Pretreatment Values Research Articles

Justification of approaches to comprehensive orthopedic treatment of patients with wedge-shaped tooth defects accompanied by dentin hypersensitivity

Background. Given the multifactorial etiology and the variety of manifestations of non-carious dental lesions, which, in addition to the visible loss of hard dental tissues, are accompanied by hypersensitivity, there is a need for a comprehensive approach involving both therapeutic and orthopedic measures. The treatment of patients with non-carious lesions, particularly wedge-shaped defects, includes several approaches: direct and indirect restoration of defects, treatment of hypersensitivity, and occlusion optimization. The choice of orthopedic treatment method is determined by clinical manifestations, particularly the degree of damage and clinical complications. The development and justification for the use of modern indirect restorations are relevant as their technology involves minimal preparation of the enamel and dentin when replacing hard tissue defects of non-carious origin. The aim of the study: to improve approaches to orthopedic treatment of patients with wedge-shaped defects of hard dental tissues accompanied by hypersensitivity. Materials and methods. We observed 34 individuals aged 30 to 44, including 16 men and 18 women, with deep cervical and coronal wedge-shaped tooth defects accompanied by hypersensitivity. The control group consisted of 11 age-matched people with intact dental arches and physiological occlusion who had no clinically diagnosed periodontal diseases or carious and non-carious lesions. The search was conducted using standard methodologies. To objectively assess the degree of hard dental tissue sensitivity at different stages of the study, the tooth hypersensitivity intensity index (THII) was used. To determine the degree of non-carious lesions and the optimal depth of preparation, the dentometry method was used with the multifunctional dental device EndoEst-3D. To restore the anatomical shape of teeth with wedge-shaped defects accompanied by dentin hypersensitivity, vestibular partial crowns and metal-free jacket crowns were applied. Orthopedic treatment was carried out after traditional oral sanitation and comprehensive professional oral hygiene. Results. The results of the dentometric study indicate significant differences in the distance from the prepared surface to the pulp chamber of vital teeth between the groups at the measurement points (p < 0.05). In particular, in individuals from clinical group I, as a result of deep total tooth preparation required by the crown fabrication technique, the thickness of the dentin above the pulp in the points of the incisal edges of canines, incisors, and the buccal cusp of premolars (1.91 ± 0.05 mm) differed significantly from the measurements in clinical group II (p < 0.05), which increases the risk of reactive changes and complications in the pulp. After preparation for the vestibular partial crowns, a significantly greater layer of dentin remains over the pulp at the measurement points compared to jacket crowns, where deep total preparation of the tooth coronal part is required (2.47 ± 0.06 mm versus 1.91 ± 0.05 mm, respectively, p < 0.05). The dentin reaction to deep total preparation is significant, as confirmed by the reliably different values when comparing the THII in the first (2.39 ± 0.03 points) and second clinical groups (1.83 ± 0.04 points) (p < 0.05). Tooth sensitivity in the second clinical group after treatment was 0.27 ± 0.08 points, showing significant differences compared to pre-treatment values and approaching the control group. This indicates a positive outcome of the proposed treatment for patients with non-carious hard tissue lesions (wedge-shaped defects) accompanied by hypersensitivity (p < 0.05). Follow-up examinations at 6 months showed that the THII remained stable and did not significantly differ from that recorded immediately after treatment. Conclusions. A comprehensive analysis of the examination and treatment results in clinical groups I and II allowed to conclude that orthopedic treatment of individuals with deep cervical and crown wedge-shaped defects complicated by hypersensitivity should be conducted by replacing the hard tissue defects with vestibular partial crowns. This method requires significantly less reduction of hard tissues and helps avoid complications in the pulp while providing aesthetic outcomes and eliminating increased tooth sensitivity.

Effectiveness of Instrument-assisted Soft-tissue Mobilization Versus Dry Cupping on Pain and Cervical Range of Motion in Treatment of Neck Pain

Abstract Background: Neck pain is characterized by symptoms of a nonspecific nature of the pain, which is of mechanical origin.[1,2] Frequently observed manifestations of neck discomfort encompass muscle pain, muscle spasms, headaches, facet joint pain, nerve pain, referred pain, and bone pain.[3] Instrument-assisted soft-tissue mobilization (IASTM) stands as a proficient myofascial intervention used for the treatment of soft tissues. Here, using instruments typically crafted from stainless steel featuring beveled edges and anatomically contoured designs to accommodate various body regions, this technique allows for enhanced depth of penetration.[4] Primarily used for the identification and therapeutic management of soft-tissue disorders, the approach involves the application of these specialized instruments.[5] Dry cupping, alternatively recognized as air cupping or suction cupping, constitutes a therapeutic methodology, wherein a vacuum is generated within cups and subsequently applied to targeted regions of the body. These cups, fabricated from diverse materials such as glass, silicone, or plastic, induce suction effects. Through the application of this suction, dry cupping serves to promote circulation, alleviate muscle tension, and facilitate the energetic flow within the treated areas. Material and Methods: The purpose of the study to effectiveness of instrument-assisted soft-tissue mobilization versus dry cupping on pain and cervical range of motion in treatment of neck pain. The study is comparative in nature, and total subjects were 15 subjects in each group. The assessment of pain and range of motion of cervical flexion and lateral flexion were taken before starting the treatment of both the groups. The patients were randomly assigned by lottery method for both the groups, and assessments were taken on 0 day and at the end of 4th week by VAS and ROM by a goniometer. Results: In IASTM treatment, the P value is 0.031. This suggests that there is a statistically significant difference between the pre-treatment and post-treatment values for the IASTM group. But, in dry cupping, the P value is 0.001. This indicates a highly significant difference between the precupping and postcupping values for this treatment group. The scores of variables VAS and ROM were improved significantly better in the subjects treated with dry cupping as compared to the group variables treated with instrument-assisted soft-tissue mobilization. Conclusion: The study conclude that the dry cupping is more beneficial for the treatment of neck pain and range of motion.

Soluble PD-L1 and Serum Vascular Endothelial Growth Factor-B May Independently Predict Prognosis in Patients with Advanced Non-Small Cell Lung Cancer Treated with Pembrolizumab

Background: Previous preclinical data have shown that the dynamic cross-talk between abnormal tumor vasculature and immune cell factors in the tumor microenvironment may exert a critical role in the progression and treatment resistance of non-small cell lung cancer (NSCLC). In the clinical setting, a variety of blood-based angiogenesis- and immune-related factors are being increasingly investigated as potential biomarkers of prognosis or treatment response in immunotherapy-treated NSCLC. We herein aimed to evaluate the clinical relevance of the peripheral blood levels of vascular endothelial growth factor-A and -B (VEGF-A and VEGF-B, respectively), soluble programmed cell death-1 (sPD-1), and programmed cell death-ligand 1 (sPD-L1) in patients with advanced NSCLC treated with immune checkpoint inhibitors (ICIs). Methods: Consecutive patients with advanced-stage, non-oncogene-addicted NSCLC, eligible to receive ICIs at the Oncology Unit of Sotiria Athens General Hospital, were prospectively recruited. A group of sex- and age-matched healthy controls was also enrolled for the evaluation of the potential diagnostic significance of the examined biomarkers. Serum levels of all biomarkers were measured using ELISA, both before and after treatment, and were correlated with standard clinicopathological features of patients, treatment response, progression-free survival (PFS), and overall survival (OS). Results: A total of 55 patients and 16 healthy controls were included in the final analysis. The mean age of patients and controls was 66.5 years (SD = 8.0 years) and 65.4 years (SD = 9.1 years), respectively. The majority of patients (65.5%) received pembrolizumab in combination with chemotherapy, while the remaining patients received pembrolizumab monotherapy. ROC curve analysis showed that VEGFB and sPD-1 were the only markers with a significant diagnostic value. Higher pre-treatment values of sPD-L1 (HR = 1.68; p = 0.040) and sPD-1 (HR = 10.96; p = 0.037) as well as higher post-treatment values of VEGF-B (HR = 2.99; p = 0.049) were all significantly associated with a reduced OS in univariate Cox regression analysis. The adverse prognostic significance of higher pre-treatment values of sPD-L1 (HR = 2.10; p = 0.014) and higher post-treatment values of VEGFB (HR = 3.37; p = 0.032) was further confirmed in multivariate analysis. Conclusions: Our study results suggest that serum levels of sPD-L1 and VEGF-B may independently predict prognosis in ICI-treated advanced-stage NSCLC.

Preliminary application of EPID three-dimensional dose reconstruction in in vivo dose verification of breast cancer intensity-modulated radiation therapy.

A preliminary study was conducted using electronic portal imaging device (EPID) based dose verification in pre-treatment and in vivo dose reconstruction modes for breast cancer intensity-modulated radiation therapy (IMRT) technique with known repositioning set-up errors. For 43 IMRT plans, the set-up errors were determined from 43 sets of EPID images and 258 sets of cone beam computed tomography images. In-house developed Edose software was used to reconstruct the dose distribution using the pre-treatment and on-treatment (in vivo) EPID acquired fluence maps. The maximum setup error was<3.5mm. For 43 pre-treatment cases, the γ pass rate (3%/3 mm) is 98.49% ± 1.15%. The chest wall target ΔV98%P, ΔV95%P, andΔV90%P are all<5%, while the majority of the ipsilateral lung ΔV5Gy, ΔV20Gy, and ΔV30Gy are also<5%. For 258 in vivo cases, the γ pass rate is 90.98% ± 6.53%, with the chest wall target ΔV90%P and ipsilateral lung ΔV30Gy both<5%, while the other volume differences all exceed 5%. The γ pass rate for in vivo verification is significantly lower than pre-treatment values. Although the in vivo γ verification satisfies the medical physics requirements, the reconstructed coverage of the chest wall target is far below the clinical dosimetry requirements. In vivo 3D dose reconstruction directly predicts changes in the planning target volume to aid clinicians better understand the actual dose received by patients with intra-fractional motion and anatomical changes.

Vonoprazan Fumarate: A Promising Therapeutic Option for the Rapid Relief of Laryngopharyngeal Reflux Disease.

The aim is to examine the Reflux Symptom Score-12 (RSS-12) and assess the effectiveness of vonoprazan fumarate in managing laryngopharyngeal reflux disease (LPRD) among the Chinese population. A total of 140 patients with LPRD who were treated at our otorhinolaryngology outpatient clinic were included. The patients were randomly divided into the vonoprazan treatment group and the esomeprazole treatment group. The outcome indicators were the pretreatment and post treatment values of the Reflux Symptom Index (RSI), RSS-12, and reflux finding score. The mean pretreatment RSS-12 and RSI values were 55.79±11.94 and 18.67±3.60 in the vonoprazan treatment group and 54.91±11.95 and 18.44±3.66 in the esomeprazole treatment group, respectively. Furthermore, both groups showed a significant decrease in the RSI and RSS-12 values after 4, 8, and 12weeks of acid suppression therapy. In particular, 12weeks of treatment led to a good treatment response in 91.4% and 87.1% of the patients in the vonoprazan treatment and esomeprazole treatment groups, respectively, based on their RSI values, and a favorable treatment response in 82.9% and 77.1% of those in the vonoprazan treatment and esomeprazole treatment groups, respectively, according to their RSS-12 values. More importantly, after 4 and 8weeks of acid-suppressive therapy, the relative baseline change in RSS-12 scores in the vonoprazan treatment group was considerably larger than that in the omeprazole treatment group. Compared to proton pump inhibitors (PPIs), vonoprazan fumarate has demonstrated superior early therapeutic efficacy, resulting in a notable improvement in laryngopharyngeal reflux symptoms at the start of treatment. When we extended acid-suppressive medication for 12weeks, we saw a treatment effect comparable to that ofPPIs.

The effects of leaching and pyrolysis on particle synthesis and their impact on thermal conductivity and cooling rates of waste PCB-dispersed quenchants

Abstract This study investigates the effects of pre-treatment processes—leaching and pyrolysis—on synthesizing particle-dispersed quenchants derived from waste printed circuit boards (PCBs) for enhanced heat treatment applications. The process begins with milling PCB powder with and without pre-treatment, followed by thermal conductivity and cooling rate analysis of synthesized quenchants. Findings reveal that full pre-treated particles, which undergo leaching and pyrolysis, achieve significantly smaller sizes, up to 80.4%, compared with the half-pre-treated particles. The better improvement was due to the breakdown of epoxy resin used in the PCB. The particle size reduction enhances the quenchant's thermal conductivity up to 17.47% for the quenchant with 0.5% dispersed particle. Similarly, the maximum cooling rate was improved by 16.93% for the same quenchant. Quenching tests on S45C medium carbon steel demonstrate that particle-dispersed quenchants increase the hardness of the quenched steel, maximized at 57.8 HRC, because of the higher density of the Martensite phase developed by the higher cooling rate. This research highlights the value of pre-treatment in optimizing quenchant performance, with potential implications for improved efficiency in industrial heat treatments.&amp;#xD;

Examination of the effect of treatment of severe early childhood caries and fluoride varnish applications on salivary oxidative stress biomarkers and antioxidants

BackgroundSaliva contains a variety of biochemical compounds, including antioxidants, and serves as the body’s first line of defense against oxidative stress caused by free radicals. The aim of this study was to investigate the effects of dental treatments on salivary oxidative stress biomarkers in children aged 3–5 years with severe early childhood caries (S-ECC) compared to children without caries.MethodThis study was conducted on 20 children aged 3–5 years with severe early childhood caries (S-ECC) and 20 children without caries. Salivary oxidative stress biomarkers and antioxidants were measured after the initial examination (T0), after the end of restorative treatments (T1), and after fluoride varnish applications (T2). Post hoc Bonferroni test was used to compare normally distributed parameters between T0-T1-T2 times. Pearson correlation analysis was used to examine the relationships between parameters that conform to normal distribution. The Mann-Whitney U test was used to compare the parameters in the control and experimental groups. Significance was evaluated at the p < 0.05 level.ResultsThe mean dmft of the participants in the study group was 8.86 ± 14.5. Advanced oxidation protein products (AOPP), dityrosine (DT), kynurenine (KYN), advanced glycation end products (AGE), lipid hydroperoxides (LHP) and malondialdehyde (MDA) values decrease after the treatment of dental caries and protective fluoride varnish applications, while an increases in total thiol (TSH) and Cu/Zn-superoxide dismutase (Cu/Zn-SOD) values were observed after protective varnish applications compared to pre-treatment values. Antioxidant parameters at time T2 in the study group were statistically significantly higher than in the control group (p < 0.05). In the study group, there was no correlation between TSH and oxidative stress mediators in terms of changes at time T1 post-treatment compared to the pre-treatment period, while an inverse moderate relationship was found with AGE and LHP in terms of changes at time T2 post-treatment (p < 0.05).ConclusionsAn increase in salivary antioxidants was detected after dental restorations were completed and protective fluoride varnish application, while a decrease in oxidative stress markers was detected.Clinical relevanceFluoride varnish applications applied in the study group may further reduce the oral microbiome load and cause salivary oxidative stress markers to be significantly lower than in the control group.

Impact of circulating tumor human papillomavirus DNA kinetics on disease outcomes in HPV-associated oropharyngeal cancer.

Circulating tumor tissue modified (TTMV)-HPV DNA has emerged as a promising biomarker in human papillomavirus associated oropharyngeal squamous cell carcinoma (HPV-OPSCC). The objective of this study was to assess ctHPVDNA TTMV clearance kinetics during RT and its relationship with progression in HPV-OPSCC. We identified 80 non-metastatic HPV-OPSCC patients with 366 TTMV samples who underwent prospective plasma TTMV testing before, during and after curative intent RT or CRT between June 2021 and February 2023. Patients with rapid favorable clearance (>95% decline from pre-treatment value) of TTMV were compared to those with suboptimal clearance (<95%). The primary objective was to evaluate the relationship between TTMV clearance during CRT and its impact on progression free survival (PFS). The median follow-up was 14.7 months. Clinical nodal stage was associated with higher TTMV-HPV DNA scores at baseline, with a median score of 128, 778, and 1219 for N0/N1, N2a/b, and N2c/3 patients, respectively. Patients who had persistent TTMV at the end of RT had an inferior PFS compared to those who cleared their TTMV at 2 years (91.7% vs. 71.7%) (log rank, p = .042). Among patients who had complete clearance of their TTMV at 3 months, those who had a negative, equivocal, and incomplete PET response had a 2-year PFS of 94.3%, 77.8%, and 59.3%, respectively (log-rank, p = .029). Our study indicates that persistent TTMV-HPV DNA is associated with worse PFS and may portend unfavorable outcomes. Thus, monitoring TTMV clearance kinetics could be a valuable biomarker for guiding treatment decisions in patients with HPV-OPSCC.

The safety and efficacy of regional citrate anticoagulation for multiple consecutive therapeutic plasma exchanges with fresh frozen plasma as a replacement solution.

Therapeutic plasma exchange (TPE) is an important blood purification technology and most patients require multiple consecutive TPEs. Regional citrate anticoagulation (RCA) could be used for membrane therapeutic plasma exchange (mTPE). However, there is no research on the metabolic complications of the RCA for patients receiving multiple consecutive mTPEs with fresh frozen plasma (FFP) as a replacement solution. We retrospectively included patients who used RCA for multiple consecutive mTPEs with FFP as a replacement solution in Xijing Hospital from 2020 to 2022. We collected blood gas analysis and electrolyte results before and after mTPE treatment and analysed the anticoagulation effectiveness and metabolic complications of the RCA. A total of 33 patients who underwent 131 mTPE sessions were included, and 129 (98.5%) sessions were successfully completed. Severe hypocalcemia (19.1%) and metabolic alkalosis (58.5%) were frequently observed. In single mTPE sessions, there was a significant decrease in ionized calcium levels and significant increases in serum sodium, potassium, pH, bicarbonate, and base excess (BE) levels compared to pretreatment values. When comparing the values after the last treatment to the baseline values in all 33 patients, the serum sodium, pH, bicarbonate, and BE levels increased significantly, while the ionized calcium decreased significantly. The levels of pH, bicarbonate, and BE increased with the number of mTPE sessions, and the cumulative incidence of metabolic alkalosis reached 95.2% after the fifth treatment according to the Kaplan-Meier survival analysis. RCA is an effective anticoagulation method for patients undergoing mTPE with FFP as a replacement solution. However, the metabolic complications associated with RCA, especially hypocalcemia and metabolic alkalosis, frequently develop in patients who undergo multiple consecutive mTPEs with FFP.

Improvement of recessed MOS gate characteristics in normally-off AlN/GaN MOS-HFETs with N2/NH3 thermal treatment

This study investigated the metal–oxide–semiconductor gate characteristics of recessed-gate AlN/GaN metal–oxide–semiconductor-heterojunction-field-effect transistor with N2/NH3 thermal treatment. The gate-channel mobility in recessed-gate structures formed by the inductively coupled plasma-reactive ion etching method is degraded due to plasma-induced damage. The application of thermal treatment to etch-damaged GaN surfaces was observed to re-form a clear step-terrace structure, effectively reversing the effects of the etching damage. A corresponding enhancement in peak field-effect mobility was experimentally verified, with an increase from a pretreatment value of 656 to 1042 cm2/V·s after thermal treatment. Concurrently, an improvement of the lower gate-leakage current by 1–2 orders of magnitude was measured. This thermal treatment method can reduce crystal defects at deep levels of 1.8–2.9 eV below Ec on the etched GaN surface. In particular, this N2/NH3 thermal treatment approach could potentially contribute to the reduction of deep levels such as atomic displacement, gallium vacancies, and those complexes generated by inductively coupled plasma-reactive ion etching.

Serum symmetric dimethylarginine concentrations in enalapril- or telmisartan-treated dogs with proteinuric chronic kidney disease.

Renin-angiotensin-aldosterone system inhibition (RAASi) reduces intraglomerular pressure and is a standard therapy for dogs with proteinuric chronic kidney disease (CKD). RAASi can acutely decrease glomerular filtration rate (GFR); however, its effects on the marker of GFR serum symmetric dimethylarginine (SDMA) concentration in dogs have not been specifically evaluated. The objective of this study was to evaluate changes, relative to pretreatment values, in serum SDMA concentrations in dogs with proteinuric CKD receiving RAASi therapy. This retrospective study used banked samples from 29 dogs with proteinuric CKD treated with enalapril (0.5 mg/kg PO q12h; n = 16) or telmisartan (1 mg/kg PO q24h; n = 13) alone (n = 22) or in combination with amlodipine if severely hypertensive (n = 7). Serum SDMA, creatinine, and urea nitrogen (SUN) concentrations were measured before and 7 and 30 days after starting RAASi. Percentage and absolute changes in these biomarkers were calculated for each dog and time point. A linear mixed model was used to test whether changes significantly differed from zero (α < 0.05). Overall, mean ± SEM Day 7 and 30 percentage change in SDMA were - 4.8 ± 3.6% and - 3.2 ± 3.4%, respectively; in creatinine were 7.4 ± 3.3% and 3.0 ± 3.1%, respectively; and in SUN were 22.1 ± 6.8% and 16.7 ± 6.2%, respectively. Mean changes varied according to whether all dogs, those on RAASi alone, or those co-treated with amlodipine were evaluated. In dogs receiving RAASi alone, at day 7, there were significant mean percentual increases in creatinine (9%; p = 0.023) and SUN (23%; p = 0.005), but SDMA was unchanged. In dogs co-treated with amlodipine, a significant absolute decrease in mean SDMA (-2.29 μg/dL; p = 0.026) occurred at days 7 and 30, while mean creatinine was unchanged and mean SUN increased. Proteinuric dogs receiving RAASi had low-magnitude changes in serum SDMA and creatinine, and moderate-magnitude changes in SUN concentrations. The direction of change in SDMA did not consistently match that of creatinine and SUN.

Prognostic significance of serum interleukin-6 in severe/critical COVID-19 patients treated with tocilizumab: a detailed observational study analysis

Baseline IL-6 levels have been found to be non-predictive of subsequent outcomes following tocilizumab treatment, highlighting the need for more reliable predictive markers. To address this, a retrospective analysis was conducted on the clinical profiles, diagnostic tests, and follow-up prognoses of 60 patients with severe or critical COVID-19, all of whom were identified as experiencing a cytokine storm and subsequently received tocilizumab treatment. Among the patients, the overall survival rate during follow-up was 80%, with further analysis revealing that advanced age was an independent risk factor for adverse outcomes. Following tocilizumab administration, a statistically significant increase in IL-6 and D-dimer levels was observed, while markers such as C-reactive protein (CRP), procalcitonin (PCT), and fibrinogen demonstrated reductions compared to pre-treatment values. Specifically, IL-6 levels initially surged briefly after tocilizumab intervention before gradually diminishing. To assess the prognostic utility of IL-6, the Receiver Operating Characteristic (ROC) curve was employed, which yielded an area under the curve (AUC) of 0.812, indicating strong predictive capability, with a sensitivity of 100% and a specificity of 53.49%. The optimal cut-off value for IL-6 was identified at 147.79 pg/mL. In conclusion, IL-6 levels tend to rise transiently following tocilizumab therapy, before gradually declining. These post-treatment IL-6 measurements may serve as a valuable biomarker for assessing prognosis in patients undergoing this treatment.

The prognostic value of pretreatment [18F]FDG PET/CT parameters in esophageal cancer: a meta-analysis.

This study aims to evaluate the prognostic implications of pretreatment [18F]FDG-PET metrics in esophageal cancer patients through a meta-analysis of the existing literature. We carefully searched electronic databases, including PubMed and Embase, from inception to April 1, 2024, to identify studies describing the prognostic value of pretreatment PET metrics for advanced esophageal cancer. Clinical endpoints examined were overall survival (OS), recurrence-free survival (RFS)/disease-free survival (DFS), and progression-free survival (PFS). Hazard ratios (HRs) for PFS and OS were taken directly from the original reports. Forty-seven publications, including 5504 patients, were included in our analysis. OS and PFS were analyzed in 31 and nine studies, respectively, and DFS/RFS was analyzed in 16 studies. The comprehensive pooled analysis revealed significant associations between metabolic parameters derived from positron emission tomography (PET) imaging and clinical outcomes. Expressly, the pooled HR indicated that patients with higher SUVmax were significantly associated with poor PFS (HR: 1.06; 95% CI: 1.01-1.12, p = 0.011) and poor RFS/DFS (HR: 1.09; 95% CI: 1.02-1.18, p = 0.019). Patients with higher SUVmean were significantly associated with poorer OS (HR: 1.07; 95% CI: 1.01-1.14, p = 0.025). High MTV was significantly associated with inferior OS (HR: 1.02; 95% CI: 1.00-1.05, p = 0.049). High TLG was significantly associated with poorer RFS/DFS (HR: 2.02; 95% CI: 1.11-3.68, p = 0.022). This study unveiled pretreatment FDG-derived parameters as valuable prognostic indicators in assessing esophageal cancer outcomes. Specifically, SUVmax is associated with PFS and RFS/DFS. SUVmean and MTV were correlated with OS, and TLG was only associated with RFS/DFS. Question Inconsistent findings on the prognostic value of pretreatment [18F]FDG PET parameters in esophageal cancer require comprehensive analysis to clarify their role in outcome prediction. Findings Higher pretreatment [18F]FDG-PET metrics (SUVmax, SUVmean, MTV, TLG) are associated with poor survival outcomes, emphasizing their potential value in enhancing prognostic assessments for esophageal cancer. Clinical relevance This study highlights the prognostic significance of pretreatment [18F]FDG-PET metrics in esophageal cancer, providing valuable insights for patient outcome prediction and potentially guiding personalized treatment strategies.

Positive Changes in Body Composition and Profiles of Individuals with Diabetes 3 Years Following Laparoscopic Sleeve Gastrectomy in Japanese Patients with Obesity.

We analyzed the changes in obesity, glucose metabolism, and body composition over a 3-year period in Japanese patients with obesity following laparoscopic sleeve gastrectomy (LSG). Body weight, parameters related to diabetes such as glycated hemoglobin (HbA1c), and electrical impedance analysis were used to assess body composition in forty-eight Japanese patients with obesity before surgery and 6 months, 1 year, 2 years, and 3 years after LSG. At 6 months, 1, 2, and 3 years post-LSG, there were significant reductions in body weight, body mass index, blood pressure, fasting plasma glucose, triglyceride, and HbA1c levels. Six months after LSG, fat mass (FM), muscle mass (MM), and %FM all showed a decrease compared to pre-treatment values (all p < 0.05). FM and %FM remained in a decreased state until 3 years had passed. In contrast, %MM increased at 6 months post-LSG and was maintained up to 3 years post-LSG (all p < 0.05). Furthermore, changes in FM and %FM were associated with changes in body weight and A1C. In contrast, change in %MM exhibited a negative correlation with body weight and A1C following LSG. Finally, multivariate regression analyses demonstrated that alterations in FM were independent factors affecting body weight in patients with obesity 3 years after LSG. We observed improvements in FM, fasting plasma glucose, and HbA1c levels over a 3-year period in Japanese patients after LSG. The reduction in FM and maintenance of %MM after LSG were suggested as possible links between the effects of LSG on obesity and diabetes over 3 years.

Pre-treatment of composite industrial wastewater by Fenton and electro-Fenton oxidation processes

The present study aims to characterize three industrial wastewater samples collected from petrochemical, food and beet sugar industries to determine the pollution potential and select the appropriate pre-treatment approach. According to the biodegradability profile of the multi-sourced mixed (composite) sample, the advanced oxidation process (AOPs) namely, Fenton (F) and Electro-Fenton (EF) were adopted as pre-treatment techniques and the operating parameters such as time, type of electrodes, pH, voltage, iron and H2O2 concentrations were critically examined. Analysis of Variance (ANOVA) was conducted to compare the performance efficiency of F& EF AOPs for treating the composite samples and the total operating costs for both approaches were assessed. The results revealed that, the initial values of the composite sample were 7.11, 19.2, 32.6, 19.3, 937, 1512, 860, 3.9, 2110 and 2.34 for pH, Total Dissolved Solids (TDS), Electrical Conductivity (EC), Salinity, BOD, COD, Oil and grease (O&G), Total Phosphorous (TP), Total Suspended Solids (TSS) and Total Kjeldahl Nitrogen (TKN), respectively. In addition, EF process achieved more removal efficiency for COD, O&G, BOD, TSS, and TKN (84.3%, 69%, 85%, 72% and 71.27%) compared to Fenton which displayed 78.43%, 66%, 69%, 70.1%, and 61%, respectively. Moreover, there are statistically significant differences (p < 0.05) between the initial and final (pretreated) values of the composite industrial wastewater for the addressed parameters and EF was significantly (p < 0.05) more effective than F process. The total operating costs were 3.117 and 2.063$ for F and EF, respectively, which confirmed that EF is more efficient and cost effective than F process. It was concluded that electro-Fenton process is favorable, eco-friendly and cost-effective option for pretreating real complicated multi-sourced industrial wastewater. The present study demonstrated a new avenue for achieving efficient management of industrial wastewater generated from similar industries.

Predictive value of pre-treatment circulating tumor DNA genomic landscape in patients with relapsed/refractory multiple myeloma undergoing anti-BCMA CAR-T therapy: Insights from tumor cells and T cells.

B-cell maturation antigen (BCMA)-directed chimeric antigen receptor T (CAR-T) therapy yield remarkable responses in patients with relapsed/refractory multiple myeloma (R/RMM). Circulating tumor DNA (ctDNA) reportedly exhibits distinct advantages in addressing the challenges posed by tumor heterogeneity in the distribution and genetic variations in R/RMM. Herein, the ctDNA of 108 peripheral blood plasma samples from patients with R/RMM was thoroughly investigated before administration of anti-BCMA CAR-T therapy to establish its predictive potential. Flow cytometry is used primarily to detect subgroups of T cells or CAR-T cells. In this study, several tumor and T cell effector-mediated factors were considered to be related to treatment failure by an integrat analysis, including higher percentages of multiple myeloma (MM) cells in the bone marrow (P=0.013), lower percentages of CAR-T cells in the peripheral blood at peak (P=0.037), and higher percentages of CD8+ T cells (P=0.034). Furthermore, there is a substantial correlation between high ctDNA level (>143ng/mL) and shorter progression-free survival (PFS) (P=0.007). Multivariate Cox regression analysis showed that high levels of ctDNA (>143ng/mL), MM-driven high-risk mutations (including IGLL5 [P=0.004], IRF4 [P=0.024], and CREBBP [P=0.041]), number of multisite mutations, and resistance-related mutation (ERBB4, P=0.040) were independent risk factors for PFS. Finally, a ctDNA-based risk model was built based on the above independent risk factors, which serves as an adjunct non-invasive measure of substantial tumor burden and a prognostic genetic feature that can assist in predicting the response to anti-BCMA CAR-T therapy. Chinese Clinical Trial Registry (ChiCTR2100046474) and National Clinical Trial (NCT04670055, NCT05430945).

Induction Chemotherapy-Related Covert Cardiac Remodeling in Pre-Autologous Hematopoietic Stem Cell Transplantation for Multiple Myeloma: A Retrospective Observational Study.

Autologous hematopoietic stem cell transplantation (ASCT) has emerged as a cornerstone in multiple myeloma (MM) management, offering the prospect of prolonged disease control. However, the induction chemotherapy drugs required prior to ASCT carry cardiovascular toxicity (CVT), potentially leading to a range of cardiovascular complications. This retrospective observational study, conducted at Guangdong Provincial People's Hospital from January 2020 to December 2023, analyzed 47 of the initial 173 patients who met the criteria. The cohort, comprising 22 males (46.81%) and 25 females (53.19%), had a mean age of 55.68 ± 11.38 years. They underwent various induction chemotherapy regimens, receiving a median of 5 (4-6) cycles of the course over an average duration of 7.10 ± 2.46 months. Before ASCT treatment following induction chemotherapy, echocardiographic findings indicated reductions in left ventricular end-systolic dimension, right atrial diameter, E-wave velocity, E/e' ratio, and the E/A ratio. The latter altered from a pretreatment value greater than 1 to posttreatment less than 1, marking diastolic dysfunction emergence or aggravation in 51.06% of patients. The electrocardiographic data indicate a reduced heart rate and prolonged P-wave duration and P-R duration, with an increase in arrhythmia incidence to 19.15% following induction chemotherapy. Induction chemotherapy, administered prior to ASCT in patients with MM, can lead to the emergence or aggravation of cardiac diastolic dysfunction and increase the incidence of arrhythmic events. Therefore, it is crucial to emphasize the importance of balancing the benefits and risks of induction chemotherapy to maximize its efficacy while minimizing CVT.

Effect of low-dose aspirin on mid-luteal phase uterine Artery blood flow in women with unexplained recurrent pregnancy loss

Objectives: As a possible therapy for recurrent pregnancy loss, this study sought to ascertain if low-dose aspirin was effective in increasing uterine artery blood flow. Study Design: This investigation was structured as a single-arm clinical trial Patients and Methods: All participants were aged 39 years or younger and had no prior or current indications of abnormal glucose tolerance, thyroid dysfunction, hyperprolactinemia, or Antiphospholipid antibody syndrome. Bilateral assessments of the Systolic/Diastolic (S/D) ratio, Resistive Index (RI), and Pulsatility Index (PI) were conducted in the chosen patients in the mid-luteal phase, before to and following a minimum of two weeks of low-dose aspirin administration. Results: The results of this investigation showed significant variation in the S/D and PI prior to and following aspirin administration. There was no discernible shift in RI. The analysis revealed a statistically significant reduction in uterine artery PI after aspirin administration (1.92±0.29) compared to the pre-treatment value (2.22±0.27), with a p-value of 0.0001. Remarkably, the pulsatility indices of the left and right uterine arteries did not significantly differ from one another. Conclusion: For women who have a history of miscarriages, low-dose aspirin can be recommended as an adjuvant therapy as it effectively improves uterine artery blood flow in these patients. However, more well-designed research is required to ascertain whether improved pregnancy outcomes are correlated with improved uterine perfusion. The current study supported the aspirin guideline for women with a history of recurrent miscarriages by showing that aspirin treatment resulted in a reduction in uterine artery PI.

Combining Transcranial Direct Current Stimulation with Exercise to Improve Mobility, Stability, and Tremor Management in 25 Individuals with Parkinson's Disease.

Parkinson's disease (PD) is a neurodegenerative disorder characterized by tremors, balance impairments, and mobility limitations. Innovative approaches like combining transcranial direct current stimulation (tDCS) with exercise show promise in addressing these symptoms. This study investigates the effects of exercise combined with tDCS on mobility and tremor management in PD patients. Twenty-five individuals aged 60-75 (66.6 ± 7.33), diagnosed with PD (Hoehn and Yahr stage 2-3), were assigned to three groups in a randomized controlled design: exercise with active tDCS (n = 8), exercise with sham tDCS (n = 8), and a control group (n = 9). Dual-task training sessions focusing on walking speed, balance, and force control were conducted over ten sessions. No significant differences were detected across the groups for grip strength or force control measures (p > 0.05). Significant improvements were observed in the intervention group: the Timed Up and Go (TUG) test showed a significant reduction in time (mean difference = 2.498 s, p < 0.001, ηp2 = 0.331); anterior-posterior displacement significantly increased (mean difference = 21.375 mm, p = 0.0269, ηp2 = 0.303); and force-tremor decoupling improved, with coherence in the 1-4 Hz band significantly decreasing (p = 0.0067). Finally, changes in TUG from post- to pre-treatment values were significantly positively correlated with the changes in coherence (R = 0.468, p = 0.018). Combining tDCS with exercise enhances mobility and tremor management in PD patients. These findings support the potential for such interventions to improve functional outcomes and quality of life for individuals with PD.

Prognostic Nutrition Index as a Biomarker for Treatment Sensitivity to Chemotherapy and Nivolumab as the First-Line Treatment in Patients with Unresectable Advanced or Recurrent Gastric Cancer: A Multicenter Study

Introduction: This multicenter study aimed to determine whether the pretreatment prognostic nutrition index (PNI) or a change in the index after two treatment courses could be a biomarker for predicting treatment sensitivity in patients with unresectable advanced or recurrent gastric cancer treated using chemotherapy and nivolumab as the first-line treatment. Methods: This multicenter retrospective study with 104 patients was conducted at 12 institutions. PNI was calculated before treatment and after two courses of treatment in each case. We also focused on changes in PNI from the pretreatment value. Results: After two courses of chemotherapy plus nivolumab treatment, the high PNI group had significantly better rates of overall survival (OS) (p = 0.0016) and time-to-treatment failure (p = 0.0060). Low PNI was an independent prognostic factor predicting both therapeutic sensitivity to chemotherapy plus nivolumab treatment and poorer OS. Furthermore, correlation with low pretreatment PNI transitioning to high after two courses of treatment was not noted in any patient in the progressive disease group (p = 0.0075). Conclusions: PNI is a score composed of a patient’s albumin level and lymphocyte count that can be easily assessed in daily clinical practice. Evaluating it is easy for each treatment; thus, when there is a focus on its transition, PNI could be a very powerful biomarker for predicting treatment sensitivity.