Long-term Quality Research Articles

Dataset of weekly intra-treatment diffusion weighted imaging in head and neck cancer patients treated with MR-Linac

Radiation therapy (RT) is a crucial treatment for head and neck squamous cell carcinoma (HNSCC); however, it can have adverse effects on patients’ long-term function and quality of life. Biomarkers that can predict tumor response to RT are being explored to personalize treatment and improve outcomes. While tissue and blood biomarkers have limitations, imaging biomarkers derived from magnetic resonance imaging (MRI) offer detailed information. The integration of MRI and a linear accelerator in the MR-Linac system allows for MR-guided radiation therapy (MRgRT), offering precise visualization and treatment delivery. This data descriptor offers a valuable repository for weekly intra-treatment diffusion-weighted imaging (DWI) data obtained from head and neck cancer patients. By analyzing the sequential DWI changes and their correlation with treatment response, as well as oncological and survival outcomes, the study provides valuable insights into the clinical implications of DWI in HNSCC.

Adverse Skeletal Muscle Adaptations in Individuals Born Preterm—A Comprehensive Review

Infants born preterm face an increased risk of deleterious effects on lung and brain health that can significantly alter long-term function and quality of life and even lead to death. Moreover, preterm birth is also associated with a heightened risk of diabetes and obesity later in life, leading to an increased risk of all-cause mortality in young adults born prematurely. While these preterm-birth-related conditions have been well characterized, less is known about the long-term effects of preterm birth on skeletal muscle health and, specifically, an individual’s skeletal muscle hypertrophic potential later in life. In this review, we discuss how a confluence of potentially interrelated and self-perpetuating elements associated with preterm birth might converge on anabolic and catabolic pathways to ultimately blunt skeletal muscle hypertrophy, identifying critical areas for future research.

Association between life’s essential 8 and frailty status among cancer survivors in the United States: a cross-sectional analysis

BackgroundFrailty not only affects disease survival but also impacts the long-term function and quality life of all adults diagnosed with and/or treated for cancer.The American Heart Association has introduced Life’s Essential 8 (LE8) as a novel metric for assessing cardiovascular health. Currently, LE8’s application in evaluating the frailty of cancer survivors remains unreported. This research seeks to explore the connection between LE8 scores and frailty levels in cancer survivors across the United States, thereby addressing a significant void in existing studies.MethodsThis study analyzed data from cancer survivors enrolled in the National Health and Nutrition Examination Surveys (NHANES) spanning the years 2005 to 2018, providing a comprehensive dataset. Multivariable logistic regression models were used to examine the linkage between LE8 rankings and frailty condition in cancer survivors. Furthermore, the study delved deeper into this correlation using restricted cubic spline (RCS) curves and subgroup analyses.ResultsIn the fully adjusted model, an increased LE8 level was closely associated with a reduced odds ratio of frailty among cancer survivors, with an OR of 0.95 (95% CI: 0.94–0.96, p < 0.0001).This pattern persisted across different categorizations of LE8 into low, moderate, and high groups, demonstrating a consistent trend. The analysis revealed a non-linear relationship between LE8 scores and frailty status, further supporting a straightforward association (p-value for non-linearity = 0.0729).ConclusionStudies have found that the higher the LE8 score, the less likely a cancer patient is to develop debilitating symptoms.This indicates that the LE8 scores may provide an opportunity for interventions aimed at improving the prognosis of cancer patients.

Assessing the utility of shellfish sanitation monitoring data for long-term estuarine water quality analysis

Regular testing of coastal waters for fecal coliform bacteria by shellfish sanitation programs could provide data to fill large gaps in existing coastal water quality monitoring, but research is needed to understand the opportunities and limitations of using these data for inference of long-term trends. In this study, we analyzed spatiotemporal trends from multidecadal fecal coliform concentration observations collected by a shellfish sanitation program, and assessed the feasibility of using these monitoring data to infer long-term water quality dynamics. We evaluated trends in fecal coliform concentrations for a 20-year period (1999–2021) using data collected from spatially fixed sampling sites (n = 466) in North Carolina (USA). Findings indicated that shellfish sanitation data can be used for long-term water quality inference under relatively stationary management conditions, and that salinity trends can be used to investigate management-driven bias in fecal coliform observations collected in a particular area.

Long-Term Quality of Life for Patients with Spina Bifida

Abstract Purpose of Review This review explores the literature that currently exists regarding quality of life for patients with spina bifida and assesses screening tools available for practitioners to assess these outcomes. Domains addressed include health related quality of life, relationships, bowel and bladder dysfunction, sexuality, pain, and mood. Recent Findings Several recent papers have assessed available questionnaires and reviewed findings of key quality of life domains, with varying results. Summary Historically, the literature has focused on surgical outcomes for patients with spina bifida. Though some authors have begun to explore quality of life for this patient population, particularly in the short-term, a paucity of quality, long-term studies exist that describe quality of life domains or offer potential targets for improvements in outcomes.

Multi-year three-dimensional simulation of seasonal variation in phytoplankton species composition in a large shallow lake

Lake Erie has been negatively impacted by multiple stressors, including nutrient enrichment and climate change, that have exacerbated eutrophication and harmful algal blooms. Management of these long-term water quality problems requires numerical models that can be run over years to decades. The three-dimensional hydrodynamics and biogeochemistry models applied to date, however, have not been tested for continuous runs longer than one year and have not been shown to accurately reproduce seasonal variation in phytoplankton species composition (e.g., the development of harmful algal blooms) over decadal timescales. We simulated the three-dimensional nutrient and phytoplankton concentrations in western Lake Erie continuously from 2002 to 2014. Using a single parameter set, we were able to reproduce both seasonal and inter-annual variation in phytoplankton species composition. The model qualitatively reproduced the observed seasonal succession (i.e., variation in phytoplankton species composition), including the spring diatom bloom and late summer cyanobacterial growth. This study demonstrates that three-dimensional models can be applied for multi-year simulations of nutrients and phytoplankton to inform large lake research and management.

Objective and subjective cognitive status after intensive care unit treatment for COVID-19

PurposeIntensive care unit (ICU) survivors can experience wide-ranging and long-lasting symptoms after hospital discharge. Cognitive impairment has received increased attention in relation to the COVID-19 pandemic and can affect patients’ long-term quality of life. This study aimed to investigate the prevalence of cognitive impairment using an objective neurocognitive test 6 and 12 months following ICU admission and possible predictive factors for scoring below the defined cut-off. We also explored the prevalence of subjective cognitive complaints at 12 months, including the associated factors. MethodsThis was a prospective observational study of a national cohort of COVID-19 ICU survivors during the three first pandemic waves in Norway. Data was collected by the Norwegian Intensive Care and Pandemic Registry and the study group. ResultsAt the six-month follow-up, 23.1% (95% CI [18.2─28.5]) of the 273 respondents scored below the cut-off on the Mini-MoCA, indicating mild cognitive impairment. At the 12-month follow-up, the prevalence declined to 11.1% (95% CI [7.5─15.6]) in 253 respondents. Older age (OR 1.06, 95% CI [1.02─1.12]) and depression (OR 1.25, 95% CI [1.07─1.55]) were associated with cognitive impairment at six months. At 12 months, almost half of the patients reported subjective cognitive complaints. Symptoms of mental health problems and fatigue were associated with subjective cognitive complaints in our exploratory analyses. ConclusionCognitive impairment declined significantly from 6 to 12 months in this cohort of COVID-19 ICU patients, while subjective cognitive complaints remained high at 12 months, perhaps attributed to a high total symptom burden.

Functional results after hiatal repair and gastropexy without fundoplication in patients with paraoesophageal hernia

PurposeParaoesophageal hernias (PEH) are associated with a high complication rate and often occur in elderly and fragile patients. Surgical gastropexy without fundoplication is an accepted alternative procedure; however, outcomes and functional results are rarely described. Our study aims to evaluate short-term outcomes and the long-term quality of life after gastropexy as treatment for PEH.MethodsSingle center cohort analysis of all consecutive patients who underwent gastropexy for PEH without fundoplication. Postoperative outcomes and functional results were retrospectively collected. Reflux symptoms developed postoperatively were reported using the validated quality of life questionnaire: GERD-Health Related Quality of Life Qestionnaire (GERD-HRQL).ResultsThirty patients (median age: 72 years (65–80)) were included, 40% classified as ASA III. Main PEH symptoms were reflux (63%), abdominal/thoracic pain (47%), pyrosis (33%), anorexia (30%), and food blockage (26%). Twenty-six laparoscopies were performed (86%). Major complications (III-IVb) occurred in 9 patients (30%). Seven patients (23%) had PEH recurrence, all re-operated, performing a new gastropexy. Median follow-up was 38 (17–50) months. Twenty-two patients (75%) reported symptoms resolution with median GERD-HRQL scale of 4 (1–6). 72% (n = 21) reported operation satisfaction. GERD-HRQL was comparable between patients who were re-operated for recurrence and others: 5 (2–19) versus 3 (0–6), p = 0.100.ConclusionGastropexy without fundoplication was performed by laparoscopy in most cases with acceptable complications rates. Two-thirds of patients reported symptoms resolution, and long-term quality-of-live associated to reflux symptoms is good. Although the rate of PEH recurrence requiring a new re-intervention remained increased (23%), it does not seem to affect long-term functional results.

Reflection on analyzing the long-term quality of life between duodenum-preserving pancreatic head resection and pancreatoduodenectomy.

Reflection on analyzing the long-term quality of life between duodenum-preserving pancreatic head resection and pancreatoduodenectomy.

Click evoked otoacoustic emissions in occupational exposure to lead, concentrations of selected essential elements and markers of oxidative stress.

This study focused on the selected markers of oxidative stress, impact of elevated lead levels on long-term hearing quality. We investigated whether the presence of certain essential minerals might provide protection to the auditory system against the effects of lead (and cadmium) compounds. The research group included 280 male employees of the zinc and lead smelter, which was divided into: L-Pb-low blood lead concentration (PbB) subgroup, H-Pb-high PbB subgroup. Hearing tests were performed using the click evoked otoacoustic emission (CEOAE). Zinc protoporphyrin level was significantly higher in the H-Pb subgroup by 68%. Cd concentration was significantly higher in H-Pb by 33%. The Ca concentration was significantly lower in the H-Pb by - 2%. Selected oxidative stress markers concentration were significantly higher in the H-Pb group: malondialdehyde (MDA) by 4%, and lipofuscin (LPS) by 9%. In the CEOAE results showed statistically significant differences between the L-Pb and H-Pb subgroups. Larger negative changes in otoemission amplitude were observed in H-Pb subgroup. All otoemission results showed a statistically significant negative correlation with age, time of work, MDA concentration, and with PbB. Selected CEOAE parameters showed a significant negative correlation with cadmium blood concentration (CdB), and a positive correlation with Ca and Zn. Elevated blood lead content in occupational exposure is associated with an increase in MDA and LPS concentration, which negatively correlates with CEOAE parameters. This suggests an important role of oxidative stress in the long-term deterioration of hearing.

Abstract PO1-19-03: The T-REX trial: a randomized international non-inferiority trial on Tailored Regional EXternal beam radiotherapy in clinically node-negative breast cancer patients with 1-2 sentinel node macrometastases

Abstract Background: Modern systemic treatment has reduced the incidence of regional recurrences and improved survival in breast cancer (BC). It is thus questionable whether regional radiotherapy (RT) is still indicated in patients with sentinel lymph node (SLN) macrometastases. Postoperative regional RT is associated with an increased risk of arm morbidity, pneumonitis, cardiac disease, and secondary cancer. Therefore, there is a need to individualize the indication for regional RT in relation to risk of recurrence. Trial design: In this multicenter, prospective randomized phase 3 trial, eligible patients have a clinically node-negative, estrogen receptor-positive, HER2-negative BC with 1-2 SLN macrometastases, and have not undergone completion axillary lymph node dissection. Participants are randomly assigned to receive regional RT (standard arm) or not (intervention arm). Regional RT includes the axillary levels I-III and the supraclavicular fossa. Internal mammary nodes are targeted in selected patients. After breast-conserving surgery (BCS), RT to the remaining breast is given in both groups while after mastectomy, chest-wall RT is only given in the standard arm. In the intervention arm, chest wall RT may be indicated in selected cases with extensive multifocality, according to national guidelines. RT quality assurance is an integral part of the trial. In addition, material from the primary tumor, SLN metastases and any recurrences is subjected to gene expression analysis to identify both prognostic markers for locoregional recurrence and predictive markers for the benefit of regional RT. After confirmation of eligibility and written informed consent, patients are randomized 1:1 between the treatment arms. Allocation is stratified by trial site and breast surgery (BCS vs. mastectomy). Participation in T-REX should not affect decisions on systemic adjuvant treatment. Eligibility criteria: Trial inclusion and exclusion criteria are given in Table 1. Specific aims: The main aim of the trial is to investigate if the omission of regional RT is non-inferior to routine regional RT in clinically node-negative BC patients with estrogen receptor-positive, HER2-negative T1-2 tumors with 1-2 SLN macrometastases not receiving axillary lymph node dissection. Secondary aims are to investigate whether refraining from regional RT reduces arm morbidity and late RT side effects, and improves short- and long-term health-related quality of life. In addition, the use of genomic classifiers for the prognostication of locoregional recurrences and the prediction of a benefit from regional RT will be investigated. Statistical methods: Primary outcome is recurrence free survival (RFS) at five years. Non-inferiority will be declared if the outcome in the intervention arm is not more than 4.5 percentage units below the standard arm, corresponding to a hazard ratio of 1.41 assuming 88% 5-year RFS with standard treatment. Secondary outcomes include locoregional recurrence, overall survival, patient-reported arm morbidity, and health-related quality of life. Accrual: The trial will include 1350 patients in Sweden, Norway and Finland from April 2023 to December 2028. First sites have been opened in April 2023. Contact information: Primary Investigator: Sara Alkner, Skåne University Hospital, Lund University, sara.alkner@med.lu.se. Responsible for the biobank: Per Karlsson, Sahlgrenska University Hospital, Gothenburg University, per.karlsson@oncology.gu.se. Inclusion and exclusion criteria Citation Format: Sara Alkner, Jana de Boniface, Dan Lundstedt, Ingvil Mjaaland, Lisa Rydén, Johan vikström, Pär-Ola Bendahl, Erik Holmberg, Helena Sackey, Elinore Wieslander, Per Karlsson. The T-REX trial: a randomized international non-inferiority trial on Tailored Regional EXternal beam radiotherapy in clinically node-negative breast cancer patients with 1-2 sentinel node macrometastases [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-19-03.

Urban heat and pollution island in the Moscow megacity: Urban environmental compartments and their interactions

Cities are highly interconnected systems where specific interactions between various urban environments occur due to the Urban Heat Island (UHI) and Urban Pollution Island (UPI) effects. Four compartments of the environment (atmospheric air, road dust, streamflow, and people) are discussed for Moscow city. Long-term meteorological, radiative, air quality, and precipitation measurements, the non-hydrostatic regional numerical COSMO model, and extensive hydrological and geochemical sampling were used. To characterize mortality and UPI interaction, a family of distributed lag non-linear models (DLNM) was applied. The study reveals increased aerosols concentrations which reduce the incoming solar radiation and increase the atmospheric longwave radiation. UHI strengthens the low-troposphere convergence due to urban breeze circulation and atmospheric circulation due to elevated surface roughness, the effect which leads to 11.6% heaviest precipitation increase compared to background values. Increased precipitation doubles streamflow rates and enhances the contribution of rain floods to annual flow. Similar geochemical associations with Sb, W, Zn, Cd, Pb, and Cu were found in aerosol PM10, indicating transport and road dust impact. Finally, associations between high temperatures and human mortality which are generally stronger at high levels of air pollution for both PM10 and NO2, and for lag 1 day and 2–6 days are discussed.

Navigating complexities and considerations for suspected anastomotic leakage in the upper gastrointestinal tract: A state of the art review

Navigating complexities and considerations for suspected anastomotic leakage in the upper gastrointestinal tract: A state of the art review

Good Health-Related Quality of Life in Older Patients One Year after mTBI despite Incomplete Recovery: An Indication of the Disability Paradox?

Background: Older adults (OAs) with mild traumatic brain injury (OA-mTBI) are a growing population, but studies on long-term outcomes and quality of life are scarce. Our aim was to determine the health-related quality of life (HRQoL) in OA-mTBI one year after injury and to assess the early predictors of HRQoL. Methods: Data from a prospective follow-up study of 164 older (≥60 years) and 289 younger mTBI patients (<60 years) admitted to the emergency department were analyzed. Post-traumatic complaints, emotional distress and coping were evaluated 2 weeks post-injury using standardized questionnaires. At 12 months post-injury, HRQoL and functional recovery were determined with the abbreviated version of the World Health Organization Quality of Life scale and Glasgow Outcome Scale Extended (GOSE), respectively. Results: One year post-injury, 80% (n = 131) of the OA-mTBI rated their HRQoL as "good" or "very good", which was comparable to younger patients (79% (n = 226), p = 0.72). Incomplete recovery (GOSE <8) was present in 43% (n = 69) of OA-mTBI, with 67% (n = 46) reporting good HRQoL. Two weeks post-injury, fewer OA-mTBI had (≥2) post-traumatic complaints compared to younger patients (68% vs. 80%, p = 0.01). In the multivariable analyses, only depression-related symptoms (OR = 1.20 for each symptom, 95% CI = 1.01-1.34, p < 0.01) were predictors of poor HRQoL in OA-mTBI. Conclusions: Similar to younger patients, most OA-mTBI rated their HRQoL as good at one year after injury, although a considerable proportion showed incomplete recovery according to the GOSE, suggesting a disability paradox. Depression-related symptoms emerged as a significant predictor for poor HRQoL and can be identified as an early target for treatment after mTBI.

Changes in Calcaneal Bone Density and Correlation With Clinical Outcomes Following Ankle Fractures

Introduction: The study investigates the long-term bone quality and its influence on clinical results after surgical treatment of Weber B-type fractures. Methods: Surgery treated isolated Weber B-type fractures between 2006 and 2016 were included. Bone density was determined by ultrasonography densitometry of the calcaneus. American Orthopedic Foot and Ankle Society (AOFAS), Foot Function Index, Olerud-Molander-Ankle-Score, Hannover-Score, and Short Form Health Survey SF 36 were recorded. Results: Sixty patients were followed up. Mean follow-up was 6.6 years (range, 2 to 12 years). Mean bone density T-score of the treated foot was significantly lower than that of the contralateral untreated side (−0.6 versus −0.3; P = 0.05). Higher T-scores on the injured side were significantly and positively correlated with improved outcomes in the AOFAS, Olerud-Molander-Ankle-Score, and SF-36 physical component summary but negatively correlated with the Hannover score (P ≤ 0.05). A significant correlation existed only between the pain scores of the AOFAS and Foot Function Index. Controlling for potential confounding variables, such as age and smoking status, in a linear regression model, increased bone density was only associated with the AOFAS score. Discussion: A significant reduction in bone density persists for more than eight years in some individuals. Statistically significant correlation between reduced bone density and clinical outcomes was found only for the AOFAS scoring system.

De novo urinary incontinence and lower urinary tract symptoms after colpocleisis: A single-center prospective study

BackgroundColpocleisis is one of traditional surgical procedures for elderly and frail women with advanced pelvic organ prolapse. The occurrence of de novo urinary incontinence following colpocleisis was considered to impair the postoperative quality of life. The incidence of de novo urinary incontinence after colpocleisis has been reported to be ranging from 6.6% to 27%. There was an absence of prospective large-sample study to investigate the accurate incidence of de novo urinary incontinence following colpocleisis and the impact on the quality of life till now. Purposes The primary objective was to report the incidence of de novo urinary incontinence after colpocleisis. The second objectives were to evaluate the long-term quality of life in patients with de novo urinary incontinence, and to conduct detailed pre- and post-operative evaluations of lower urinary tract symptoms. MethodsThis prospective study included 253 patients with symptomatic pelvic organ prolapse who underwent colpocleisis between 2009 and 2021. De novo urinary incontinence was defined as the occurrence of urinary incontinence 3 months postoperatively. All patients were required to complete the Urinary Distress Inventory questionnaire and the Urinary Impact Questionnaire for the evaluation of patients’ quality of life, and the Patient Global Impression of Improvement questionnaire for the evaluation of patients’ satisfaction. Results245 patients (245/253, 96·8%) completed the 3-month follow-up, and were included in the final analysis. The incidence of de novo urinary incontinence was 5.4% (10/185). There was no significant difference in the Urinary Distress Inventory -6 scores (22.50 vs. 10.30, P=0.276) or the subjective satisfaction rate (100% vs. 98.9%, P=0.250) between the patients with or without de novo urinary incontinence at the long-term follow-up. The incidence of voiding difficulty was significantly reduced after colpocleisis (27.8% vs. 0.0%, P<0.001). The patients’ quality of life indicated by Urinary Distress Inventory-6 and Urinary Impact Questionnaire-7 scores were significantly improved postoperatively (26.27 vs. 13.39, and 19.13 vs. 6.05, P<0.05). ConclusionThe incidence of de novo urinary incontinence after colpocleisis was very low. Patients’ quality of life, and low urinary tract symptoms were significantly improved after colpocleisis.

An integrated approach to the assessment of balance and functional mobility in individuals with history of severe traumatic brain injury

Individuals who experienced severe Traumatic Brain Injury (sTBI) are often characterized by relevant motor dysfunctions which are likely to negatively affect activities of daily living and quality of life and often persist for years. However, detailed objective information about their magnitude are scarce. The aim of this study was to quantitatively assess the extent of motor deficits in terms of postural control effectiveness under static and dynamic conditions and to investigate the existence of possible correlations between the results of clinical tests and instrumental measures. Postural sway and functional mobility (i.e., instrumented Timed Up and Go test, iTUG) were objectively measured in 18 individuals with sTBI and 18 healthy controls using a pressure plate and a wearable inertial sensor. Additionally, participants with history of sTBI completed the Rivermead Mobility Index (RMI). One-way ANOVA and Spearman's rank correlation analysis were employed to examine differences between the two groups and determine potential correlations between the instrumental tests and clinical scales.The results show that people with sTBI were characterized by larger sway area and longer iTUG walking sub-phase. Significant correlations were also detected between RMI scores and iTUG total duration, as well as the walking phase. Taken together, these findings suggest that, even years after the initial injury, individuals with sTBI appear characterized by impaired postural control and functional mobility, which appears correlated with the RMI score. The integration of instrumental measures with clinical scales in the routine assessment and treatment of individuals with sTBI would result in more comprehensive, objective, and sensitive evaluations, thus improving precision in treatment planning, enabling ongoing progress monitoring, and highlighting the presence of motor deficits even years after the initial injury. Such integration is of importance for enhancing the long-term quality of life for individuals with sTBI.

Long-term assessment and analysis of the radiometric quality of standard data products for Chinese Gaofen-1/2/6/7 optical remote sensing satellites

The first Chinese Gaofen (GF) remote sensing satellite was launched in August 2013 and has been in orbit for more than 10 years, providing a rich variety of image product data for remote sensing applications in various industries, with other remote sensing satellites of the GF series. To ensure the reliability of the information generated via remote sensing applications, all remote sensing images must undergo systematic quality evaluation. The quality of GF satellites is evaluated almost comprehensively during in-orbit testing at the early stage after launch; however, the remaining evaluations of product quality including geometric or radiometric calibrations are performed only annually. Thus, long-term systematic image quality evaluations are lacking, and the quality level and long-term change trends of the image products are unknown. These deficits have introduced uncertainty in the application of these products. This study aimed to establish a radiometric quality evaluation index framework for GF satellites to comprehensively measure the radiometric quality of GF image products. Multiple types of sample data, such as uniform field, knife-edge target, and radiometric calibration field data with different reflectance features, were acquired globally. Four core indexes, namely, the relative radiometric correction accuracy (RRCA), absolute radiometric correction accuracy (ARCA), modulation transfer function (MTF), and signal-to-noise ratio (SNR), were used to analyze and evaluate the long-term radiometric quality of the images from four GF optical remote sensing satellites: GF1, GF2, GF6, and GF7. The four GF satellites had high SNR and RRCA but low dynamic MTF and variable ARCA for different reflectance features. For example, the average SNRs for the four satellites reached 42.66, 43.91, 44.33, and 47.46 dB; the average RRCA (@root-mean-square errors) values reached 1.6%, 1.0%, 1.6%, and 0.1%; the average MTF values (at Nyquist frequency) of the panchromatic bands were only 0.15, 0.12, 0.07 and 0.04; and the difference in ARCA for different reflectance targets was approximately 10%. In the long time series, the SNRs for each sensor of the four GF satellites were high and stable for high-reflectance features, whereas the RCA and SNR values for low-reflectance features and the MTF of the sensors fluctuated in a cyclic manner. Meanwhile, large dynamic fluctuations and episodic image quality problems occurred at certain local time points, which must be considered during practical applications. The findings presented here will lay a foundation for the in-depth application of GF images.

Development of technology for obtaining juice from persimmon fruit (Diospyros kaki L.)

Organizing proper and environmentally friendly nutrition is one of the most pressing problems. Widespread persimmon fruits are of great technological importance as raw materials for the production of concentrated juice, used as a natural sweetener. The object of this study is the processes of obtaining juices from persimmon fruits. Quality indicators were studied in juices prepared by preliminary heat treatment and the use of an enzyme preparation. The juice yield from the Khachia variety was 93.9 %, and from the Hiakume variety – 93.8 %. To prepare concentrated juice, persimmon juice was used, prepared by preliminary heat treatment, and using 0.1–0.2 % enzyme preparation. A scheme for preparing concentrated juice has been developed, which is recommended for use as an environmentally friendly sweetener in food production. The concentrate contained 7.25 µg/100 g of iodine. The prepared concentrate is rich in nutritional components necessary for human life, as well as sugars, phenolic compounds with antioxidant and antimicrobial properties, as well as vitamin C. Nutritional components perform a wide range of functions in the optimal functioning of the immune system and play an important role in metabolic processes. The use of persimmon concentrate in the preparation of various food products increases the bioavailability of many minerals. Therefore, to ensure the nutritional value of the finished product and increase long-term quality storage, it is recommended to use concentrated persimmon juice as a sugar substitute

Pancreas after kidney transplantation, is it the time to overcome the stigma?

Pancreas transplantation is the most effective treatment to improve quality of life and overcome complications in patients with end-stage renal disease and diabetes mellitus. One of the main approaches for concurrent renal disease and diabetes mellitus which has been underutilized during the past decade is a pancreas transplant after kidney transplantation. Our study aimed to quantify outcomes following pancreas after kidney transplants (PAKs) in the United States from 2001 to 2020 with an emphasis on graft and patient survival. A retrospective registry analysis was performed by accessing the OPTN/UNOS database for PAKs that were performed in the United States from January 2001 to April 2020. The study population was divided into two subgroups: patients receiving a pancreas transplant between 2001 and 2010 and those receiving a pancreas transplant between 2011 and 2020. The study examined a total number of 3706 PAK recipients; patients who received a PAK from January 2001 through December 2010 (n=2892) and those who received a PAK from January 2011 to April 2020 (n=814). The selection process of transplant recipients did not drastically change throughout the 2001-2010 and 2011-2020 periods. Length of stay at the hospital after the transplantation improved significantly in the 2011-2020 group relative to the 2001-2010 group (8.48 vs. 10.08days, mean, p<0.01). Additionally, more transplantation with 4-6 human leukocyte antigen mismatch occurred in the 2011-2020 group than in the 2001-2010 group (80.6% vs. 71.4%, p<0.01). The pancreas preservation time of 13.35h in the 2001-2010 group decreased significantly to 11.17h in the 2011-2020 group (p<0.001). The mean donor's amylase and lipase also decreased significantly in the 2011-2020 cohort. Significant graft survival improvement was observed in the 2011-2020 group compared to the 2001-2010 group after a long-term follow-up (p<0.001). The mean Calculated Pancreas Donor Risk Index was 1.08 for the 2001-2010 group and 0.99 for the 2011-2020 group with a significant difference (p<0.001). The beneficial results and improved outcomes observed in PAK patients demonstrate the effectiveness of the operation for individuals in need of a pancreas transplant. PAKs can prove to be a meaningful solution to overcome long waiting times, decrease the donor-recipient imbalance, expand the donor pool, and overcome the current underutilization in order to improve the short- and long-term quality of life in the groups of interest.