalysis, old group of stages I and II received fewer chemotherapy compared to youngers (P < .05), but not in stage III. In Cox regression analysis, age and stage had significant impact on prognosis (hazard ratio 2-3), but treatment factors did not. However, in stratified analysis of adjuvant therapy and stage, prognosis of Old TNBC patients in stage II was improved when they underwent neo or adjuvant chemotherapy. ConclusionTNBC presents challenges in older patients, who receive less aggressive treatment and have poorer outcomes. The primary cause of poor prognosis in old TNBC patients is the high disease stage at diagnosis, underscoring the need for promotion and education on early screening. Additionally, it is suggested that a more proactive approach to adjuvant chemotherapy is necessary for stage II old TNBC patients.

Insulin-like growth factor 1 receptor expression correlates with programmed death ligand 1 expression and poor survival in non-small cell lung cancer.

The insulin-like growth factor 1 receptor (IGF1R) has been associated with growth and metastasis in various cancers. However, its role in postoperative recurrence and prognosis in lung cancer lacks clear consensus. Therefore, this study aimed to investigate the potential relationship between IGF1R and postoperative recurrence as well as long-term survival in a large cohort. Additionally, we assessed the relationship between IGF1R and programmed death ligand 1 (PD-L1) expression. Our study encompassed 782 patients with non-small cell lung cancer (NSCLC). Immunostaining of surgical specimens was performed to evaluate IGF1R and PD-L1 expression. Among the patients, 279 (35.8%) showed positive IGF1R expression, with significantly worse relapse-free survival (RFS) and overall survival (OS). Notably, no significant differences in RFS and OS were observed between IGF1R-positive and -negative groups in stages 2 and 3. However, in the early stages (0-1), the positive group displayed significantly worse RFS and OS. In addition, PD-L1 expression was detected in 100 (12.8%) patients, with a significant predominance in the IGF1R-positive. IGF1R may serve as a prognostic indicator and a guide for perioperative treatment strategies in early-stage lung cancer. In conclusion, our findings underscore an association between IGF1R expression and poor survival and PD-L1 expression in NSCLC.

Effectiveness of Trans-Theoretical Model-Based Health Education Intervention in the Promotion of Lifestyle Changes among Adults with Metabolic Syndrome: A Randomized Controlled Trial.

Evidence revealed that, 60% of deaths in the underdeveloped nations are linked to adoption of unhealthy lifestyles. The Trans-theoretical Model (TTM) has been considered a useful interventional approach in smoking cessation, drug addiction and weight control. However, its effectiveness in improving changes in dietary pattern, physical activity and alcohol consumption has not been reported. The study aimed at evaluating the effectiveness of the TTM-based health education intervention in the promotion of lifestyle changes among adults with metabolic syndrome. This was an experimental design where 352 participants with metabolic syndrome were allocated to intervention and control groups. The participants were randomly assigned to receive either standard CVD care or a TTM stage-based lifestyle modification intervention for 12-months. Lifestyle patterns were assessed at baseline and endpoint. The mean difference of the subtotal TTM concept scores between pre and post intervention was evaluated using paired t-test. The chi-square test of independence was used to detect between group differences in the categorical data. Most of the participants were in the pre-action stage of change for their dietary intake patterns and physical activity habits at the baseline assessment with no difference between the groups. The intervention group's total level of change toward adopting a healthy lifestyle was markedly (p < 0.001) improved than the control group at the endpoint. The mean scores for the intervention group's stage of change, self-efficacy, and pros and cons of decisional balance all improved significantly (p < 0.001) from the baseline. The mean scores for the control group's pros and cons of decisional balance and stage of change also considerably (p < 0.05) improved from baseline to the endpoint. The TTM- based health education intervention was effective in improving the participants' lifestyles that includes diet and physical activity. Health care providers, particularly nurses should implement TTM staged-matched educational intervention for individuals who are at risk for cardiovascular diseases.

Progressive brain structural abnormality in cerebral small vessel disease assessed with MR imaging by using causal network analysis

AimsCerebral small vessel disease (CSVD) is a complex condition characterized by a combination of microcirculation disorders and neurodegenerative processes, CSVD is associated with structural abnormalities in multiple brain regions. However, the progressive pattern of structural changes remains unknown. MethodsIn order to detail the progressive structural changes in CSVD patients according to the degree of cognitive impairment, we recruited 121 CSVD patients and 104 healthy controls (HCs). Voxel-based morphometry was employed to measure the gray matter volume (GMV) of each participant. According to the VICCCS-2 diagnostic criteria, patients were initially divided into three stage groups, then we investigated the GMV changes in each stage and their causal relationships using causal structure covariance network (CaSCN) analysis. ResultsOverall, patients with CSVD presented stage-specific GMV alterations compared with HCs. With the worsening of cognitive impairment, the decrease in gray matter volume starts from the right hippocampus and gradually spreads to the cortical-subcortical brain regions. Importantly, the right hippocampus in CSVD patients plays a driving role in the directional network and forms both positive and negative causal effect networks with cortical-subcortical brain regions. ConclusionsThis study reveals the significance of the right hippocampus as an early pathological area in CSVD patients and its causal impact on brain GMV changes with disease progression, shedding light on structural brain damage hierarchy and compensatory mechanisms.

NEUROTROPIC PROPERTIES OF RETROVIRUSES IN THE CONTEXT OF ANXIETY-DEPRESSIVE AND COGNITIVE DISORDERS IN HIV-POSITIVE PATIENTS

The aim: a comprehensive assessment and comparison of the prevalence of undiagnosed anxiety-depressive and cognitive symptoms in HIV-positive individuals at different stages of the disease who have been undergoing treatment for an extended period. Materials and methods According to the criteria of the scientific project, 71 HIV-positive individuals undergoing outpatient treatment with a compensated condition were involved. To explore dependencies on clinical stages (ClSt) of HIV infection and search for gender differences, the study was divided into 2 stages, respectively. The research included the collection of epidemiological and clinical-anamnestic data, as well as laboratory studies. Clinical-psychopathological and psychometric methods were used. Inclusion criteria for the study were HIV-positive status, receiving ART for more than 6 months, adulthood, and voluntary consent to participate. The obtained information was statistically processed by mathematical methods of statistics, using ANOVA criteria, Student's t-test, etc. Elements of neurocognitive and anxiety-depressive symptomatology were considered, utilizing GAD-7, HADS, and MMSE scales. Results: In patients of different groups in the first stage of the study, a gradually increasing level of anxiety and cognitive impairments was identified, depending on the stage of HIV infection. In the second stage of the study, gender and stage-related differences in anxiety and cognitive disorders were found in patients of all groups. Conclusions. Individuals in the first clinical stage (I ClSt) exhibited the least anxiety-depressive and cognitive disorders, indicating emotional and cognitive stability at this stage of HIV infection. HIV-infected individuals in the second and third clinical stages (II and III ClSt) demonstrated a progressive tendency toward anxious and depressive disorders, indicating a stage-dependent relationship to the progression of the disease. Patients in the fourth clinical stage (IV ClSt) showed the most pronounced anxious, depressive, and cognitive symptoms, which may be associated with the duration of the illness and antiretroviral therapy (ART). Research results in the female group (Group A1) suggest their lower susceptibility to disorders compared to males (Group A2) in the early stages of HIV infection. In the later stages (III-IV), it was found that women had pronounced anxious and depressive disorders (Group B1), while men exhibited signs of cognitive and depressive disorders (Group B2).

Effectiveness of Cognitive Behavioral Therapy on Body Image Concern in Women with Depression Symptoms

Background and Objective: Untreated depression can lead to impaired academic performance, increased severity of depression, migraines, alcohol and substance abuse, high stress, low social support, feelings of inferiority in school, feelings of emptiness and worthlessness, somatic symptoms, conflicts with parents, and risk of suicide, imposing a substantial economic burden on governments. Therefore, finding effective treatment methods for this disorder is increasingly necessary. This study aimed to evaluate the effectiveness of cognitive behavioral therapy (CBT) on body image concern in women with depression symptoms in 2023. Methods and Materials: This research is applied in terms of its objective, applied in terms of data collection, and quantitative (questionnaire-based) in terms of data collection method, relying on an experimental approach using analysis of variance. Findings: Statistical findings indicate that CBT significantly increased the mean scores of the experimental group compared to the control group in the post-test stage, at least in one of the dependent variables (depression and body image concern). There is a significant difference between the two research groups in the linear combination of depression and body image concern variables in the post-test stage. Additionally, statistical findings indicate a significant difference in the depression variable between women with depression symptoms in the experimental group and the control group. Moreover, findings showed a significant difference in the body image concern variable between women with depression symptoms in the experimental group and the control group. Conclusion: Apart from the aforementioned findings, the most important result of this study was that the impact of CBT on depression and body image concern was found to be 53% and 47%, respectively, indicating a positive and substantial effect.

Adding chitosan nanoparticles of green tea extract in diluent and thawing temperatures ameliorate the post-thawed quality of Boer buck semen

Objective: To improve the quality of post-thawing Boer buck semen for artificial insemination by adding green tea extract chitosan nanoparticles to skimmed egg yolk diluent, and the proper thawing temperature. Methods: The ejaculate of Boer buck was added to skimmed egg yolk diluent without (the control group) and with adding 1 μg of chitosan nanoparticles of green tea extract per mL of diluent (the treatment group). Then, the diluted semen was filled in French mini straws containing 60× 106 live sperm per straw, frozen in a standard protocol, and stored as frozen semen at -196 °C for a week. Six replicates from each group were diluted for 30 s at 37 °C or 39 °C sterile water to evaluate the semen quality. Results: Post-thawing (at 37 °C or 39 °C) of live sperm, progressive motility, and plasma membrane integrity were lower compared to those of the pre-freezing stage (P&lt;0.05). Thawing at 37 °C resulted in no significant difference in live sperm, progressive motility, and plasma membrane between the control group and the treatment group (P&gt;0.05). The live sperm, progressive motility, and plasma membrane of the treatment group in the pre-freezing stage, and post-thawed at 39 C were higher compared to those of the control group (P&lt;0.05). There was no significant difference in malondialdehyde (MDA) concentration, DNA fragmentation, and catalase concentration of thawing at 37 °C compared to those of 39 °C in the same group. The MDA concentration and DNA fragmentation in thawing at 37 °C and 39 °C of the treatment group were significantly lower than those of the control group (P&lt;0.05). However, the catalase concentration in thawing at 37 °C and 39 °C of the treatment group was not significantly different than the control group (P&gt;0.05). Conclusions: Higher quality post-thawing Boer buck semen is achieved by adding 1 μg/mL of chitosan nanoparticles of green tea extract to the skimmed egg yolk diluent and thawing at 39 °C.

Instability of viscous annular liquid film jet under high air-to-fluid velocity rate

Based on the surface wave dispersion relation equation of viscous annular liquid film jet established by the research group in the early stage, a dispersion relation equation calculation program is written according to Mathematica. A linear stability analysis is carried out for the high air-fluid velocity ratio viscous annular liquid film jet entering a compressible gas medium environment. The relationship between the surface wave growth rate of an annular liquid film jet and the surface wave number under different characteristic parameters is obtained. The connection based on the dominant wave’s growth rate or the dominant wave’s number with dimensionless parameters such as air-fluid velocity rate, air-fluid density rate, Weber number of liquid, liquid Reynolds number, and gas Mach number was analyzed. The consequences reveal that under the high air-fluid velocity ratio, the increase of the above dimensionless parameters promotes the fragmentation course of the annular liquid film jet. Moreover, the augment of the air-fluid velocity rate has the greatest influence on the stability of the viscous annular liquid film jet. In contrast, the Reynolds number of the liquid has less influence than the reliability of the annular liquid film jet. Linear stability analysis under this condition lays the foundation for the prediction model of the most unstable parameters of annular liquid film jet in practical engineering applications.

The Effectiveness of Mindfulness-Based Cognitive Behavioral Therapy Focused on Anger Management on Suicidal Thoughts in Male Students

Objective: The aim of the present study is to determine the effectiveness of mindfulness-based cognitive behavioral therapy (CBT) focused on anger management on suicidal thoughts in male students in the first grade of secondary school in Chabahar County. Methodology: The present study utilized a quasi-experimental design with a pre-test and post-test framework. The statistical population of the study comprised all male students in the first grade of secondary school in Chabahar County during the 2022-2023 academic year. A sample of 30 male students who scored higher on the Beck Suicidal Ideation Scale (2004) was randomly selected and then divided into two groups: an experimental group and a control group (15 students each). The experimental group received ten sessions of mindfulness-based CBT focused on anger management, while the control group received no intervention. The Beck Suicidal Ideation Scale (2004) was used to collect data, and the data were analyzed using analysis of covariance (ANCOVA) in SPSS 22 software. Findings: The results of the present study showed a significant difference in the mean scores of suicidal thoughts between the experimental group and the control group in the post-test stage (p &lt; 0.01). Conclusion: The findings of the present study suggest that mindfulness-based CBT focused on anger management can be effective in reducing suicidal thoughts among students.

Proposal Model for A Community-friendly Wetland Park in Egypt: A Social approach.

As community engagement is considered the key to a successful project outcome, it was necessary to change the general attitude dealing with main ecosystem projects such as Wetlands from just being producers supporting primary industries to community-friendly projects providing urban spaces with recreational, educational and ecological facilities and assuring high quality of life. Wetland parks play a vital role for the benefit of its communities. This paper focuses on social aspects and values in designing Wetland parks; it emphasizes the importance of involving community groups to overcome various difficulties and challenges of these projects’ existence. The paper aims to create a design model that achieves a community-friendly Wetland Park; a social guiding model that raises community awareness, participation and ensures sustainability of such projects. A theoretical design guideline review on parks and Wetlands is being presented to provide the basis for the design model and for a community-oriented questionnaire. The paper addresses decision-makers and urban designers in Egypt providing social guidelines to engage local groups in early stages of design. The paper then directs the questionnaire survey to com-munity groups to attain the proposed design model for a community-friendly Wetland Park in Egypt that paves the way for long-term development.

Effects of different HIIT protocols on exercise performance, metabolic adaptation, and fat loss in middle-aged and older adults with overweight.

Introduction: There is evidence that aging and obesity are associated with increased oxidative stress and chronic inflammation. High-intensity interval training (HIIT) may be superior to moderate-intensity continuous training (MICT) in anti-inflammatory and anti-obesity benefits. Therefore, the objective of this study is to determine which HIIT prescriptions will be more effective in reducing fat accumulation, inflammation, and improving metabolic adaptation and exercise performance in middle-aged and older overweight adults. Methods: Thirty-six middle-aged with overweight adults were divided into one of three groups: 1. L-HIIT group: the long-interval HIIT group (4 × 4 min Exercise/4 min Rest), 2. M-HIIT group: the medium-interval HIIT group (8 × 2 min Exercise/2 min Rest), 3. Control group: no exercise training intervention. All groups underwent the training stage for eight weeks (three sessions per week), followed by a detraining stage of four weeks in order to investigate the effects induced by different HIIT interventions on inflammation, metabolic adaptation, anti-fatigue and exercise performance, and fat loss Results: There was a significant physiological response in the change rate of heart rate (HR) after an acute L-HIIT session compared with an acute M-HIIT session (ΔHR: ↑49.66±16.09% vs ↑33.22±14.37%, p=0.02); furthermore, systolic blood pressure (SBP) and diastolic blood pressure (DBP) decreased significantly following a single L-HIIT session. After an eight-week training stage, the L-HIIT and M-HIIT groups exhibited a significant increase in aerobic capacity (ΔVO2peak), with values of +27.93±16.79% (p<0.001) and +18.39±8.12% (p<0.001), respectively, in comparison to the control group. Furthermore, in the L-HIIT group, the anaerobic power of relative mean power (RMP) exhibited a significant increase (p=0.019). However, following a four-week detraining stage, the adiponectin concentration remained 1.78 times higher in the L-HIIT group than in the control group (p=0.033). The results of blood sugar, blood lipids, body composition, and inflammatory markers did not indicate any improved it did not indicate any improvements from the two different HIIT protocols. Conclusions: The results indicate that an eight-week L-HIIT or M-HIIT intervention (three sessions per week, 32 minutes per session) may be an effective approach for improving aerobic capacity. It can be posited that L-HIIT may be a more advantageous mode than M-HIIT for enhancing anaerobic power, adipokine levels, and improving blood pressure in an aged and overweight population due to the induced physiological responses.

Beneficial Alterations of Intestinal Microbiota in Chronic Cholecystitis Patients Treated With NOTES Gallbladder-Preserving Surgery.

Objective: NOTES gallbladder-preserving surgery (N-GPS) has been heralded as a new paradigm shift in minimally invasive surgery for chronic cholecystitis patients. The objective of this research was to evaluate the impact of N-GPS on the intestinal microbiota of patients. Methods: The study selected patients with benign gallbladder disease (BG group) within 1 week preoperative (BG_DPR stage) and followed up over 1 year postoperative (BG_YPO stage) and selected healthy controls (HC group) whose sex, age, and BMI index matched with patients at BG_YPO stage, too. Accordingly, stool samples from healthy controls and two stages of patients with benign gallbladder disease were collected; among them, the selected samples were sent for 16S rDNA sequencing with Illumina MiSeq platform, and then, the combined samples were sent for short-chain fatty acid (SCFA) analysis with GC-MS platform. Results: The result of alpha diversity of Shannon index showed that the difference among the two stages of BG group and HC group wasn't statistically significant, while the result of beta diversity based on the weighted UniFrac distance suggested that the structure of intestinal microbiota of BG group at YPO stage was closer to HC group. LEfSe analysis suggested that BG_YPO stage enriched genus, such as Enterocloster and Hungatella_A_128155, which improved bile acid metabolism. Compared with BG_DPR stage, BG_YPO stage and HC group enriched Faecalibacterium and Roseburia, but depleted Streptococcus, while fecal SCFA concentrations increased. Conclusion: Patients with benign gallbladder disease and chronic cholecystitis after N-GPS treatment for over 1 year improved gut microbial community structure. With the improving bile acid metabolism, SCFA-producing bacteria increased and pathobionts decreased, which helped the intestinal microbiota structure of BG group at YPO stage restore and close to HC group. Trial Registration: Chinese Clinical Trial Registry identifier: ChiCTR1900028267.

Yeast supplementation potentiates fluoxetine's anti-depressant effect in mice via modulation of oxido-inflammatory, CREB, and MAPK signaling pathways

IntroductionThe therapeutic potential of yeast in the management of depression is unknown. Thus, we evaluated the modulatory effect of nutritional yeast supplementation on antidepressant activity of fluoxetine in mice models of depressive-like behaviors (DLB). MethodsA total of 112 mice were divided into 16 groups (n = 7 each) for a 3-stage study. Stage I (non-DLB study) had groups Ia (10 mL/kg vehicle), Ib (20 mg/kg fluoxetine), Ic – If (2% yeast diet for all, but Id - If additionally received 5 mg/kg, 10 mg/kg, and 20 mg/kg fluoxetine respectively). Stage II (lipopolysaccharide [LPS] model of DLB) had groups IIa - IIb (10 mL/kg vehicle), IIc (20 mg/kg fluoxetine), IId (yeast) and IIe (yeast + 20 mg/kg fluoxetine). After these treatments for 24 days, animals in IIb - IIe received 0.83 mg/kg of LPS on the 25th day. Except for group IIIa (10 mL/kg vehicle), animals in other groups of stage III (unpredictable chronic mild stress [UCMS] model) were exposed to UCMS for 24 days along with 10 mL/kg vehicle (IIIb), 20 mg/kg fluoxetine (IIIc), yeast (IIId), or yeast + fluoxetine (IIIe). ResultsYeast and fluoxetine attenuated LPS- and UCMS-induced immobility, derangement of oxido-inflammatory (TNF-α, IL-6, NO, MDA, SOD, GSH, CAT, and AChE) and CREB/MAPK pathways. While fluoxetine had more potent effect than yeast when used separately, pre-treatment of mice with their combination had more pronounced effect than either of them. ConclusionYeast supplementation improves the antidepressant activity of fluoxetine in mice by modulating oxido-inflammatory, CREB, and MAPK pathways.

Low-dose-rate, high-dose-rate, and pulsed-dose-rate intra-cavitary brachytherapy for cervical cancer: The very first comparison study.

For cervical cancer patients, intra-cavitary brachytherapy (ICBT) is utilized with various dose-rate systems, such as low-dose-rate (LDR), high-dose-rate (HDR), and pulsed-dose-rate (PDR). This retrospective analysis aimed to compare the therapeutic outcomes of cervical cancer patients treated with either LDR-, HDR-, or PDR-ICBT. A total of 613 patients were treated with pelvic external beam radiation therapy (EBRT), followed by either LDR- (271 patients), HDR- (259 patients), or PDR- (83 patients) ICBT. Point-based planning was performed according to orthogonal radiographs in LDR patients, and computed tomography (CT) imaging in HDR and PDR patients. ICBT prescribed dose was as follows: for LDR treatment, 30 Gy in a single-session; for HDR: 7 Gy × 3 fractions (once a week fraction); and for PDR: 27 Gy in an hourly pulse of 70 cGy, with all the doses prescribed at point A. Radioactive source used was cesium-137 for LDR, and iridium-192 for HDR and PDR treatments. Loco-regional control (LRC) rate was 74%, 75%, and 77% in LDR, HDR, and PDR groups, respectively (p = 0.80). The 5-year overall survival (OS) in the three groups, i.e., LDR, HDR, and PDR was 63%, 64%, and 68%, respectively (p = 0.77). Severe late toxicity (RTOG grade ≥ 3) rate in the three groups was comparable (LDR, 12%; HDR, 8%; and PDR, 8.9%, p = 0.36). Our study revealed comparable LRC, 5-year OS, and late toxicity rates using three dose-rate systems. Lower OS rates were observed in LDR group for stage III patients compared with patients in HDR and PDR groups. Therefore, we suggest that LDR should be used with caution while treating stage III patients.

Hypoxic Ischemic Encephalopathy Indicators of Sarnat and Sarnat Scoring in Neonatal Subjects with Perinatal Asphyxia.

Hypoxic-ischemic encephalopathy (HIE) is still a relevant cause of neonatal mortality and morbidity. HIE severity can predict long-term outcomes. Sarnat staging is one of the most common methods used to evaluate HIE severity. However, an ongoing urge exists to find other accurate and affordable ways to accompany this clinical staging for HIE. This study aimed to evaluate the relationship between cerebral arteries' resistive indices and other hypoxic-ischemic encephalopathy indicators using Sarnat scoring of newborns subjected to perinatal asphyxia. In this retrospective study, 76 neonates with gestational age ≥34 weeks affected with HIE were investigated. The patients were categorized into three groups according to Sarnat staging: I, II, and III. Initially, perinatal data were analyzed to assess the correlation between HIE severity and various factors such as gestational age, type of delivery, Apgar scores, necessity for resuscitation, and requirement for respiratory assistance. Notably, these relationships were significant. Examining various symptoms in different HIE stages showed that the incidence of coagulopathy was significantly higher in severe HIE neonates than in mild neonates. Eventually, proposedly, cranial arterial Doppler indices, i.e., the anterior cerebral artery's resistive index (RI), significantly differed between HIE stage groups. This study represented a combination of available and affordable data to achieve early HIE staging, including perinatal data, clinical symptoms, and a bedside Doppler ultrasonography of cerebral perfusion. Higher cranial artery RI was associated with severe HIE and could be considered for therapeutic hypothermia, which may reduce HIE mortality and morbidity.

Investigation of the morphological and histological features of the testes of pigeon (Columba livia domestica) in pre-puberty and post-puberty.

Morphological and histological examination of the testes can provide a suitable insight into the health of the reproductive system. The objective of the current study was to investigate the morphological and histological features of the testes of local pigeons (Columba livia domestica) at mature and immature stages of age. Two groups of collected specimens underwent macroscopic and microscopic investigation to evaluate and compare the main general properties of their testes. The findings indicated that the testis has an oval shape in both pre-puberty and post-puberty stages, situated on the inner side of the kidney towards the caudal extreme of the lungs. However, the left testis was bigger than those on the right side. In the pre-puberty stage group, the testicular parenchyma was small, and almost collapsed seminiferous tubules containing a single layer of Spermatogonia and Sertoli cells. In contrast, in the post-puberty stage, the parenchyma space between seminiferous tubules was small, and tubules adhered closely to each other. Also, mature cells including sertoli, spermatogonia, and spermatocytes were noticed to spread within the tubules. The change in the histological structure of testes before and after maturity may help to evaluate the complexity of the male reproductive system of pigeons and draw attention to the organization of sex hormones and the function of several types of cells within the testes.

Observational study of blood complement levels of components before infusion

To investigate the changes in complement content in component blood before clinical transfusion. According to different preparation processes, storage temperatures and time periods, 180 specimens of plasma from the same source of 20 people were left at different stages of the preparation process. Homologous specimens were concentrated in the same batch of experiments to observe the changes in complement C3 and C4 content under different storage temperature and process stage grouping conditions. Using the same specimen to detect C3 and C4 content, the detection results of homologous specimens were sorted into nine groups according to different storage temperatures and preparation process stages for comparison.and there is no significant difference between simple -40°C and -60°C storage at different temperatures. Storage at 4°C for 7 days can significantly reduce complement content. Virus inactivation preparation process can significantly reduce complement content. Repeated freezing and thawing during the processing of frozen plasma can change complement content. Correlation analysis of complement C3 and C4 content determination experiments showed that the changes of the two under different conditions such as temperature, preparation process and storage time were significantly positively correlated. The storage temperature and storage time of frozen plasma, repeated freezing and thawing, centrifugal concentration and light inactivation can affect the complement content.

Alcoholmisuse/dependence carepathway in and outside the general hospital. Detecting, motivating and treating the whole person.

Problematic alcoholuse is a common problem, frequently missed , as somatic medicine and mental health services are seperated/siloed. Patients admitted to a general hospital have an increased probability of a comorbid alcoholproblem (and other mental health problems like depression and anxiety) which is not adressed due to the separation of mind and body, which leads to greater costs for society , poor patient experience and discomfort with the somatic team.&#x0D; Comorbidity within the general hospital is largest for the patient with gastrointestinal (GI) problems, which is why we opted to roll out our approach here, gradually expanding to other patient groups in a later stage.&#x0D; To tackle this problem, the mental health department of the hospital contacted the GI-team (i.e. nurses, doctors, social services), the psychological services, management, general practitioners and service users (AA).&#x0D; After consultation of the existing literature, we chose a collaborative care approach mixed with population based screening and a proactive approach. In the past, a care pathway for alcohol was developed with first line actors (general practitioners, social services, psychologists, AA and mental health services), which was used to determine the level of care in the hospital and after discharge. The team comprises a fulltime psychiatric nurse and 0.3 full time employee (FTE) psychiatrist (trainee) embedded in the somatic GI team.&#x0D; Patients are screened for alcohol and psychiatric issues within 48 hours. If necessary, the appropriate detoxification scheme is started and followed up by the somatic team, aided by the mental health team. The patient is assessed and encouraged to stop drinking, depending on the stage they are in. Motivational interviewing techniques are used, along with psycho-education and other (pharmacological) interventions. A care plan is developed together with the patient and is then communicated with the primary care provider. &#x0D; After discharge, psychiatric follow-up is scheduled with the primary care provider, mobile crisis team or psychiatric nurse when pt comes for follow-up visits to the ambulatory GI service if needed.&#x0D; Teammembers are trained in mental health issues so they become able to recognice and handle mental health issues, making them much more comfortable with comorbid psychiatric problems and optimizing workflows.&#x0D; &#x0D; We have since expanded to the AE department and planned surgery. &#x0D; Since the program started there were fewer cases of delirium tremens. Due to a merger with an other hospital while the pathway started we have no exact data. Over a period of 1 year 235 patients were included in the project and 143 were followed-up after testing positive on intake for planned surgery.&#x0D; We want to further expand to the entire hospital and develop a digital care support plan which follows the patient after discharge, with all the information about the patient for future care-givers, with their care plan , controlled by the patient.&#x0D; Due to COVID, involvement of partners outside the hospital was delayed. This is now top of the agenda.&#x0D; As a proof of concept this integrated pathway was well received and initiated a new pathway , integrating mental health into perinatal care.