Pretreatment Phase Research Articles

Trauma-informed behavioral supports (TIBS) for inpatient treatment of individuals who experience BPD

Trauma-Informed Behavioral Supports (TIBS) is a novel treatment approach targeting aggression against self or against others in individuals who experience borderline personality disorder (BPD). It is based on applied behavior analysis and uses a person-centered and trauma-informed framework. People with BPD hospitalized because of concerning behaviors, [aggression to others, verbal aggression (e.g., defined as aggression in the forms of verbal threats, etc.), physical aggression, and self-injury, etc.] may experience exacerbations of such behavior in the hospital. Individuals diagnosed with BPD were treated with TIBS to diminish the frequency of concerning behaviors in the context of a pilot study. Functioning during a three-month pre-treatment phase was compared with a six-month treatment phase. The TIBS intervention resulted in statistically significant and clinically meaningful decreases in physical and verbal aggression. The results of this pilot investigation approach suggests that TIBS can promote behavior change in the inpatient setting.

Home-based exercise interventions' impact on breast cancer survivors' functional performance: a systematic review.

Home-based exercise (HBE) programs can be a feasible strategy to enhance functional performance and promote physical activity (PA) in breast cancer survivors. A deeper analysis of the effects of HBE interventions, structured by HBE program type and treatment phase, is needed. This systematic review aimed to synthesize the evidence on HBE interventions' impact on breast cancer survivors' functional performance, PA levels, and program adherence rates, according to HBE intervention type and treatment phase. A comprehensive search of peer-reviewed articles reporting HBE interventions' effects on the outcomes of interest was performed in Pubmed, Google Scholar, EBSCO, Web of Science, Science Direct, and B-ON until January 15th, 2024. Data were synthesized according to Denton's domains to classify HBE interventions (prescription: structured vs. unstructured; Delivery method: supervised vs. facilitated vs. unsupervised) and treatment phase. Methodological quality appraisal was performed using the Effective Public Health Practice Project tool. Twenty-six studies were included. Most studies conducted structured/facilitated interventions and reported positive effects on functional performance (particularly aerobic capacity), increases in PA levels, and high adherence rates (> 70%) during and post-treatment. HBE interventions may be feasible to improve functional performance and promote physical activity among breast cancer survivors. Further studies are needed to confirm which HBE intervention type is more appropriate for each treatment phase. More evidence applying HBE interventions with different designs is required to allow the drawing of more solid conclusions. Studies exploring the effects of HBE interventions on the pre-treatment phase are needed.

Ankilozan Spondilit Hastalarında Hastalık Aktivitesi ve Anti-Tümör Nekroz Faktörü Alfa Ajanlar ile Tedavi Yanıtını Değerlendirmede Hematolojik Endekslerin Klinik Yararlılığı

Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease which influences the proportion of immune cells. Tumor necrosis factor alpha (TNF-α) is essential in the pathogenesis of AS, and TNF inhibitors are the most effective treatment for AS patients. In recent years, routine blood parameters were reported as markers of systemic inflammation associated with the diagnosis and prognosis of numerous malignancies and chronic inflammatory diseases. This study aimed to investigate the relationship between haematological parameters and clinical parameters, disease severity and treatment response in AS patients treated with TNF inhibitors. Methods: A total of 326 participants were recruited from the rheumatology department in this study. Participants were divided into healthy controls (n = 178) and AS (n = 148). Neutrophil, lymphocyte, monocyte and platelet counts, neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), platelet crit (PCT), mean platelet volume (MPV), red cell distribution width (RDW), systemic inflammatory index (SII), systemic inflammatory response index (SIRI), cluster systemic inflammation index (AISI) and RPR levels were analyzed for each participant. They were compared between healthy control, AS patients during the pre-treatment phase and three months after the treatment. Results: RDW, PLR, NLR, MLR, SIRI, AISI and SII were higher than healthy controls and decreased with treatment except SIRI. The decrease in AISI and SII after treatment was significant in HLA-B27 positive patients. MPV was lower than healthy controls and increased with treatment. SII, SIRI and AISI were significantly higher in the active AS patients than in the inactive patient. Also, they were correlated with erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Conclusion: SII, AISI, and SIRI may be valuable markers for demonstrating disease activation and evaluating the effectiveness of anti‐TNF‐α therapy.

Biomass conversion and radiocaesium (Rad-Cs) leaching behaviors of radioactive grass in anaerobic wet fermentation systems: Effects of pre-treatments

Persistent concerns regarding environmental hazards arise from the difficulty in disposing of radioactive plant-based wastes originating from the nuclear accident at the Fukushima Daiichi Nuclear Power Plant (FNPP) in Japan in 2011. In this study, three anaerobic digestion (AD) strategies were proposed: Sole anaerobic wet fermentation, and wet fermentations with either alkaline-heat or ultrasonic pre-treatment, which were employed for long-term anaerobic treatment of a genuine radioactive grass stemming from the FNPP accident. The objectives of this work are to investigate the effects of pre-treatments on biomass conversion efficiency and to gain insight into the leaching behavior of radiocaesium (Rad-Cs) within AD processes. Experimental results indicate that by introducing alkaline-heat and ultrasonic pre-treatments to AD systems, the removal efficiencies of total solids (TS) from the raw grass increased by 60.8 % and 42.5 %, respectively, compared to sole wet fermentation. Pre-treatments have been shown to enhance the stability of AD systems, both in terms of enhancing methane production and mitigating pH fluctuations triggered by the accumulation of organic acids. Remarkably, even though the Rad-Cs leaching rate was highest when the AD system was fed with the alkaline-heat pre-treated grass, it remained unsatisfactory at only 5.77 %. We inadvertently isolated a soil-like component from the raw grass, and analyzed both its proportion in the raw grass and the radioactivity intensity. The results indicate that although the soil constituted only 9.51 % TS of the raw grass, it accounted for a significant 81.35 % of the total radioactivity. The soil, which has a pronounced affinity for ionic Cs, being mixed into the raw grass, was identified as the primary factor limiting the leaching efficiency of Rad-Cs throughout both the pre-treatment and wet fermentation phases.

Dual-Stage ultrasound in deep frying of potato chips; effects on the oil absorption and the quality of fried chips

Potato chips are popular high-consuming ready-to-eat meals in all of the world which specially attract a lot of attention from youth and children. Reducing oil absorption and improving the quality of chips are major undertakings within the industry. This research aimed to find the best ultrasonic bath-based method by investigating the optimal ultrasonic pre-treatment and developing an ultrasound (US) assisted frying system (UAFS) to reduce the oil absorption of potato chips while maintaining an acceptable quality. Through this technique, the potato chips get sonicated during deep frying in hot oil. US-pretreatment at temperatures of 25 °C and 73 °C, along with US-assisted frying, resulted in the minimal amount of oil which may be due to the US creating potential pores during the pre-treatment phase, which then expand further during the subsequent sonication stage. UAFS in combination with US-pretreatment produced more crispy chips due to the fact that the texture of potato slices becomes more porous. UAFS resulted in a decrease in the moisture content of the fried chips attributed to an increase in the effective diffusion coefficient and mass. Pretreating the chips at 73 °C significantly reduce the color change producing brighter product by inactivation of enzymes such as polyphenol oxidase. Finally, the result of TOPSIS optimization based on potato chips properties confirms that US-pretreatment in 73 °C brine followed by frying using UAFS is the best approach. Scanning electron microscope (SEM) images of potato chips also support this issue.

Clinical Application of Intestinal Ultrasound in Inflammatory Bowel Disease.

Intestinal ultrasound (IUS) is a non-invasive, accurate, and well-tolerated tool that provides real-time assessment of inflammatory bowel disease (IBD) activity and is therefore an ideal monitoring tool. This review describes the evolving role of IUS in each phase of clinical management of IBD. Accumulating evidence has demonstrated that IUS is an excellent tool for the assessment of suspected IBD, with a very high negative predictive value. It accurately assesses disease activity, disease complications, and in the pre-treatment phase, provides a benchmark for subsequent follow-up. IUS can detect early therapeutic response and correlates well with other established monitoring modalities with arguably superior predictive capabilities and ability to assess a deeper degree of remission, transmural healing (TH). IUS has a crucial role in the management of IBD and has ushered in a new era of monitoring with more rapid evaluation and the opportunity for early optimization, deeper therapeutic targets, and improved outcomes.

Thermo-mechanical coupling simulation analysis of cryotherapy on real anatomical structure lung cancer model

Cryotherapy is an ideally invasive way for lung cancer. Conventional cryoablation treatment lacks precise treatment plans and evaluation methods, relying on medical images for assistance. Furthermore, the current simulations primarily employ simplistic geometric models, lacking the complexity of real structures. Consequently, our research endeavors to introduce a reconstructed 3D model based on actual lung tumor tissue and employ the thermo-mechanical coupling analysis to strategize the entire surgical procedure. Additionally, we explore the optimization of probe number and angle during the pre-treatment phase. In order to enhance the heat transfer and efficacy of killing, the inclusion of nanoparticles was implemented. The assessment of effective injury was based on the criteria of thermal and stress damage, which were visualized through the cloud images depicting temperature and stress distribution. Further, a genuine clinical case was reconstructed and refined through our simulation. It is expected to establish a comprehensive database of cases and develop an optimized surgical planning system for cryotherapy.

Analysis of Errors Following SCVTr Treatment: An Indicator for Improved Lexical Retrieval Abilities in Persons with Aphasia

Purpose: Error analysis technique aids in understanding the psycholinguistic mechanisms associated with word retrieval. In addition to the linguistic test scores, if authors document the change in errors following treatment it may give better insight into the prognosis of PWAs. Despite the significance of error analysis, most of the study results elucidate the improvement merely in assessing the accuracy of naming skills. Thus, the present study was designed to assess the error patterns following treatment.Methods: A total of 11 PWAs (fluent and non-fluent aphasia) were enrolled for the study, these participant’s average age was 38.72 years (Range=24-64, SD=11.97). SCVTr treatment was rendered; in this treatment, PWAs were presented with 10 targeted verbs with a range of minimal (broad cues) and maximal cues (narrower cues) based on the success of the retrieval minimal to maximal cues were presented. The verbatim of trained and untrained stimuli (probes) of pre-treatment phase, post-treatment phase, and follow-up phase were subjected to error analysis using Edmonds and Babb (2011) protocol.Conclusions: The error patterns of individual participants across pre and post-treatment phases showed alleviated scores in the post-treatment phase among all the participants. Furthermore, all the participants exhibited almost identical error score patterns in the follow-up phase as in the post-treatment phase. The error analysis technique is the most powerful tool to track the changes at the psycholinguistic level.

Targeting Gut Microbiome With Prebiotic in Patients With CKD: The TarGut-CKD Study

IntroductionDisruption of gut microbiota underpins some of the metabolic alterations observed in chronic kidney disease (CKD). MethodsIn a non-randomized, open-label, 3-phase pilot trial, with repeated measures within each phase, we examined the efficacy of oligofructose-enriched inulin (p-inulin) in changing the gut microbiome and their metabolic products in 15 CKD patients. The stability of microbiome and metabolome was studied during the pre-treatment phase (8 weeks), a p-inulin treatment phase (12 weeks), and a post-treatment phase (8 weeks) of the study. ResultsStudy participants completed 373 of the 420 expected study visits (88.8%). Adherence to p-inulin was 83.4%. 16S rRNA sequencing was performed in 368 stool samples. A total of 1085 stool, urine, and plasma samples were subjected to untargeted metabolomic studies. P-inulin administration altered the composition of the gut microbiota significantly, with an increase in abundance of Bifidobacterium and Anaerostipes. Inter-subject variations in microbiome and metabolome were larger than intra-subject variation, indicating the stability of the gut microbiome within each phase of the study. Overall metabolite compositions assessed by beta diversity in urine and stool metabolic profiles were significantly different across study phases. Several specific metabolites in stool, urine and plasma were significant at FDR ≤ 0.1 over phase. Specifically, there was significant enrichment in microbial metabolites derived from saccharolysis. ConclusionResults from our study highlight the stability of the gut microbiome and the expansive effect of p-inulin on microbiome and host co-metabolism in CKD patients. Findings from this study will enable rigorous design of microbiome-based intervention trials.

Transitioning insomnia patients from zolpidem to lemborexant: A multicenter, open-label study evaluating a next-dose transition approach to insomnia pharmacotherapy

ObjectiveFew clinical studies have assessed real-world abrupt transitioning between insomnia medications. This study assessed strategies for directly transitioning patients from zolpidem tartrate (ZOL) immediate/extended release to the dual orexin receptor antagonist, lemborexant (LEM). MethodsThis randomized, open-label, multicenter study (Study 312; E2006-A001-312) enrolled 53 adults age ≥18 years with insomnia disorder and ≥1-month history of intermittent (3–4 nights/week) or frequent (≥5 nights/week) ZOL use. Subjects recorded their ZOL use in a 3-week Pretreatment Phase, followed by a 2-week Treatment Phase (TRT; Titration) during which ZOL was discontinued. Intermittent ZOL users transitioned to LEM 5 mg (LEM5), Cohort 1, and frequent ZOL users were randomized 1:1 to LEM5, Cohort 2A, or LEM 10 mg (LEM10), Cohort 2B. One dose adjustment was permitted during the TRT. Subjects completing the TRT could continue LEM in the 12-week Extension Phase (EXT). The primary outcome was proportion of subjects who successfully transitioned and remained on LEM at the end of the TRT. ResultsMost subjects (43 [81.1 %]) successfully transitioned to LEM (9 [90 %], 17 [81.0 %], and 17 [77.3 %] in Cohorts 1, 2A, and 2B, respectively). By the end of the EXT, 66.7 % in Cohort 1 and 60.0 % in Cohort 2A up-titrated to LEM10, whereas 41.2 % in Cohort 2B down-titrated to LEM5; 61.0 % were receiving LEM10 at study end. At the end of the TRT, more subjects taking LEM reported that it helped them return to sleep after waking, compared with those taking ZOL (71.7 % vs. 49.1 %). There were no important differences between treatments regarding how subjects reported feeling as they fell asleep. Most of the treatment-emergent adverse events with LEM were mild in severity. ConclusionsMost subjects transitioned successfully to LEM from ZOL (intermittent or frequent use). LEM was well tolerated.

Impact of In-Feed versus In-Water Chlortetracycline and Tiamulin Administrations on Fecal Prevalence and Antimicrobial Susceptibilities of Campylobacter in a Population of Nursery Pigs.

Antimicrobial resistance (AMR) in bacteria is a major public health concern in the US and around the world. Campylobacter is an important foodborne pathogen that resides in the gut of pigs and is shed in feces, with the potential to be transmitted to humans. In pigs, the oral route, either in-feed or in-water, is by far the most common route of administration of antimicrobials. Because the distribution of the antibiotic in the gut and the dosages are different, the impact of in-feed vs. in-water administration of antibiotics on the development of AMR is likely to be different. Therefore, a study was conducted to compare in-feed vs. in-water administrations of chlortetracycline (CTC) and/or tiamulin on fecal prevalence and AMR profiles of Campylobacter among weaned nursery piglets. A total of 1,296 weaned piglets, allocated into 48 pens (27 piglets per pen), were assigned randomly to six treatment groups: Control (no antibiotic), in-feed CTC, in-water CTC, in-feed tiamulin, in-water tiamulin, or in-feed CTC and tiamulin. Fecal samples were collected randomly from 5 piglets from each pen during the pre-treatment (days 0, 7), treatment (days 14, 21), and post-treatment (days 28, 35) phases. Bacterial isolations and species identifications were conducted by culture and PCR, respectively. The microbroth dilution method with SensititreTM plates was used to determine the antimicrobial susceptibility and resistance of Campylobacter isolates. The results on resistance were interpreted based on the European Committee on Antimicrobial Susceptibility Testing (EUCAST) epidemiological cutoff values for Campylobacter. The overall prevalence of Campylobacter was 18.2% (262/1440). Speciation of Campylobacter isolates by PCR indicated the prevalence of only two species: Campylobacter hyointestinalis (17.9%; 258/1440) and C. coli (0.3%; 4/1440). Campylobacter isolates were resistant to tetracycline (98.5%), ciprofloxacin (89.3%), and nalidixic acid (60.3%). Neither the antibiotic nor the route of administration had an effect (p > 0.05) on the prevalence of AMR Campylobacter in the feces of piglets.

Naringenin, a Functional Food Component, Improves Motor and Non-Motor Symptoms in Animal Model of Parkinsonism Induced by Rotenone.

Parkinson's disease (PD) and other age-related neurodegenerative ailments have a strong link to oxidative stress. Bioflavonoid naringenin has antioxidant properties. The effects of pre- and post-naringenin supplementation on a rotenone-induced PD model were examined in this work. Naringenin (50mg/kg, p.o.) was administered to rats for two weeks before the administration of rotenone in the pre-treatment phase. In contrast, rotenone (1.5mg/kg, s.c.) was administered for eight days before naringenin (50mg/kg, p.o.) was supplemented for two weeks in the post-treatment phase. During behavioral investigation, the motor and non-motor signs of PD were observed. Additionally, estimation of neurochemical and biochemical parameters was also carried out. Compared to controls, rotenone treatment substantially increased oxidative stress, altered neurotransmitters, and caused motor and non-motor impairments. Rotenone-induced motor and non-motor impairments were considerably reduced by naringenin supplementation. The supplementation also increased antioxidant enzyme activities and restored the changes in neurotransmitter levels. The findings of this work strongly imply that daily consumption of flavonoids such as naringenin may have a therapeutic potential to combat PD.

Prognostic significance of serum testosterone level in patients with castration-resistant prostate cancer treated with cabazitaxel.

Serum testosterone level is a potential prognostic marker for castration-resistant prostate cancer. However, its role as a prognostic marker in cabazitaxel chemotherapy remains unclear. This study aimed to elucidate the clinical significance of serum testosterone levels before cabazitaxel chemotherapy. This single-institution, retrospective study included 47 patients with metastatic castration-resistant prostate cancer (mCRPC) who received cabazitaxel therapy. Serum testosterone levels were measured before the initiation of cabazitaxel therapy. Progression-free survival and overall survival (OS) were not significantly different between patients with high and low serum testosterone levels. Analysis of patients aged <70 years revealed that those with high serum testosterone levels (total testosterone level > 0.055 ng/mL) had significantly longer OS than those with low serum testosterone levels (total testosterone level < 0.055 ng/mL, p = 0.012). Multivariate analysis revealed that low serum testosterone levels (hazard ratio [HR] = 11.874, 95% confidence interval [CI] 2.076-67.953, p = 0.005) and high prostate-specific antigen levels (HR = 18.051, 95% CI 2.462-132.347, p = 0.004) in the pretreatment phase were independent prognostic factors for OS in patients receiving cabazitaxel therapy. Serum testosterone level may be a prognostic marker for cabazitaxel therapy in patients with mCRPC who are younger than 70 years, and high serum testosterone levels may lead to longer survival.

Environmental and Technological Assessment of Operations for Extraction and Concentration of Metals in Electronic Waste

The exponential growth in the consumption of electronics, in combination with the reduction in their useful life, has led to a significant increase in the volume of electronic materials which are discarded. Printed Circuit Boards (PCBs) are modules composed of ceramic, polymer, and metallic materials of high economic value and with a great potential for damage to biotic and anthropic environments when inadequately discarded. The aims of this work were to study the main environmental impacts and the efficiency of mechanical operations in the electronic waste recycling process in optimizing the concentration of metallic copper. For this, the samples obtained were characterized according to their morphology and chemical composition, and subjected to physical and mechanical treatments: dismantling, grinding, separation by granulometry, density, and magnetic property. The environment impacts were estimated by the Life Cycle Assessment of the pre-treatment processes, associated with copper extraction operations in Waste Printed Circuit Boards (WPCBs). According to the results obtained, it is possible to infer that the NM + 1 mm Concentrated product presents in its metallic composition around 78% copper, which contributes to the efficiency of the hydrometallurgical extraction processes. It is noteworthy that the Concentrated class represents about 14% of copper (wt) taking into account the amount of 3.789 kg of PCB waste input material. The potential for reinsertion of the dust in the material recovery process is highlighted, given that the chemical composition of this particulate has a significant presence of metals. In general, it was found that due to the higher concentration (wt%) of the sample being allocated in the range of −0.15 mm + 0.05 mm, the elements Fe (18.30%), Si (10.73%), Ca (9.21%), and Cu (8.89%) stand out regarding the participation of the elemental composition of this fraction and also regarding the general composition of the sample. Furthermore, the generation of dust during the fragmentation process can be associated with occupational respiratory diseases when not managed. About the Life Cycle Assessment, in seven of the nine categories evaluated, crushing and screening activities accounted for more than 90% of the recorded impact values. In general, it is estimated that in the pre-treatment phase it generated 15.4 kg CO2 eq.

Biotransformation of Lignocellulosic Biomass Hydrolysate into Polyhydroxybutyrate Biopolymer via Ralstonia Eutropha

Currently, a rampant cultural shift is occurring in the modern world to progressively substitute fossil-derived plastics and shift to novel biomaterials that are benign to the environment owing to increased awareness of environmental sustainability along with the implementation of strict regulations worldwide. Polyhydroxyalkanoates (PHAs) are promising intracellular biodegradable polymers that have attracted considerable focus owing to their biocompatibility, biodegradability, non-toxicity and environment-friendly nature to function in diverse applications notably in the pharmaceutical, medical, textile, materials, fuel, agricultural industries. Nonetheless, despite its huge market potential, the commercial growth of PHA is achieved on a small extent only, since the cost-effectiveness of this product is highly debatable owing to the high production cost of processing the carbon substrate. The goal behind this research study is to explore the possibility of exploiting low-cost carbon substrates from low-value lignocellulosic materials that would have otherwise been discarded as waste and add stress to the landfill to manufacture biopolymer compounds that are used in everyday lives as well as to enhance the functionality and yields of glucose from PHA substrates that can undergo industrial upscaling. One of the major challenges of transforming lignocellulosic biomass into fermentable sugars is the recalcitrant nature of the fibre which renders it very resistant to the release of sugars for fermentation. Since lignocellulosic biomass has a specific attribute such as an extremely coordinated matrix which renders it very resistant to the release of sugars for fermentation owing to biological degradation, a pre-treatment phase is necessary prior to the hydrolysis stage for the transformation of the fermentable sugars. This study focuses on the biosynthesis of biopolymers from lignocellulosic biomass through sustainable approaches such as enzyme and microbial activities in order to examine its viability as a replacement for traditional polymers. Cupriavidus Necator H16 (Ralstonia Eutropha) having 8×108 CFU/ml viable colonies were cultured at 30 oC and was inoculated in submerged fermentation of M9 minimal salt medium using 1% reducing sugar from Furcraea Foetida as carbon source. Batch fermentation of PHB in submerged cultivation conducted for a residence time from 0 to 48h resulted in a dry cell weight from 0.32±0.05% to 1.62±0.05%. The nitrogen limiting phase was achieved after 48h and 17.05±0.35% of PHB was extracted from 3ml of the fermentation broth. The PHB yield was dramatically lower than reported optimal yields of 37.55 to 97.80% from works of literature. Nonetheless, Fourier-transform infrared spectroscopy (FTIR) spectroscopy revealed characteristics bands for carbonyl, methine and ester groups along with intermolecular hydrogen bonds in the biopolymer. Sudan Black B and FTIR spectrum demonstrate that PHB biosynthesis successfully bioaccumulates inside the cells of Ralstonia Eutropha using cellulose from Lignocellulosic biomass (LCB) as carbon source. Hence, the process needs to be optimized in terms of variables such as inoculum size, inoculum concentration, incubation time and salt medium conditions in order to maximise the production of PHB from Furcraea Foetida in Ralstonia Eutropha cultivation.

Impact of Mandibular Symphyseal Distraction Osteogenesis (MSDO) on the Sagittal Dimension and Long-Term Skeletal stability.

To evaluate the long-term effects of mandibular symphyseal distraction osteogenesis (MSDO) on the correction of class II malocclusion correction and dental crowding. Twenty-two patients received MSDO and presented class II malocclusion with transverse mandibular discrepancy. The authors collected data on 2 different cephalometric analyses. On Tweed analysis, The authors recorded ANB, SNA, SNB, and FMA angles. On Delaire analysis, we recorded the distance from Pti (pterygoid inferior) to ENAt (anterior nasal spine) and the distance from Cos (superior condyle) to Pog (pogonion). Superimpositions studies were performed at pre-treatment phase (T1) and post-treatment phase (T2) to evaluate the new position and changes in the dimensions of the mandible and maxilla. On superimposition of Tweed analysis of T1 and T2, reduction of ANB was seen in 18 patients, no change in ANB in 2 patients, and increase in ANB (by 1 deg) in 2 patients. Superimposition of Delaire analysis showed a mean difference of 0.3mm (SD, 3.6mm) between T1 and T2 for the maxilla and a mean difference of 6.0mm (SD, 7.3mm) for the mandible. Mandibular symphyseal distraction osteogenesis performed after the pubertal growth peak can effectively correct class II malocclusion and dental crowding with a single light surgical procedure.

Quality of life and its correlates in pretreatment patients with locally advanced head and neck cancer: A cross-sectional study in Thailand.

Locally advanced head and neck cancer (LAHNC) can significantly impact the quality of life of patients in various ways. However, several factors can contribute to the decrease in quality of life. In Thailand, there is limited knowledge about the factors that affect the quality of life of patients with LAHNC before they receive treatment. This study aimed to examine the correlations between Palliative Performance Scale (PPS), family income, body mass index (BMI), age, comorbidity index, and the quality of life of patients with LAHNC before they undergo treatment. A correlational cross-sectional study was conducted, and data were collected from 94 pretreatment patients with LAHNC who were admitted to a cancer center in central Thailand using purposive sampling. The data collection instruments included a demographic data form, a medical record form, the Charlson Comorbidity Index (CCI), the Palliative Performance Scale (PPS), and the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) version 4. Descriptive statistics, Pearson's correlation, and Spearman's rank correlation were used to analyze the data. All study participants completed the questionnaire. The results showed that the overall quality of life of the patients was moderate. PPS, family income, and body mass index were moderately positively correlated with quality of life (r = 0.494, p <0.01; r = 0.420, p <0.01; r = 0.339, p <0.01, respectively). Age had a moderate negative correlation with quality of life (r = -0.596, p <0.01), while comorbidity was not significantly associated with quality of life. The quality of life of patients with LAHNC before treatment was associated with various factors, including PPS, family income, body mass index, and age. These findings highlight the importance of nutritional support before treatment and the need for social support, especially for older adult patients, to improve their quality of life. The results of this study can be valuable for nurses in developing care programs that enhance the quality of life for patients with LAHNC during the pretreatment phase.

Empirical evidence for the neurocognitive effect of nitrous oxide as an adjunctive therapy in patients with treatment resistant depression: A randomized controlled study

Nitrous oxide (N2O) has demonstrated an antidepressant effect for treatment-resistant depression (TRD), but no studies investigated the effects of N2O on different cognition domains. This study aimed to test whether N2O would display pro-cognitive effects. We conducted a double-blinded, placebo-controlled, randomized controlled trial, 44 patients with TRD were randomized to N2O group (one-hour inhalation of 50% N2O/50% oxygen) or placebo group (50% air/50% oxygen). Thirty-four patients completed cognitive tests at the pre-treatment phase, 1-week, and 2 weeks post-treatment including subjective cognitive function, processing speed, attention, and executive function. Although the antidepressant effect of N2O was not significant at 1 week, patients still showed better performance of executive function at 1 week after receiving N2O compared with the placebo. Moreover, this significant improvement still existed at 1 week after controlling for the change in depressive symptoms over-time. Additionally, no significant difference was observed in subjective cognitive function, processing speed, and attention between these two groups across the 2-week follow-up period. As the first study investigating the treatment effects of N2O on improving cognitive function in TRD patients, the current study indicated that N2O has a potential pro-cognitive effect on executive function and this effect might be independent from improvements in depressive symptoms.

Comparison of quantitative FDG-PET and MRI in anti-LGI1 autoimmune encephalitis

ObjectivesAnti-leucine glioma-inactivated protein 1 (anti-LGI1) autoimmune encephalitis (AE) presents as subacute memory loss, behavioral changes, and seizures. Diagnosis and treatment delays can result in long term sequelae, including cognitive impairment. 18F-FDG PET/CT may be more sensitive than MRI in patients with AE. Our objective was to determine if anti-LGI1 is associated with a distinct pattern of FDG uptake and whether this pattern persists following treatment.MethodsNineteen18F-FDG PET/CT brain scans (13 pre-treatment, 6 convalescent phase) for 13 patients with anti-LGI1 were studied using NeuroQ™ and CortexID™. The sensitivity of the PET images was compared to MRI. The Z scores of 47 brain regions between the pre-treatment and next available follow-up images during convalescence were compared.ResultsAll 18F-FDG PET/CT scans demonstrated abnormal FDG uptake, while only 6 (42.9%) pre-treatment brain MRIs were abnormal. The pre-treatment scans demonstrated hypermetabolism in the bilateral medial temporal cortices, basal ganglia, brain stem, and cerebellum and hypometabolism in bilateral medial and mid frontal, cingulate, and parietotemporal cortices. Overall, the brain uptake during convalescence showed improvement of the Z scores towards 0 or normalization of previous hypometabolic activity in medial frontal cortex, inferior frontal cortex, Broca’s region, parietotemporal cortex, and posterior cingulate cortex and previous hypermetabolic activity in medial temporal cortices, caudate, midbrain, pons and cerebellum.ConclusionsBrain FDG uptake was more commonly abnormal than MRI in the pre-treatment phase of anti-LGI1, and patterns of dysmetabolism differed in the pre-treatment and convalescent phases. These findings may expedite the diagnosis, treatment, and monitoring of anti-LGI1 patients.

Smetto quando non voglio: lo smart training orientato DBT per i consumatori di cocaina

We report here the experimentation of a group of cocaine users facing two SERDP offi ces in the province of Bologna enlisted by the reference operators on a "smart" Skills training program of 10 meetings.The candidates were 8 male, with a fl uctuating relationship with substances characterized by periods of abstinence and periods of resumption of use often in conjunction with relationship diffi culties or emotional crises.All the candidates were socially integrated with a regular job, 3 of them were married with offspring and all had contacted the Relationship Service with a partner or a family member who was the fi rst to see the urgency of asking for help for the dysfunctional behavior of the relative. 4 out of 8 patients were in individual psychotherapy with the group leader who suspended individual interviews in favor of skills training for the entire duration of the group, the others benefi ted from psycho-social and educational support from a professional educator.All patients underwent the PID 5 test in the diagnostic phase and the pre-treatment phase was treated in terms of opportunity and commitment.After the 10 skills sessions, the patients will be followed up individually by taking the dbt forms and group follow-ups will be organized at 3 and 6 months.The results we report are in terms of frequency (average 66.6%), active participation and evaluation of the experience by problem consumers.