Improvement In Rate Research Articles

Flexibility enhancement of combined heat and power unit integrated with source and grid-side thermal energy storage

The potential of improvement of both overall energy efficiency and penetration of renewable energy for the combined heat and power (CHP) unit was investigated by integrating the source-side and grid-side thermal energy storage (TES) systems simultaneously. The mathematical model of the proposed thermal system was established, with which the flexibility-enhancing features across diverse operating conditions were analyzed. The flexibility improvement rate, heat consumption rate, TES cycle efficiency and energy efficiency were revealed. Moreover, the wind power consumption, coal-savings and net annual revenue of CHP unit integrated with different TES were presented. The results indicated that the flexibility improvement rate of source-side TES, grid-side TES and dual TES is 2.4 %, 21.2 % and 26.2 %, respectively. The heat consumption rate of a CHP unit integrated with source-side TES system is lower compared to that of a traditional CHP unit when power load ratio is below 50 %. The CHP unit integrated with a dual TES system exhibited a maximum increase in wind power accommodation rate of 37.7 % and a maximum reduction in standard coal consumption of 7.7 %. The proposed systems offer a promising approach for enhancing the flexibility of CHP units to accommodate more renewable energy.

Comparative analysis of treatment protocols and clinical outcomes in the management of acute urticaria and angioedema in the emergency department

Objective: The purpose of the study was to identify clinical differences in patients with acute urticaria and/or angioedema receiving various treatment regimes in the emergency department of Lady Reading Hospital, Peshawar. Particularly, it compared modern antihistamine therapy with corticosteroids as an analogue to routine antihistamines with regard to the rate of symptom improvement, relapse, and hospitalisation. Methods: This was a cross-sectional descriptive study involving 542 patients with acute urticaria and/or angioedema. Patients were categorised into two groups: Group A, receiving a combination of antihistamines and corticosteroids (280); and Group B, receiving only antihistamines (262). Thus, the primary end points considered include time to resolution of symptoms, recurrence within 48 hours, and hospitalisation need. Data was analysed using the statistical package of social sciences (SPSS), while a p-value of < 0.05 formed the basis of significance. Results: The overall improvement time for symptoms was 3.6 hours in Group A and 5.1 hours in Group B (p < 0.001). The rates of recurrence were also lower in Group A (15%) than in Group B (29.8%, p < 0.01). Meanwhile, patients who were in Group A had 10% that needed inpatient admission as an intervention compared to 19.1% in Group B; p < 0.05. Side effects were few and were comparable between the two groups; therefore, patients in both groups had reactions such as drowsiness and gastrointestinal disturbances. Conclusion: Together, antihistamines plus corticosteroids were superior to antihistamines only in the treatment of acute urticarial and angioedema in patients in the emergency department. Patients reported symptoms resolved sooner, the rate of relapse was shorter, and hospitalisation was reduced. Based on this observation, corticosteroids should be considered as part of the usual care of patients presenting with moderate to severe symptoms in the emergency department. Future research should aim at sorting out various recommendations of treatment value for the purpose of achieving even better results of the therapy.

Innovation and Expansion of Neural System-Based Teacher Evaluation Management Mechanism in Academy

The traditional evaluation mechanism of ideological education in universities faces many challenges. How to improve the quality of knowledge service work in the university and enhance instructors' skill level and effectiveness is the main problem facing the sustainable development of higher education in the new century. This article studies the innovation and expansion of the evaluation and management mechanism for university teachers based on the neural system in order to achieve effective scientific and systematic teaching methods. The experimental results show that the improvement rate of higher education academic performance under neural system learning is 75.12%, which is 17.34% higher than traditional Blended Open Learning(BOP) learning methods. Therefore, the improvement rate using the neural system learning is higher. This article targets different groups responsible for university-level teaching, thereby greatly improving the learning of college students.

Treatment outcome in patients with spinal neurocysticercosis: a systematic review of published cases and case series.

Spinal neurocysticercosis is a rare central nervous system infection caused by the larval form of the Taenia solium. Due to its rarity, most knowledge is derived from isolated case reports. This review aims to evaluate existing case reports and observational studies to provide a comprehensive overview of the disease's clinical presentation and treatment outcomes. Following PRISMA guidelines, a comprehensive search was performed across various databases. The review included case reports, case series, and observational studies, and it is registered with PROSPERO (CRD42024496957). This review analyzed 206 spinal neurocysticercosis cases (from 171 published reports). Symptoms persisted for one week to six months in 49% of cases, and common presentations included paraparesis/quadriparesis (61.7%) and neck/limb/back pain (40.8%). CSF abnormalities were observed in 23.8%. Thoracic involvement was most frequent (39.3%), followed by cervical (27.2%). Neurocysticercosis lesions in other regions, primarily the brain, were found in 18.9%. Differential diagnoses included spinal cord tumors (13.1%). Treatment often involved surgery alone (32%) or with cysticidal drugs (45.6%), with a 91.3% improvement rate, indicating favorable outcomes. Spinal neurocysticercosis primarily affects the thoracic and cervical regions. Most patients respond well to medical therapy; surgery is mainly for progressive neurological deficits.

Evaluating the clinical potential of bioceramic-rods for revascularization in osteonecrosis of the femoral head: a systematic review.

To evaluate the safety, reliability, and effectiveness of bioceramic rods (BR) in treating osteonecrosis of the femoral head (ONFH), compared with other treatments such as core decompression and autologous bone grafting. Systematic review and meta-analysis. Pubmed, Embase, and CNKI databases from January 2011 to July 2023. Included studies involved patients treated with bioceramic rods. Studies were required to have a follow-up time of more than six months and no statistically significant differences in baseline information between groups in controlled studies. Exclusions included literature reviews, case reports, conference abstracts, animal experiments, and studies without defined success criteria or lacking analysis on factors influencing efficacy. The primary outcome measure was the Harris Hip Score (HHS) improvement rate. Secondary outcomes included the femoral head stability and survival rate, alongside the hip replacement rate. The systematic review revealed significant improvements in symptom relief and functional recovery using BR for the treatment of ONFH. An average follow-up of 20.44 months showed an overall HHS improvement rate of 33.93%. Hip preservation efficacy with BR was superior to core decompression and autologous bone grafting. The overall femoral head survival rate was 84.42%, with results sustained for three years. The success rate of hip preservation was notably higher with early intervention, which showed better outcomes when the overall HHS improvement exceeded 27%, and rates of excellent and good outcomes approached 90%. Bioceramic rods offer a safe, minimally invasive, reliable, and effective treatment option for ONFH, ensuring substantial symptom relief and functional recovery. The technique's success in early disease stages suggests a strong potential for broader clinical adoption. Although additional benefits from combining BR with stem cells, platelet-rich plasma, and traditional Chinese medicine are noted, definitive conclusions on enhanced therapeutic effects remain inconclusive.

Effectiveness and Safety of a Hyaluronic Acid Filler for Chin Augmentation and Correction of Chin Retrusion: A Multi-center, Prospective, Randomized Controlled Trial.

The chin significantly influences facial aesthetics, contributing to the overall balance and harmony of the face. This study aimed to assess the effectiveness of the hyaluronic acid filler Hyamax® Volumizer for chin augmentation and correction of chin retrusion compared to a no-treatment control. Participants aged 18-55 years with mild to moderate chin retrusion were randomized in a 3:1 ratio to receive either the treatment group (n = 150) or control group (n = 50). Evaluations included blinded assessments using the validated Galderma Chin Retrusion Scale, Global Aesthetic Improvement Scale for aesthetic enhancement, and safety follow-up. The Galderma Chin Retrusion Scale responder rate (≥1 grade improvement) was significantly higher for the treatment group (70%) compared to the control group (0%) at 6 months (p < 0.0001), and remained higher at 12 months (54.67% vs. 0%; p < 0.0001). Aesthetic improvement rates were consistently high as reported by both blinded evaluating investigator (≥89.33%) and subjects (≥91.33%). Treatment-related adverse events were mild to moderate. Hyamax® Volumizer treatment is safe and effective when injected in the chin to treat chin retrusion, with results lasting through 1 year. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

E'jiao and Cubilose Formula Induced Antioxidant Activity and Improved Collagen Expression of Human Skin Fibroblasts During Oxidation Damage.

As traditional Chinese medicinal materials, E'jiao and cubilose are rich in various bioactive substances with good antioxidant, anti-inflammatory, and immune-regulating effects. To obtain the optimal ratio of synergistic effect between E'jiao and cubilose. The antioxidant capacity of E'jiao and cubilose digestive fluid was evaluated invitro, as well as the intracellular oxidation balance between HSF cells and 3D whole-skin model induced by H2O2. E'jiao, cubilose, and their different ratios of composites had better scavenging ability against free radicals such as DPPH (2,2-Diphenyl-1-picrylhydrazyl). Using HSF cells induced by H2O2 as an oxidative damage model, it was found that the combination of E'jiao and cubilose in a ratio of 2:3 significantly enhanced the activities of SOD, GSH-PX, and CAT enzymes compared to the separate treatments of E'jiao and cubilose, as well as other combination ratios. It effectively reduced the accumulation of reactive oxygen species caused by H2O2 in HSF (Human Skin Fibroblast)cells and protected the integrity of the cells. Further analysis using flow cytometry and a 3D full-thickness skin model revealed that the combination ratio of 2:3 increased the proportion of H2O2-treated cells in the S%+G2% phase from 19.1% + 7.4%-22.1% + 28.8%, helping oxidatively damaged cells partially recover their proliferative capacity. It also promoted the expression of collagen I and collagen IV in the 3D full-thickness skin model, with improvement rates reaching 168.00% and 123.68%, respectively. These findings indicate that the combination of E'jiao and cubilose in a ratio of 2:3 exhibits good synergistic effects, enhancing the ability of cells to resist oxidative damage, promoting cellular renewal and metabolism, and improving skin antiwrinkle capacity.

RADT-33. GAMMA KNIFE RADIOSURGERY FOR ORBITAL CAVERNOUS HEMANGIOMA: A SYSTEMATIC REVIEW AND SINGLE-ARM META-ANALYSIS

Abstract Gamma knife radiosurgery (GKRS) for orbital cavernous hemangioma (OCH) has emerged as a promising method due to its significant clinical improvement and low incidence of complications. This study aimed to evaluate the safety and efficacy of GKRS for the treatment of OCH. Following the PRISMA framework, we searched PubMed, Cochrane Central, and Embase for studies reporting outcomes of GKRS for OCH, including complications, visual improvement, proptosis, tumor reduction rate, and tumor progression rate. From 1856 search results, six studies with 100 patients were included. Only five minor complications related to GKRS were reported, including three with orbital pain and two with periorbital chemosis, resulting in a complication rate of 13% (95% CI: 7% - 25%). Visual acuity and visual field improvement rates after GKRS were 80% (95% CI: 63% - 96%) and 71% (95% CI: 47% - 95%), respectively. Proptosis improved in 94% of cases (95% CI: 83% - 100%). The tumor reduction rate was 77% after GKRS (95% CI: 69% - 85%). In conclusion, GKRS for OCH appears to be a safe technique, as evidenced by the rate of clinical improvement and radiological improvement. However, studies are limited by the absence of a control group, and additional studies are needed to evaluate the relative efficacy of GKRS compared with alternative surgical modalities for OCH.

SURG-45. OUTCOMES OF PATIENTS RECEIVING SURGICAL RESECTION AND STEREOTACTIC RADIOSURGERY VS. STEREOTACTIC RADIOSURGERY ALONE FOR MOTOR CORTEX METASTASES

Abstract BACKGROUND Local therapy for brain metastases typically involves stereotactic radiosurgery (SRS), with surgical resection considered for larger and/or symptomatic tumors. For lesions in eloquent areas, surgical management is controversial given the risks of neurologic deficits. This study compared clinical outcomes in patients with motor cortex metastases who received surgery + SRS or SRS alone. METHODS Patients treated for motor cortex metastases from 1/2018 – 12/2022 were identified. Demographic/preoperative variables included age, gender, race, tumor histology, adjuvant therapies, pre-treatment neurological exam, and Karnofsky Performance Scale. Treatment variables included the number of brain metastases, maximum tumor diameter, and radiation dose/number of fractions. Outcome measures included post-treatment neurological exam, seizures, and overall survival (OS). RESULTS 351 charts were identified – 80 surgery + SRS and 271 SRS alone. 50 consecutive patients in each group were included in this analysis. Surgery + SRS patients were younger (59.0 vs. 63.9; P=0.020) with larger tumors (2.8 vs. 0.83cm; P&amp;lt;0.001), while the SRS only group had more brain metastases per patient (2 vs. 6; P&amp;lt;0.001). No differences were seen in the remaining demographic/preoperative variables. Pre-treatment, surgery + SRS patients had significantly increased frequency (45/50, 90% vs. 25/50, 50%; P&amp;lt;0.001) and severity (4 vs. 5; P=0.001) of motor deficits, and a higher likelihood of seizures (25/50, 50% vs. 8/50, 16%; P&amp;lt;0.001). Despite the surgery + SRS group being more symptomatic pre-treatment, the frequency and severity of motor deficits and seizures was similar between cohort’s post-therapy. Surgery + SRS patients also demonstrated higher rates of pre- to post-treatment improvement in motor function (29/45, 64% vs. 3/25, 12%; P&amp;lt;0.001) and longer OS from the date of treatment (7.5 vs 4 months; P=0.021). CONCLUSION Given the equivalent neurological outcomes, higher rates of functional improvement, and improved oncologic outcomes, surgery should be a consideration for patients with brain metastases in eloquent areas, particularly those with symptomatic lesions.

Tocilizumab for Advanced Non-Small-Cell Lung Cancer With Concomitant Cachexia: An Observational Study.

Cancer cachexia significantly contributes to morbidity and mortality in patients with non-small-cell lung cancer (NSCLC). Inflammatory pathways mediated by interleukin-6 (IL-6) play a crucial role in the development of cancer cachexia. This study aimed to investigate the use of tocilizumab in the management of NSCLC with coexisting IL-6-elevated cachexia. In this retrospective study, data were collected from patients with NSCLC and concurrent IL-6-elevated cachexia who received either tocilizumab plus antitumour therapy or antitumour therapy alone. The primary endpoints were overall survival (OS) and improved modified Glasgow Prognostic Score (mGPS) at Week 12. The secondary endpoints included changes from baseline over 12 weeks in body weight, albumin, C-reactive protein (CRP) and mGPS. Qualitative improvements in patient self-rated appetite and fatigue were reported as exploratory analysis. The study included 49 patients diagnosed with NSCLC and IL-6-elevated cachexia, Eastern Cooperative Oncology Group performance status of 2-4. Of these, 26 received tocilizumab in combination with antitumour therapy, and 23 received antitumour therapy alone. The majority of these patients were male (87.8%). Baseline characteristics were almost identical between the two groups. The tocilizumab group demonstrated a significantly longer median OS compared to the control group (15.1 vs. 3.2 months; hazard ratio 0.18, 95% confidence interval 0.08-0.38; p < 0.001). The rate of patients surviving with mGPS improvement at Week 12 was significantly higher in the tocilizumab group than in the control group (risk difference 0.88, 95% confidence interval 0.75-1.00; p < 0.001). Over the 12-week period, significant improvements were observed in body weight, albumin, CRP and mGPS in the tocilizumab group compared to the control group (body weight: 5.15 ± 0.53 kg vs. -5.69 ± 0.76 kg, p = 0.041; albumin: 5.89 ± 0.70 g/L vs. -2.97 ± 0.71 g/L, p < 0.001; CRP: -91.50 ± 7.15 mg/L vs. 9.47 ± 13.69 mg/L, p < 0.001; mGPS: -1.61 ± 0.15 vs. 0.03 ± 0.08, p < 0.001). The tocilizumab group also displayed significantly higher rates of improvement in appetite and fatigue (both p < 0.001). The incidence of Grade 3 or higher adverse events was 34.6% in the tocilizumab group compared to 78.3% in the control group. Tocilizumab-related adverse events were observed in three patients (11.5%), including two cases of neutropenia and one case of skin and subcutaneous tissue infection. Tocilizumab demonstrated significant benefits in survival and various clinical parameters, including body weight, albumin, CRP, mGPS and symptom burden in patients with NSCLC and concurrent IL-6-elevated cachexia. Given the existing unmet medical need for effective interventions for cancer cachexia, tocilizumab may be considered as a potential treatment option.

CNSC-14. GLIOBLASTOMA MULTIFORME TUMOR VOLUME AND PERSISTENCE OF CHIMERIC ANTIGEN RECEPTOR T CELLS FOLLOWING TREATMENT

Abstract Glioblastoma Multiforme (GBM) is one of the most common and aggressive high-grade primary brain tumors that arises from the glial cells of the central nervous system and occurs most often in the frontal and temporal lobes. Despite current treatment options, long-term prognosis of GBM remains low with no significant improvement rates. Chimeric antigen receptor (CAR)-expressing T cells target the B cell marker CD19 and have shown increased efficacy in B cell lymphomas, and lymphoblastic leukemias suggesting benefits in GBM. This study aims to quantify the persistence of CAR-T cells in the context of GBM tumor volume following neurosurgical debulking procedure. A radiology software known as the mint Lesion was utilized to provide Tumor Response Assessment by Criteria (TRAC) reports that consist of volumetric measurements of the tumor lesions (target enhancing lesions, non-target enhancing lesions, and non-target non-enhancing lesions). Fluorescence-activated cell sorting (FACS) analysis takes a sample mixture of cells and sorts them into different populations based on specific biomarkers and characteristics. B7-H3 CAR-T cell persistence was increased in patients with a larger post-surgical tumor volume (3.04% Subject 001 with 2438 mm² volume and 2.38% Subject 003 with 224 mm² tumor volume). However, the number of CAR-T cells per 1 mm² was significantly reduced in patients with a larger post-surgical tumor volume (0.0012 cells/mm² Subject 001 and 0.010 cells/mm² Subject 003). This study shows that although there is an overall increased CAR-T cell persistence for a larger tumor volume, the number of CAR-T cells per 1 mm² is significantly smaller for larger tumor volumes, while illustrating that a larger post-surgical tumor bulk volume is correlated with an increased CAR-T cell persistence within 1-week post-infusion. These findings provide novel information and complement other correlative studies as part of the Phase 1 interventional clinical trial for glioblastoma patients.

THE EXTERNAL DRAFT TUBE GASLIFT BIOREACTOR: HYDRODYNAMIC CHARACTERISTICS AND PARAMETRIC OPTIMIZATION

Gaslift reactors are employed in several bioapplications due to their characteristics of cost-effectiveness and high efficiency. However, the nutrient and thermal gradient is one of the obstacles that stand in the way of its widespread use in biological applications. The diagnosis, analysis, and tracking of fluid paths in external draft tube gaslift bioreactor-type are the main topics of the current study. Several parameters were considered to assess the mixing efficiency such as downcomer-to-rizer diameter ratio (Ded/Dr), the position of the diffuser to the height of bioreactor ratio (Pd/Lr), and gas bubble size (Db). The multiple regression of liquid velocity indicates the optimal setting: Ded/Dr is (0.5), Pd/Lr is (0.02), and Db is (400) um. However, for technical and operational reasons, it was necessary to make some changes in the optimal values obtained from the numerical equations. The study also revealed that the size of gas bubbles is the characteristic that has the greatest influence on the dynamic efficiency of the fluid inside the bioreactor, since, reducing the bubble size by half can enhance the improvement rate in the circulation of the liquid up to 35%.

An evaluation of 30 years’ experience in the use of botulinum toxin injections in the management of sixth nerve palsies

ABSTRACT Intrroduction Sixth nerve palsy is the most common type of extraocular muscle palsy. The therapy options in sixth nerve palsies include monitoring with or without conservative treatment, botulinum toxin injections or strabismus surgery. The aim of this retrospective study was to compare botulinum toxin (BT) injections into the medial rectus to conservative treatment in sixth nerve palsies. The rate of patients improved after intervention and treatment outcomes for the two treatment options were be evaluated at a German tertiary referral center. Methods A service evaluation was conducted on adult patients with sixth nerve palsy. Patient files were reviewed and data including abduction deficit and size of deviation were collected retrospectively. Patients which presented between January 1987 and April 2022 were considered. Patients were allocated into two treatment groups: BT injected into medial rectus or conservative treatment, which included observation, providing occlusion and Fresnel prisms. Inclusion criteria were attendance of two visits with orthoptic assessment. Exclusion criteria included presence of further oculomotor palsies, strabismus, strabismus surgery and suppression. Non-parametric statistical analysis was conducted using IBM® SPSS Statistics. Results A total of 606 adult patients with unilateral or bilateral sixth nerve palsy attended during the named period. A total of 137 adult patients met the inclusion criteria. Of which, 36 had a bilateral palsy, 101 had a unilateral palsy. 45.26% (n = 62) were treated with BT injections and 54.75% (n = 75) were treated conservatively. The median initial abduction deficit was greater in the BT group, (−4 to −5 after Scott and Kraft) than in the conservative treatment group (−1). The initial angle of deviation at distance was significantly larger in the BT group than in the conservative treatment group (p = <0.001). The rate of improvement in the BT group was 24.19% (n = 15) and 20% (n = 15) in the conservative treatment group. When excluding longstanding palsies rates of improvement in both groups increased to 28.85%. The improvement of the angle of deviation at distance in all patients was greater in the BT group (p = <.001). The improvement of abduction in bilateral palsies were greater in the BT group (p = .016), but in unilateral palsies, there was no significant difference in abduction improvement in the two treatment groups (OD p = .3, OS p = .406). Conclusion This service evaluation found that BT injection into medial rectus in unilateral and bilateral sixth nerve palsies did not increase the rate of improvement compared to conservative treatment. But BT injections reduced the angle of deviation to a greater extent than conservative treatment. Additionally, BT was able to improve abduction in bilateral palsies to a greater extent than conservative treatment. It is recommended a BT injection is considered in symptomatic bilateral sixth nerve palsies to enable fixation and improved ocular motility. More research is needed to verify reliable clinical guidelines for the use of BT in sixth nerve palsies.

Does snake-eye appearance affect the clinical outcome of ACDF in treating cervical myelopathy.

To explore the impact of the snake-eye appearance (SEA) on the efficacy of anterior cervical discectomy and fusion (ACDF) in treating Degenerative Cervical Myelopathy (DCM). A total of 316 Patients were divided into three groups, those with SEA were in the SEA group, and those with the absence of SEA were in the non-SEA group. Meanwhile, in the non-SEA group, patients with grade 1 or 2 increased signal intensity (ISI) on T2-weighted MRI were in the ISI group, and the remaining patients without ISI were in the non-ISI group. The modified Japanese Orthopaedic Association scale (mJOA) and the neurologic functional improvement rate (IR) were measured. The number of patients who achieved upper-limb motor weakness improvement was recorded and compared. Propensity score matching (PSM) was used among the three groups. The postoperative JOA and IR were similar in the SEA and non-SEA group; however, they were significantly lower than in the non-ISI group after PSM(P < 0.05). Besides, only 32.1% of patients in the SEA obtained an improvement of upper-limb motor weakness, which was the lowest in three groups after PSM (60.7% in the non-SEA group and 78.6% in the non-ISI group, P < 0.05). We suggested that patients with SEA tend to achieve an inadequate neurological recovery after ACDF. Besides, a SEA may be an unfavorable prognostic factor for upper extremity motor function recovery.

Evaluation of Performance Improvement Rate of Plastic Production System Using ARENA: A Case Study of Phoenix Plastic Services

Production improvement has become essential to all industrial activity because of the fierce competition among today's production systems and organizations and the unquenchable customer demand. The shorter product life cycle has significantly increased the demand for prompt reactions to increase the productivity and efficiency of these industrial systems. This study examined the evaluation of performance improvement rate of plastic production system using ARENA. The report provided by the plastics industry was used in the study to analyze and assess the rate of performance improvement of the plastic manufacturing system. The location of the bottleneck was determined by the research following a thorough analysis of the plastic company's data, which included information on all manufacturing lines and procedures. The research employed Arena to assess and compute the rate of improvement in system performance while accounting for the material transporting process throughout the production line. The conveyor velocity maintains a lock at 75m/min, despite the company's report stating that the transports run at 30m/min. The optimized and unoptimized processes when obtained from a finished recycling process running for 1000 working hours, indicate that the conveyor process had 1045 and 1027 entity input and output, respectively, and the transporter process had 953 and 929 entities input and output respectively. The remaining number left when considering the number that enters the system with the number that leaves the system went to waste, resulting from the sorting and demagnetization process. The introduction of the conveyor brings 10.549% in the production rate and 50% decrease on expenses spent in labor. Through the conveyor system's speed control factor, which is an automated procedure, the system's percentage increment may be further raised. By raising the conveyor system's speed, more items will be produced. Conveyor system installation free up more space for additional production-related equipment, increasing products formed and the company's profit. The cost of purchasing and installing the conveyor will be covered by the excess profit.

Efficacy of Janus Kinase Inhibitors (JAKi) in the treatment of biologic-naive and biologic-experienced patients with ulcerative colitis

Abstract Introduction Janus kinase inhibitors (JAKi) are an orally available treatment for patients with moderately to severe ulcerative colitis (UC). There are currently 3 JAKi for UC: tofacitinib, filgotinib and upadacitinib with variable selectivity to JAK-11. There is limited data comparing the outcomes between biologic-naive and biologic-experienced patients. This study describes the effectiveness of JAKi according to biologic exposure. Aim To investigate the effectiveness of 3 the JAKi’s, tofacitinib, filgotinib and upadacitinib according to biologic exposure. Method We undertook a retrospective study of UC patients treated with JAKi within a tertiary hospital. Clinical endpoints were assessed at week 8-12. Baseline disease activity, previous advanced therapies and use of corticosteroids were documented. Clinical response was defined as reduction in SCCAI score by ≥3 points from baseline or a sustained score of &amp;lt;2.5. Clinical remission was defined as a SCCAI score of &amp;lt; 2.5, and/ or a calprotectin level of &amp;lt;250 mg/g with a CRP of &amp;lt; 5mg/L. Ethical approval has been granted by HRA and Health and Care Research Wales (HCRW) (REC ref: 24/HRA/1198) Results 52 patients were reviewed at week 8-12 following their first dose. 15, 15 and 22 patients were on tofacitinib, filgotinib, and upadacitinib respectively. 3 (20%) of patient in the tofacitinib group were exposed to at least 3 biologics prior to initiating the JAK Inhibitor, followed by upadacitinib which was 3 (14%) of patients. In the tofacitinib group, most patients were exposed to 2 previous biologics (n=7, 47%), whereas majority of patients on filgotinib and upadacitinib had exposure to 1 previous biologic, 7 (47%) and 8 (36%) patients respectively. For the patient group exposed to 3 or more biologics (n=7, 14%), 100% patients on tofacitinib (n=3) and upadacitinib (n=3) achieved clinical remission by week 8-12, whereas none of the patients on filgotinib achieve clinical remission. In biologic naïve patients, filgotinib demonstrated the greatest improvement in calprotectin score with a reduction in 30% from baseline (n=2, 100%). In patients exposed to ≥3 biologics, upadacitinib achieved higher rates of improvement in faecal calprotectin score (n=2, 100%). Conclusion Our observations suggest that patients exposed to at least 3 biologics, tofacitinib and upadacitinib were the most effective, whereas filgotinib seems to be more effective in biologic naïve patients. Our patient cohort is small. We will continue to collect data and undertake further statistical analysis to examine the significance of the observations and factors associated with effectiveness. Reference 1. Goetsch, A et al. Advances in pharmacotherapy for ulcerative colitis: a focus on JAK1 inhibitors. Expert Opinion on Pharmacotherapy, 2023, 24(7), 849–861.

Two types of vidian neurectomy show efficacy in treating allergic rhinitis and vasomotor rhinitis

This study aimed to evaluate the efficacies of endoscopic vidian neurectomy (VN) and highly selective vidian neurectomy (HSVN) for the treatment of allergic rhinitis (AR) and vasomotor rhinitis (VMR). All AR and VMR patients were divided into two groups, Group VN and Group HSVN. The efficacy evaluation methods were visual analog scale (VAS), rhinoconjunctivitis quality of life questionnaire (RQLQ), and medication score. The efficacy evaluations were used to assess patient rhinitis symptoms, quality of life and drug usage. The time points of follow-up period were preoperative, 3 months, 6 months, 1 year, 2 years, and 3 years post operation. By analyzing pre- and postoperative VAS, medication score and RQLQ score, the results showed that rhinitis symptoms and quality of life in both VN and HSVN groups were significantly improved at 3 years, and the rate of improvement decreased gradually with time. Post operation, there were no significant differences in VAS and medication scores between the VN and HSVN groups. With respect to RQLQ, postoperative 2 years and 3 years improvements in sleep disorders, non-nasal symptoms and eye symptoms were significantly greater in the HSVN group than in the VN group. Improvements in rhinitis symptoms and quality of life in AR and VMR were sustained by VN and HSVN until 3 years post operation, with greater quality of life improvements in the HSVN group.

Isotretinoin Combined Laser/Light-Based Treatments Versus Isotretinoin Alone for the Treatment of Acne Vulgaris: A Meta-Analysis.

This study aims to compare the efficacy and safety of oral isotretinoin with and without laser/light-based treatments for acne. This study was conducted under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines; this meta-analysis utilized data from PubMed, EMBASE, ClinicalTrial.gov, and the Cochrane Central Register of Controlled Trials until December 2023. We evaluated clinical improvement, lesion reduction, adverse events, as well as intraoperative and postoperative discomfort rates. Analyses were performed using Review Manager 5.3. This review included six articles with a total of 285 patients. Isotretinoin combined with laser/light therapy outperformed in clinical improvement rates, significantly reducing acne vulgaris and acne scars lesions compared to isotretinoin alone. Additionally, there was no significant difference in the incidence of adverse events between the two groups. The study suggests that combining isotretinoin with laser/light-based therapy for acne yields superior efficacy and satisfaction without increased complications (e.g., dryness, hyperpigmentation, and scarring). However, patients experience notable treatment-related discomfort.

Kết quả điều trị và một số yếu tố liên quan ở người bệnh nhược cơ sau phẫu thuật cắt tuyến ức

Objective: To evaluate the treatment outcomes and associated factors in myasthenia gravis patients after thymectomy. Subjects and Methods: The study included 66 myasthenia gravis patients who underwent thymectomy at the Neurology Center and Thoracic Surgery Department of Bach Mai Hospital from October 2019 to January 2023. Results: The rate of improvement after thymectomy was 77.3%. The long-term stable rate was 33.3%; pharmacologically stable rate was 18.4%; minimal manifestation rate was 25.8%; 10.6% of patients showed no improvement, 7.6% had worsening conditions, and 4.6% of patients died. The average time to improvement was 20.25 months, with a median of 18 months. The likelihood of improvement in patients who underwent surgery within one year of symptom onset was 5.04 times higher than those who had surgery after one year, with p&lt;0.05. Patients without bulbar or respiratory symptoms had a higher likelihood of improvement compared to those with symptoms. Specifically, patients without dysphagia had a significant improvement (p&lt;0.05, OR=9.80, 95%CI: 1.20–80.35), and patients without dyspnea had an OR=5.00 (95%CI: 1.31–19.07), both showing statistically significant relationships with p&lt;0.05. Patients in clinical stages I and IIA (mild stage) had a higher likelihood of improvement compared to those in stage III (p&lt;0.05, OR=14.67, 95%CI: 1.16–185.23; OR=12.67, 95%CI: 1.56–102.30). Patients in the mild clinical stage had a significantly higher likelihood of improvement compared to those in moderate and severe stages (p&lt;0.05, OR=164.50, 95%CI: 152.3–708.50). Conclusion: The majority of patients showed improvement after surgery, with an average improvement time of 20.22 months. Factors associated with improvement after thymectomy included: surgery performed within one year of symptom onset, absence of bulbar and respiratory symptoms, and mild clinical stages (I, IIA).

Efficacy of compound sodium acetate Ringer’s solution in early fluid resuscitation for children with septic shock: a preliminary retrospective cohort study

BackgroundThe effectiveness of acetated Ringer’s solution in pediatric shock has received little attention. This study aimed to assess the clinical outcomes of using compound sodium acetate Ringer’s solution (AR) for fluid resuscitation in children with septic shock.MethodsWe retrospectively analyzed the clinical data of children with septic shock admitted to the pediatric intensive care unit of the Affiliated Hospital of Southwest Medical University from December 2019 to January 2023. Based on the resuscitation fluid administered, the participants were categorized into the compound AR and normal saline (NS) groups. We compared blood circulation conditions, internal environment parameters (arterial blood pH, lactic acid, serum sodium, chloride, calcium, magnesium, potassium, and blood glucose), and 28-day clinical outcomes between the two groups.ResultsThis study included 40 children, with 13 and 27 in the compound AR and NS groups, respectively. The two groups showed no significant differences in sex, age, body weight, body mass index, primary inflammation level, or Pediatric Sequential Organ Failure Assessment on admission. Similarly, no significant difference was observed in resuscitation fluid volume administered during the first hour (compound AR group: 250.00 mL [100.00, 390.00]; NS group: 250.00 mL [100.00, 500.00]). The total amount of crystalloid and colloid fluids administered within 24 h, vasoactive drug use, and blood pressure recovery post-resuscitation did not significantly differ between the groups. However, at 6 h post-resuscitation, the compound AR had considerably lower lactate level than the NS group (1.12 vs. 2.20 mmol/L). There were no significant differences in arterial blood pH, serum sodium, chloride, calcium, magnesium, potassium, and blood glucose levels between the groups. After treatment, in the compound AR group, 3 patients died, 2 improved, and 8 were cured. In the NS group, 7 patients died, 8 improved, and 12 were cured. The 28-day treatment outcomes (mortality rate, improvement rate, cure rate, or side effects) showed no significant differences between the groups.ConclusionsCompound AR was as effective as NS as a resuscitation fluid in pediatric septic shock, demonstrating similar intravascular volume restoration and hemodynamic stability maintenance. However, it caused a faster decline in arterial lactate levels without obvious side effects.