One-way Analysis Research Articles

Cost-utility analysis of expanding the colorectal cancer screening policy in Flanders

ObjectiveSince 2013, Flanders has introduced a screening programme for colorectal cancer for all citizens aged between 50 and 74 years. The objective of this study was to assess the cost-utility of an expansion of the colorectal cancer screening policy in Flanders (Belgium) and to place these findings in the international context. MethodsCost-utility analysis using high-detail data about screening participation, screening results, and epidemiological data, a Markov cohort model has been constructed to study long-term costs and effects. A cost-utility analysis was performed as a three-way comparison between current, expanded (from age 45 years), and no screening scenarios, from a societal and healthcare perspective. Robustness was assessed by both one-way and probabilistic sensitivity analyses. ResultsAnalyses show that both current and expanded screening result in quality-adjusted life years (QALY) gains and are mostly cost-saving. Overall, 97.5% of Incremental Cost-Effectiveness Ratios (ICERs) remained well below € 2000 per QALY for all comparisons. Parameters related to the colonoscopy that follows a positive test result such as compliance and cost are especially impactful on the cost-effectiveness. ConclusionsScreening participation and screening costs have remained comparatively stable, making colorectal cancer screening a cost-effective (dominant) policy. Expanding the screen age to 45 years is also cost-effective (dominant) compared with current screening, albeit with a slimmer margin.

Neuroinflammation in the Rat Brain After Exposure to Diagnostic Ultrasound

ObjectiveTo date there have been no studies exploring the potential for neuroinflammation as an intracranial bio-effect associated with diagnostic ultrasound during neonatal cranial scans in a mammalian in vivo model. The study described here was aimed at investigating the effects of B-mode and Doppler mode ultrasound on inflammation in the rat brain. MethodsTwelve Wistar rats (7–9 wk old) were divided into a control group and an ultrasound-exposed group (n = 6/group). A craniotomy was performed, followed by 10 min of B-mode and spectral Doppler interrogation of the middle cerebral artery. The control group was subjected to sham treatment, with the transducer held stationary over the craniotomy site, but the ultrasound machine switched off. Animals were euthanized 48 h after exposure, and the brains formalin fixed for immunohistochemical analysis using allograft inflammatory factor 1 (IBA-1) and glial fibrillary acidic protein (GFAP) as markers of microglia and astrocytes, respectively. The numbers of IBA-1- and GFAP-immunoreactive cells were manually counted and expressed as areal density (cells/mm2). Results were analyzed using Student's unpaired t-test and one-way repeated-measures analysis of variance. ResultsThe ultrasound-exposed brain exhibited significant increases in IBA-1 and GFAP immunoreactive cell density in all regions of B-mode and Doppler mode exposure compared with the control group (p < 0.001). ConclusionTen minutes of B-mode and Doppler mode ultrasound may induce neuroinflammatory changes in the rat brain. This suggests that exposure of brain tissue to current diagnostic ultrasound intensities may not be completely without risk.

Influential Signs of Dry Eye-Related Ocular Symptoms in Participants With Unstable Tear Film.

The aim of this study was to investigate the factors influencing dry eye disease (DED)-related ocular symptoms in participants with short fluorescein tear break-up time (FTBUT). This cross-sectional study included 82 participants with short FTBUT (<10 seconds). Examinations included Ocular Surface Disease Index (OSDI), FTBUT, average noninvasive tear break-up time (NIBUTave), lid wiper epitheliopathy, lipid layer thickness, blink rate, partial blink, tear meniscus height, and meibomian gland (MG) evaluation which included ratio of residual MG area (RMGA) and MG grade in tarsal plates. One-way analysis of variance was used to detect differences between symptomatic tear film instability group (FTBUT <5 s, OSDI ≥13), asymptomatic tear film instability group (FTBUT <5 s, OSDI <13), and control group (FTBUT ≥5 s, OSDI <13). A bivariate correlation, partial correlation, and multiple linear regression analyses were used to identify major factors. Only the right eye was included. Among the participants with FTBUT <5 seconds, symptomatic group showed less upper RMGA ( P < 0.001) and NIBUTave ( P = 0.010). OSDI was negatively associated with upper RMGA ( r = -0.450, P < 0.001) and NIBUTave ( r = -0.414, P = 0.001), and positively associated with upper MG grade ( r = 0.277, P = 0.027). Linear regression analysis showed that the upper RMGA significantly affected OSDI (B = -41.895, P = 0.001), while not significantly correlated with age, upper MG grade, and NIBUTave. The upper RMGA might be the main factor affecting DED-related discomfort in participants with unstable tear film, indicating an early ocular change in DED.

The effect of rosemary, ginger, or garlic on microbial shelf life and sensory acceptability of nutritionally enriched cassava-based pancake (Kabalagala)

Iron and vitamin A contents of Cassava-based pancake (Kabalagala), a delicacy among children in northern Uganda have recently been improved through the addition of biofortified iron-rich beans and orange-fleshed sweet potato. The nutritionally improved product (NIK) was designed as a strategy to address iron and vitamin A deficiencies which are endemic challenges among children in Uganda. However, the NIK had a lower microbial shelf life (24 hours) than the original product (72 hours). The objective of this study was to investigate the potential of the spices; rosemary, ginger, and garlic to improve the microbial shelf life of the NIK. Each of the spices was used individually to prepare NIK at a rate of 0.5, 0.75, and 1%. The resultant products were evaluated for counts of total microbial load, Enterobacteriaceae, lactic acid bacteria, yeasts and molds as well as consumer sensory acceptability during storage at ambient temperature. Results of One-way Analysis of Variance (ANOVA) showed that all the spices exhibited potency against the microbial groups investigated only when included in the NIK at 0.75% or 1% (p<0.05). The microbial shelf life of the NIK based on total microbial count increased from 24 to 72 hours depending on the spice type and concentration. The spice, 1% ginger resulted in Enterobacteriaceae and yeast and molds counts within acceptable microbial threshold for the entire storage time (72 hours) with a maximum load of 3.41 and 2.82 log10 CFU/g, respectively. The NIK containing ginger or garlic at 0.75 or 1%, was more accepted and the extent of acceptability increased with storage time (p<0.05). Based on the overall acceptability, the consumer acceptability varied from 1% garlic > 0.75% garlic > 1% ginger > 0.75% ginger > 0.5% ginger in decreasing order. Spearman's correlation analysis revealed a strong association between the sensory parameters examined (appearance, aroma, texture, taste) and the overall acceptability of the products (p<0.05). The magnitude of association between appearance, aroma, texture, taste and overall acceptability varied between 0.396-0.703, 0.504-0.679, 0.452-0.589, and 0.498-0.698, respectively. This study has demonstrated that ginger or garlic when applied at 0.75-1% improves microbial shelf life of NIK concomitant with better consumer sensory acceptability. Therefore, ginger or garlic can be applied at 0.75-1% to produce microbiologically and sensorially acceptable NIK for use to improve intake of vitamin A and iron among children in Uganda.

Comparative effects of glazing versus polishing on mechanical, optical, and surface properties of zirconia ceramics with different translucencies.

This study compared the effects of glazing versus polishing on mechanical, optical, and surface properties of zirconia ceramics with different translucencies. In this in vitro study, 120 bar-shaped specimens (25 × 4 × 1.2 mm) were fabricated from three different types of zirconia with different translucencies (n = 40, DD Bio ZW, ZX2, and Cube X2). After sintering, each zirconia group was randomly divided into five subgroups of control (glazing), glazing + bur abrasion, glazing + bur abrasion + polishing with EVE Diacera® kit, glazing + bur abrasion + reglazing, and glazing + bur abrasion + polishing with EVE Diacera® kit + reglazing. The specimens underwent surface roughness, hardness, flexural strength, and translucency tests, as well as X-ray diffraction (XRD) and scanning electron microscopy (SEM) for assessment of surface topography. Data were analyzed by one-way analysis of variance, Tukey test, and Pearson test (α = .05). Flexural strength, surface hardness, and translucency were significantly correlated with zirconia type. ZW zirconia had significantly higher flexural strength and surface hardness and significantly lower translucency than Cube X2 and ZX2 (p < .001). Surface roughness had no significant correlation with zirconia type (p = .274). Polishing created the smoothest, and bur abrasion created the roughest surface (p < .001). Flexural strength and hardness in most experimental groups were significantly lower than in the control group (p < .001). Translucency was not significantly different in bur abrasion and polishing groups, compared with the control group; however, reglazing significantly increased the translucency (p < .001). SEM micrographs confirmed the surface roughness results. XRD showed monoclinic phase only in reglazed groups. Of different surface treatments, polishing improved the surface properties and caused the smallest change in mechanical properties of zirconia with different translucencies.

Sub-acute studies on the effects of trona consumption at varied low doses on male fertility and antioxidant properties using Wistar Rats

Geologically known as trona, evaporite, or locally known as greyish potash, akanwu, or kaun, it serves a multitude of purposes in Nigeria. These include, but are not limited to, softening legumes and flesh, augmenting the therapeutic attributes of herbal expectorant remedies, and reducing male libido or fertility. The unrestricted consumption and accessibility of this salt in the local markets of Anambra State, Nigeria, are due to its affordability and accessibility. Currently, there is no investigation into the comprehensive impact of potash's antioxidant properties at various low doses on male fertility. This led to a study that lasted for 28 days and involved rats weighing between 120 g and 140 g. The rats were separated into four groups, with each group consisting of seven rats. Group A was the control group, while groups B, C, and D were the test groups administered doses of 150 mg/kg, 300 mg/kg, and 450 mg/kg of potash, respectively. At the end of the study, the antioxidant properties of potash were tested. Prostate, gland, testis, and blood were collected and analyzed. Data was analyzed with the statistical social science (SPSS) version 27. Results were presented as mean ± standard deviation (SD). A one-way analysis of variance (ANOVA) was used to compare the mean values. Our study found a significant (p&lt;0.05) dose dependent decrease in fertility hormones and semen parameters. Prostate specific antigen (PSA) increased dose-dependently compared to the control. Our findings indicate that trona is rich in antioxidants.

A comparative study of transcervical, endoscope-assisted transcervical, and endoscope-assisted transoral resection of retrostyloid space schwannomas.

The aim of this retrospective study was to compare the efficacy of transcervical (TC), endoscope-assisted transoral (TO), and endoscope-assisted TC for resection of retrostyloid space schwannomas. The study included patients who underwent complete resection of schwannomas by only one surgical approach. The data we collected included tumor size, estimated blood loss, postoperative complications, and so on. Statistical analysis was performed using one-way analysis of variance and Fisher's exact test. The study collected 85 patients with tumors mostly located at the oropharyngeal level who were followed up 6 months at least. The results showed that endoscope-assisted TO had certain advantages over others. Additionally, the endoscope-assisted TO set the lowest incidence of neurological complications. Our findings demonstrate that for team with rich experience in the skull base surgery, endoscope-assisted TO is a superior option compared to the other two groups for resection of retrostyloid space schwannomas, with the better preservation of neurological function.

Within-trial hospitalization resource utilization and budget impact analysis for darolutamide in metastatic hormone-sensitive prostate cancer using ARASENS.

ARASENS was a randomized, double-blind, phase 3 trial comparing darolutamide + docetaxel + androgen deprivation therapy (ADT) with placebo + docetaxel + ADT in patients with metastatic hormone-sensitive prostate cancer (mHSPC). To use clinical trial data from ARASENS to understand whether the addition of darolutamide to docetaxel + ADT leads to increased hospitalizations and to estimate the budget impact on the US health care system. We used mixed-effects negative binomial regression to estimate hospitalization and intensive care unit (ICU) admission rates and length of hospital stay (LoHS) counts. Hospitalization rates were estimated per treatment arm for the period during and after administration of docetaxel. Based on these estimates, a budget impact analysis evaluated the hospitalization costs (including ICU admissions) and standalone ICU hospitalization costs for the totality of the US population over a 5-year time horizon. The analysis compared a scenario without darolutamide vs one with darolutamide included in the US payer formulary. Hospitalization estimates were varied in a one-way sensitivity analysis. The first 4 months of treatment (when patients were receiving docetaxel) were associated with increased hospitalizations across both arms. The addition of darolutamide was associated with a numerical reduction in the rate of hospitalization (per year) due to any reason both during docetaxel treatment (1.01 visits per year [95% CI = 0.82-1.20] vs 1.18 visits per year [95% CI = 0.96-1.41]) and after docetaxel treatment (0.28 visits per year [95% CI = 0.23-0.34] vs 0.33 visits per year [95% CI = 0.27-0.40]). Darolutamide was associated with a marginally longer LoHS per hospitalization compared with placebo (+1.90 days per year) both during and after docetaxel treatment. ICU admissions were low in the ARASENS data; admission rates were assumed to be the same during and after docetaxel treatment. ICU admission rate estimates were equivalent across arms (0.02 visits per year [95% CI = 0.01-0.03]). The budget impact per treated member per month represents a cost-neutral option after Year 5 with a cumulative budget impact of -$9.71. The addition of darolutamide to docetaxel + ADT was associated with a numerically lower rate of hospitalization but marginally longer LoHS compared with docetaxel + ADT alone. Darolutamide represents a cost-neutral alternative per treated member per month compared with docetaxel + ADT with regard to hospitalizations at the end of a 5-year time horizon.

C/EBPβ-Lin28a positive feedback loop triggered by C/EBPβ hypomethylation enhances the proliferation and migration of vascular smooth muscle cells in restenosis.

The main cause of restenosis after percutaneous transluminal angioplasty (PTA) is the excessive proliferation and migration of vascular smooth muscle cells (VSMCs). Lin28a has been reported to play critical regulatory roles in this process. However, whether CCAAT/enhancer-binding proteins β (C/EBPβ) binds to the Lin28a promoter and drives the progression of restenosis has not been clarified. Therefore, in the present study, we aim to clarify the role of C/EBPβ-Lin28a axis in restenosis. Restenosis and atherosclerosis rat models of type 2 diabetes (n = 20, for each group) were established by subjecting to PTA. Subsequently, the difference in DNA methylation status and expression of C/EBPβ between the two groups were assessed. EdU, Transwell, and rescue assays were performed to assess the effect of C/EBPβ on the proliferation and migration of VSMCs. DNA methylation status was further assessed using Methyltarget sequencing. The interaction between Lin28a and ten-eleven translocation 1 (TET1) was analysed using co-immunoprecipitation (Co-IP) assay. Student's t-test and one-way analysis of variance were used for statistical analysis. C/EBPβ expression was upregulated and accompanied by hypomethylation of its promoter in restenosis when compared with atherosclerosis. In vitroC/EBPβ overexpression facilitated the proliferation and migration of VSMCs and was associated with increased Lin28a expression. Conversely, C/EBPβ knockdown resulted in the opposite effects. Chromatin immunoprecipitation assays further demonstrated that C/EBPβ could directly bind to Lin28a promoter. Increased C/EBPβ expression and enhanced proliferation and migration of VSMCs were observed after decitabine treatment. Further, mechanical stretch promoted C/EBPβ and Lin28a expression accompanied by C/EBPβ hypomethylation. Additionally, Lin28a overexpression reduced C/EBPβ methylation via recruiting TET1 and enhanced C/EBPβ-mediated proliferation and migration of VSMCs. The opposite was noted in Lin28a knockdown cells. Our findings suggest that the C/EBPβ-Lin28a axis is a driver of restenosis progression, and presents a promising therapeutic target for restenosis.

Exploring Drivers of Wildfires in Spain

Wildfires play a dual role in ecosystems by providing ecological benefits while posing catastrophic events; they also inflict non-catastrophic damage and yield long-term effects on biodiversity, soil quality, and air quality, among other factors, including public health. This study analysed the key determinants of wildland fires in Spain using openly available spatial data from 2008 to 2021, including fire perimeters, bioclimatic variables, topography, and socioeconomic datasets, at a resolution of 1 km2. Our methodology combined principal component analysis (PCA), linear regression analysis, and one-way analysis of variance (ANOVA). Our findings show that scrub/herbaceous vegetation (average 63 ± 1.45% SE) and forests (average 19 ± 0.76% SE) have been highly susceptible to wildfires. The population density exhibited a robust positive correlation with wildfire frequency (R2 = 0.88, p &lt; 0.0001). Although the study provides insights into some fire-related climatic drivers over Spain, it includes only temperature and precipitation-based variables and does not explicitly consider fuel dynamics. Therefore, a more advanced methodology should be applied in the future to understand the local specifics of regional wildfire dynamics. Our study identified that scrub/herbaceous areas and forests near densely populated regions should be prioritised for wildfire management in Spain, particularly under changing climate conditions.

Examining pancreatic stone protein response in ICU-acquired bloodstream infections: a matched event analysis.

Pancreatic stone protein (PSP) exhibits potential as a plasma biomarker for infection diagnosis and risk stratification in critically ill patients, but its significance in nosocomial infection and intensive care unit (ICU)-acquired bloodstream infection (BSI) remains unclear. This study explores the temporal responses of PSP in ICU-acquired BSI caused by different pathogens. From a large cohort of ICU patients, we selected episodes of ICU-acquired BSI caused by Gram-negative rods (GNRs), enterococci, or Candida species. Events were matched on length of ICU stay at infection onset, Severe Organ Failure Assessment (SOFA) score, presence of immune deficiency, and use of renal replacement therapy. PSP concentrations were measured at infection onset (T0) and at 24, 48 and 72h prior to infection onset as defined by the first occurrence of a positive blood culture. Absolute and trend differences in PSP levels between pathogen groups were analysed using one-way analysis of variance. Sensitivity analyses were performed in events with a new or worsening systematic inflammatory response based on C-reactive protein, white cell count and fever. We analysed 30 BSI cases per pathogen group. Median (IQR) BSI onset was on day 9 (6-12). Overall, PSP levels were high (381 (237-539) ng/ml), with 18% of values exceeding the assay's measurement range. Across all 90 BSI cases, there was no clear trend over time (median change 34 (- 75-189) ng/ml from T-72 to T0). PSP concentrations at infection onset were 406 (229-497), 350 (223-608), and 480 (327-965) ng/ml, for GNR, enterococci, and Candida species, respectively (p = 0.32). At every time point, absolute PSP levels and trends did not differ significantly between pathogens. PSP values at T0 correlated with SOFA scores. Eighteen (20%) of 90 BSI events did not exhibit a systemic inflammatory response, primarily in Candida species. No clear change in PSP concentration before BSI onset or between-group differences were found in sensitivity analyses of 72 cases. Against a background of overall (very) high plasma PSP levels in critically ill patients, we did not find clear temporal patterns or any pathogen-specific differences in PSP response in the days preceding onset of ICU-acquired BSI.

Cost-effectiveness analysis of alternative screening strategies for the detection of cervical cancer among women in rural areas of Western Kenya.

While the incidence of cervical cancer has dropped in high-income countries due to organized cytology-based screening programs, it remains the leading cause of cancer death among women in Eastern Africa. Therefore, the World Health Organization (WHO) now urges providers to transition from widely prevalent but low-performance visual inspection with acetic acid (VIA) screening to primary human papillomavirus (HPV) DNA testing. Due to high HPV prevalence, effective triage tests are needed to identify those lesions likely to progress and so avoid over-treatment. To identify the optimal cost-effective strategy, we compared the VIA screen-and-treat approach to primary HPV DNA testing with p16/Ki67 dual-stain cytology or VIA as triage. We used a Markov model to calculate the budget impact of each strategy with incremental quality-adjusted life years and incremental cost-effectiveness ratios (ICER) as the main outcome. Deterministic cost-effectiveness analyses show that the screen-and-treat approach is highly cost-effective (ICER 2469 Int$), while screen, triage, and treat with dual staining is the most effective with favorable ICER than triage with VIA (ICER 9943 Int$ compared with 13,177 Int$). One-way sensitivity analyses show that the results are most sensitive to discounting, VIA performance, and test prices. In the probabilistic sensitivity analyses, the triage option using dual stain is the optimal choice above a willingness to pay threshold of 7115 Int$ being cost-effective as per WHO standards. The result of our analysis favors the use of dual staining over VIA as triage in HPV-positive women and portends future opportunities and necessary research to improve the coverage and acceptability of cervical cancer screening programs.

The relationship and pathways between resting-state EEG, physical function, and cognitive function in older adults

ObjectiveBased on resting-state electroencephalography (EEG) evidence, this study aimed to explore the relationship and pathways between EEG-mediated physical function and cognitive function in older adults with cognitive impairment.MethodsA total of 140 older adults with cognitive impairment were recruited, and data on their physical function, cognitive function, and EEG were collected. Pearson correlation analysis, one-way analysis of variance, linear regression analysis, and structural equation modeling analysis were conducted to explore the relationships and pathways among variables.ResultsFP1 theta (effect size = 0.136, 95% CI: 0.025–0.251) and T4 alpha2 (effect size = 0.140, 95% CI: 0.057–0.249) were found to significantly mediate the relationship. The direct effect (effect size = 0.866, 95% CI: 0.574–1.158) and total effect (effect size = 1.142, 95% CI: 0.848–1.435) of SPPB on MoCA were both significant.ConclusionHigher physical function scores in older adults with cognitive impairment were associated with higher cognitive function scores. Left frontal theta and right temporal alpha2, as key observed indicators, may mediate the relationship between physical function and cognitive function. It is suggested to implement personalized exercise interventions based on the specific physical function of older adults, which may delay the occurrence and progression of cognitive impairment in older adults with cognitive impairment.

Impact of Eight Weeks of Supplementation with Vitamins C and E on the Expression of CP Protein and the HSP70 Gene in the Brain Tissue of Rats with Alzheimer’s Disease

Introduction: Impact of antioxidant supplements on the health of patients with Alzheimer’s disease has not yet been clearly defined. Given that no study has been conducted so far to evaluate the effectiveness of vitamins C and E on the expression of Carbonyl Protein (CP) and Heat Shock 70 (HSP70) genes in rats with Alzheimer’s, this study aims to investigate the effect of an eight-week supplementation of vitamins C and E on the expression of CP and HSP70 in the brain tissue of rats with Alzheimer’s disease. Methods: In this experimental study, 28 rats with Alzheimer disease were injected with 10 mg/kg of trimethyltin and divided into four groups: patient control, sham (soluble vitamin E), Vitamin C, and Vitamin E (VE). Seven healthy rats were included in the control group to investigate the effects of disease induction on the variables under study. They were administered a daily supplement of 4 mg/kg of vitamin C and 30 mg/kg of vitamin E for eight weeks. After supplementation period, the groups were compared in terms of CP values and HSP70 gene expression. Data were analyzed by SPSS16 statistical software. Shapiro-Wilk test was used to check normality of the finding distributions. Effect of vitamin E and vitamin C supplementation was evaluated using one-way analysis of variance. Tukey's post hoc test was used to check the type of variable effects. A significant level of 0.05 was considered for all analyses. Results: Levels of carbonyl protein in both the vitamin C and vitamin E groups were significantly lower than those in the patient control group (P &lt; 0.05). HSP70 levels in the vitamin C and E groups were significantly higher than those in the patient control group (P &lt; 0.05). No significant difference was observed between vitamin C and E supplement groups (P &gt; 0.05). Conclusion: Findings of this study suggest that both vitamin C and E exhibit similar antioxidant and cellular protective effects in the brain tissue of mice with Alzheimer’s disease. Given the impact of vitamins C and E on reducing carbonyl protein levels and increasing HSP70 levels in the hippocampal tissue of rats, it is recommended to explore the effects of these vitamins on other neurodegenerative disorders in future studies.

Incidence of blood transfusion and associated risk factors during hip arthroplasty hospitalization

To investigate the incidence and risk factors of blood transfusion during hospitalization in patients receiving hip arthroplasty. Clinical data of 347 hip arthroplasty patients admitted between January and January 2019 and December 2021. Patients were divided into 184 patients in the transfusion group and 164 patients in the nontransfusion group according to whether they received blood transfusion during hospitalization. The basic medical history data, biochemical results and surgical conditions of the patients in two groups were collected and compared. They were divided into total hip arthroplasty (THA) and hemiarthroplasty (HA) according to the different surgical methods. One-way analysis and Spearman correlation were used to analyze the factors associated with blood transfusion in hip arthroplasty patients. Multi-factor logistic regression analysis was performed for statistically significant(P<0.05) indicators, thus screening for independent risk factors for blood transfusion during hospitalization in hip arthroplasty patients. The receiver operating characteristic(ROC)curves for intraoperative bleeding in all hip arthroplasty patients, total hip arthroplasty patients, and hemi arthroplasty patients were plotted and compared, and area under curve(AUC) and the optimal threshold were calculated. A total of 347 patients were included for hip arthroplasty, including 207 total hip arthroplasty and 140 hemi arthroplasty. The transfusion rates of all hip arthroplasty patients, total hip arthroplasty patients and hemi arthroplasty patients were 53.03%(184/347), 53.14%(110/207) and 52.86%(74/140), respectively. Multifactorial logistic regression analysis showed that preoperative cystatin C (OR=2.739, P=0.001), hemoglobin at admission (OR=0.960, P<0.000 1), intraoperative bleeding (OR=1.010, P<0.000 1), postoperative pneumonia (OR=1.897, P=0.024), and right hip arthroplasty (OR=2.277, P=0.002) were independent risk factors for all hip arthroplasty patients;hemoglobin at admission (OR=0.978, P=0.016), intraoperative bleeding (OR=1.012, P<0.000 1), and postoperative pneumonia (OR=2.769, P=0.013) were independent risk factors for total hip arthroplasty;hemoglobin at admission (OR=0.930, P<0.000 1), intraoperative bleeding (OR=1.010, P<0.000 1), preoperative cystatin C (OR=2.277, P=0.023), and right hip arthroplasty (OR=2.428, P=0.046) were independent risk factors for hemi arthroplasty. Hemoglobin on admission and intraoperative bleeding were common risk factors for total and hemi arthroplasty. The AUCs were 0.688, 0.778, and 0.652 for total hip arthroplasty patients, total hip arthroplasty patients, and hemi arthroplasty patients, respectively. Intraoperative bleeding volume and preoperative hemoglobin are important risk factors for transfusion during hip arthroplasty hospitalization, and cystatin C may be a new biomarker for transfusion during hip arthroplasty hospitalization. At the same time, given the high incidence and potential risk of blood transfusion in hip arthroplasty, interventions should be made during hospitalization for identified risk factors.

Pumilio RNA binding family member 1 deficiency activates anti-tumor immunity in hepatocellular carcinoma via restraining M2 macrophage polarization

ABSTRACT Pumilio RNA-binding family member 1 (PUM1) has been implicated in both the progression of colorectal cancer and the regulation of inflammation. The role of PUM1 in the polarization of tumor-associated macrophages (TAMs) into the M2 phenotype has not yet been reported in hepatocellular carcinoma. Using the PUM1-knockout mice model, flow cytometry, and IHC, we validated the role of PUM1 in hepatocellular carcinoma (HCC) TAMs. One-way analysis of variance (ANOVA) or student’s t-tests was used to compare the experimental groups. We found that PUM1 inhibited anti-tumor immunity in HCC through TAM-mediated inhibition of CD8+ T cells. We also showed that PUM1 promotes the transformation of TAMs into pro-tumorigenic M2-like phenotypes by activating cAMP signaling pathway. This study emphasized the potential of PUM1 as a target for immunotherapy in HCC through TAMs. The present study revealed the molecular mechanism underlying the pro-tumor role of PUM1 in HCC.

A New Approach to Postoperative Rehabilitation Following Mosaicplasty and Bone Marrow Aspiration Concentrate (BMAC) Augmentation

Background: Chondral defects in the knee present a significant challenge due to their limited self-healing capacity, often leading to joint degeneration and functional disability. Current treatments, including surgical approaches like mosaicplasty and regenerative therapies such as bone marrow aspirate concentrate (BMAC) augmentation, aim to address these defects and improve patient outcomes. Materials and Methods: This study conducted a single-center, randomized controlled trial to evaluate the efficacy of different treatment approaches and rehabilitation protocols for chondral defects. Thirty-seven subjects presenting with symptomatic chondral or osteochondral defects (&gt;3 cm2) in the weight-bearing region of the femoral condyle were partitioned into three groups, and underwent mosaicplasty with or without BMAC augmentation, followed by either a 6-week or 12-week rehabilitation program. Group 1 (n = 10) received mosaicplasty combined with BMAC augmentation and engaged in a twelve-week two-phase rehabilitation protocol. Group 2 (n = 15) underwent mosaicplasty alone and participated in the same twelve-week two-phase rehabilitation regimen. Meanwhile, Group 3 (n = 12) underwent mosaicplasty and underwent a shorter six-week one-phase rehabilitation program. Clinical assessments were performed using the visual analog scale (VAS) for pain, goniometry for the knee’s range of motion (ROM), manual muscle testing (MMT) for quadricep strength, and the Western Ontario and McMaster University Arthritis Index (WOMAC) for functional evaluation in three test phases. Results: Significant differences in WOMAC scale scores were observed between the three groups at the intermediate (F(2, 34) = 5.24, p &lt; 0.010) and final (F(2, 34) = 111, p &lt; 0.000) stages, with post hoc Tukey tests revealing variations shared among all three groups. The between-group analysis of the VAS scale demonstrated no statistically significant difference initially (F(2, 34) = 0.18, p &lt; 0.982), but significant differences emerged following the intermediate (F(2, 34) = 11.40, p &lt; 0.000) and final assessments (F(2, 34) = 59.87, p &lt; 0.000), with post hoc Tukey tests revealing specific group variations, notably between Group 1 and both Group 2 and Group 3, and also between Group 3 and Group 2. The between-group analysis of quadricep muscle strength using MMT scores revealed no statistically significant differences initially (F(2, 34) = 0.376, p &lt; 0.689) or following the intermediate assessment (F(2, 34) = 2.090, p &lt; 0.139). The one-way ANOVA analysis showed no significant difference in the knee ROM initially (F(2, 34) = 1.037, p &lt; 0.366), but significant differences emerged following intermediate (F(2, 34) = 9.38, p &lt; 0.001) and final assessments (F(2, 34) = 11.60, p &lt; 0.000). Post hoc Tukey tests revealed significant differences between Groups 1 and 2, Groups 1 and 3, and Groups 2 and 3 at intermediate and final assessments. Conclusions: The patients who received BMAC augmentation and completed a 12-week rehabilitation protocol had significantly better outcomes in pain relief, knee function, and ROM when compared to those who did not receive BMAC augmentation or those who completed a shorter rehabilitation period. Our findings suggest that combining mosaicplasty with BMAC augmentation and a comprehensive rehabilitation program can lead to superior clinical outcomes for patients with chondral defects in the knee.

Cost-effectiveness of treating relapsed or refractory 3L+ follicular lymphoma with axicabtagene ciloleucel vs mosunetuzumab in the United States

IntroductionNovel therapies for 3L+ relapsed/refractory (r/r) follicular lymphoma (FL) have been approved recently by the US Food and Drug Administration including anti-CD19 CAR-T therapies such as axicabtagene ciloleucel (axi-cel) and CD20 × CD3 T-cell-engaging bispecific monoclonal antibodies such as mosunetuzumab (mosun). The objective of this study was to assess the cost-effectiveness of axi-cel compared to mosun in 3L+ r/r FL patients from a US third-party payer perspective.MethodsA three-state (progression-free, progressed disease, and death) partitioned-survival model was used to compare two treatments over a lifetime horizon in a hypothetical cohort of US adults (age ≥18) receiving 3L+ treatment for r/r FL. ZUMA-5 and GO29781 trial data were used to inform progression-free survival (PFS) and overall survival (OS). Mosun survival was modeled via hazard ratios (HRs) applied to axi-cel survival curves. The PFS HR value was estimated via a matching-adjusted indirect comparison (MAIC) based on mosun pseudo-individual patient data and adjusted axi-cel data to account for trial populations differences. One-way sensitivity analysis (OWSA) and probabilistic sensitivity analyses (PSA) were conducted. Scenario analyses included: 1) the mosun HRs were applied to the weighted (adjusted) ZUMA-5 24-month data to most exactly reflect the MAIC, 2) mosun HR values were applied to axi-cel 48-month follow-up data, and 3) recent axi-cel health state utility values in diffuse large B-cell lymphoma patients.ResultsThe analysis estimated increases of 1.82 LY and 1.89 QALY for axi-cel compared to mosun. PFS for axi-cel patients was 6.42 LY vs. 1.60 LY for mosun. Increase of $257,113 in the progression-free state was driven by one-time axi-cel treatment costs. Total incremental costs for axi-cel were $204,377, resulting in an ICER of $108,307/QALY gained. The OWSA led to ICERs ranging from $240,255 to $75,624, with all but two parameters falling below $150,000/QALY. In the PSA, axi-cel had an 64% probability of being cost-effective across 5,000 iterations using a $150,000 willingness-to-pay threshold. Scenarios one and two resulted in ICERs of $105,353 and $102,695, respectively.DiscussionThis study finds that axi-cel is cost-effective compared to mosun at the commonly cited $150,000/QALY US willingness-to-pay threshold, with robust results across a range of sensitivity analyses accounting for parameter uncertainty.

Comparative evaluation of the efficacy of Triphala mouthwash and Curcumin mouthwash in the treatment of gingivitis – A randomized controlled study

BackgroundNumerous studies on Triphala and Curcumin mouthwashes were analyzed individually and no study has compared the efficacy of Triphala mouthwash to Curcumin mouthwash in the management of gingivitis. Although various mouthwashes have shown reduction of plaque and gingivitis the search is still on for an ideal mouthwash with minimum side effects and better patient acceptance. ObjectivesTo access the efficacy of all the mouthwashes in the management of gingivitis. MethodsBy purposive sampling, 81 patients of both sexes with gingivitis were randomized by lottery method into 3 groups - A, B and C. Group A received scaling and Triphala mouthwash, Group B received scaling and Curcumin mouthwash and Group C underwent scaling and received Chlorhexidine mouthwash. Oral hygiene was assessed using Plaque, Gingival and Bleeding indices at baseline,7th day and 14th day. The inter-group comparisons were analysed using One-way analysis of variance (ANOVA) and multiple comparisons using Tukey's Honest significant difference test (α = 0.05) and the intra-group comparisons for the indices across various time periods within each group were analysed using Repeated-measures ANOVA and Bonferroni-adjusted pairwise comparisons post hoc test (α = 0.05). The statistical significance was set at p ≤ 0.05. ResultsThe study has shown that herbal mouthwashes are as effective as chlorhexidine in treating gingivitis although curcumin mouthwash showed a greater potential in reducing gingival inflammation. ConclusionBoth Triphala and Curcumin mouthwashes were proven to be equally effective in reducing plaque, gingival and bleeding scores, although curcumin was better in reducing gingival inflammation. Hence herbal mouthwashes such as Triphala and Curcumin with no side effects can be considered as an alternative mouthwash to chlorhexidine.

Formulation of Vegetable Noodles

This research study aimed to test the sensory acceptability of the Formulation of Vegetable Noodles. It made use of four treatments including the control treatment. Specifically, it identified the microbial load of selected vegetable noodles and determined the level of sensory acceptability as to texture, appearance, color, aroma. It also determined difference between the treatments of the vegetable noodles, the proximate/ nutrient content of the best formulation, and the shelf life of the vegetable noodles. It also calculated the return of investment of the product. The experimental method of research was used in this study. Purposive sampling was employed in the selection of 5 Panciteria restaurants in Bangued, Abra, 15 culinary students, and 10 TLE professionals. Data gathered were analyzed using mean, one-way analysis of variance and the Scheffe test. The microbial analysis, proximate analysis and shelf-life analysis were conducted in a laboratory. The findings revealed that the absence of pathogens in the microbial load analysis of Vegetable noodles signifies a commendable standard of food safety and quality assurance. The Vegetable noodles meet consumer’s expectations, making them a favorable choice in the market. The inclusion of 100 g of vegetable powder in the preparation of Vegetable noodles has resulted in a remarkably high level of acceptability and improves sensory appeal among consumers.