Short Treatment Research Articles

Discontinuation of Antidepressants and the Risk of Medication Resumption among Community-Dwelling Older Adults with Depression in the US.

Antidepressants are among the most prescribed drugs in the US, but the current treatment patterns and modalities among older adults are unclear. This study assessed the patterns of discontinuation of antidepressants and the risk of medication resumption among community-dwelling older adults with depression. Using Medicare Current Beneficiary Survey (MCBS) data from 2015-2019, we identified 1084 beneficiaries with depression who newly initiated serotonergic antidepressants. The risk of medication resumption was explored using survival analysis. The median duration of continuous medication was 90 days. However, about 30% of patients had a treatment duration of 30 days or shorter, 26% for 31-90 days, 15% for 91-180 days, and 30% for 181 days or more. After adjusting for all covariates, patients with less than 30 days of continuous medication were half as likely to resume the medications compared to those with 91-180 days (HR: 0.49 (95% CI: 0.37, 0.65)). Nearly one-third of older adults used an antidepressant medication for a short duration with a lower risk of medication resumption. A shorter treatment duration without resumption might suggest over-prescription of antidepressants among community-dwelling older adults.

Comparative analyses of short- and long-term outcomes between endoscopic submucosal dissection and endoscopic laryngo-pharyngeal surgery for superficial pharyngeal carcinomas.

Endoscopic treatment of superficial pharyngeal carcinomas includes endoscopic submucosal dissection (ESD; usually performed by endoscopists), and endoscopic laryngo-pharyngeal surgery (ELPS; primarily performed by otolaryngologists). Few studies have compared the efficacy of the two techniques in treating superficial pharyngeal carcinomas. In this study, we compared the outcomes of these two techniques to determine the advantages. We retrospectively examined the short- and long-term outcomes of 93 consecutive patients with superficial pharyngeal carcinoma who either underwent an ESD or ELPS between August 2008 and December 2021. There were 35 lesions among 29 patients and 93 lesions among 71 patients in the ESD and ELPS groups, respectively. The ELPS group had a significantly shorter procedure time (121.2 ± 97.4 min vs. 54.7 ± 40.2 min, p<0.01), greater procedure speed (0.10 ± 0.06 min/min vs. 0.30 ± 0.23 min/min, p<0.01), and less laryngeal edema than that of the ESD group. There were no significant differences in the 3-year overall, relapse-free, or disease-specific survival rates between the two groups. Intervention with ESD during ELPS was most commonly required when it was difficult to secure the visual field. There were no differences in batch resection rates or long-term prognoses between the two groups; nevertheless, the ELPS group had a shorter treatment time and less laryngeal edema than the ESD group. However, the treatment of narrow areas, such as the esophageal inlet patch, is a technical limitation of ELPS; thus, ELPS should be combined with ESD techniques.

A meta-analysis of randomized controlled studies examining the effects of sodium-glucose co-transporter-2 inhibitors on peripheral artery disease and risk of amputations.

Sodium-glucose co-transporter-2 inhibitors (SGLT-2is) are used to maintain glycaemic control as well as for their beneficial cardiovascular and renal effects in diabetes patients. However, increased risk of amputation and peripheral artery disease (PAD) have been observed with the use of some SGLT-2is. A meta-analysis was conducted to understand the effect of SGLT-2is on amputation and PAD events using data from randomized controlled trials (RCT). A systematic literature review was conducted using Medline and Central databases for RCTs that involved the administration of SGLT-2is versus placebo/active comparators to diabetic patients. The primary outcome was amputation events and PAD. A random-effects model was used to calculate the pooled odds ratio, and subgroup analyses was performed. A total of 51 RCTs were included in the meta-analysis with data from 97 589 patients. Meta-analysis of the data showed that there was a significant increase in PAD risk (p = 0.04) but no significant increase in amputation risk with SGLT-2i use versus placebo/active comparators (p = 0.43). Subgroup analyses demonstrated no significant difference between SGLT-2i type, duration of treatment or patient risk factors on amputation or PAD incidence. However, length of drug treatment (> 100 weeks) was associated with a significant increase in both PAD and amputation risks in the SGLT-2i treatment groups. The results of the meta-analysis showed no significant association between SGLT-2i use and PAD and amputation risks in diabetic patients when used for shorter treatment durations.

Evaluating Antibiotic Misuse and Cost Analysis Among Hospitalized Dengue Virus-Infected Adults: Insights From a Retrospective Cohort Study.

Dengue is a prevalent cause of acute febrile illness, predominantly in Asia, where it necessitates supportive care without the need for antibiotics. This study aimed to evaluate antibiotic usage and analyze hospitalization costs among adults infected with the dengue virus. This retrospective cohort study was conducted at the Hospital for Tropical Diseases, Thailand, in 2022. Two independent reviewers assessed all adult cases with confirmed dengue from 2016 to 2021. Determinants of inappropriateness were analyzed using Poisson regression. The study included 249 participants with over half presenting with severe dengue or dengue with warning signs upon admission. The cumulative incidence of antibiotic use was 9.3% (95% CI, 8.23-10.47), predominantly involving empirical treatment strategies. Ceftriaxone and doxycycline were the most frequently prescribed antibiotics. Notably, patients who received empirical antibiotics showed no definite or presumed bacterial infections. Among those who received definite strategies, inappropriate durations, including both short treatments and the overuse of broad-spectrum antibiotics, were observed. A private ward admission was identified as a significant predictor of inappropriate use, with an incidence rate ratio of 4.15 (95% CI, 1.16-14.82) compared with intensive care unit admission. Direct medical costs did not differ significantly between appropriate and inappropriate uses. The incidence of antibiotic use among dengue cases was moderate; however, inappropriate use by indication was observed. Antimicrobial stewardship strategies should be encouraged, particularly in patients with dengue with warning signs admitted to a general or private ward. Direct medical costs between appropriate and inappropriate use were comparable.

Effect of Extracorporeal Shock Wave on IGF-1, TNF-α, and IL-1in Joint Fluid of Patients with Temporomandibular Joint Disorder Syndrome.

As a new therapeutic method, extracorporeal shock wave (ESW) has shown remarkable efficacy in the treatment of temporomandibular joint disorder syndrome. Numerous studies have shown that it has the advantages of noninvasiveness, short treatment time, etc. It can effectively relieve pain and improve symptoms such as joint mobility and opening degree. In clinical practice, through accurate diagnosis and positioning of different patients, appropriate treatment parameters such as therapeutic transducer, frequency and pressure can be selected to significantly improve the efficacy. At the same time, follow-up evaluation after treatment, including temporomandibular joint disorder index and visual analogue score, is also helpful to fully understand the rehabilitation of patients. Extracorporeal shock wave therapy (ESWT) brings new hope to patients with temporomandibular joint disorder syndrome and has a broad application prospect.

ThP2.15 - Investigating the use of autologous stem cell therapy in the treatment of Androgenetic Alopecia

Abstract Background and Introduction Androgenetic alopecia (AGA) is the commonest form of alopecia and is characterised by progressive degeneration of hair follicles and programmed cell death, impacting individuals of both genders. This affects 80% of individuals in the Caucasian population and causes impairment of quality of life. The cause of AGA is complex and involves androgens, genetics, and hormonal miniaturisation. Dihydrotestosterone (DHT) is the primary androgen responsible for activating pathogenic pathways, resulting in the shortening of terminal follicles. Existing treatment methods are currently limited, and the development of a therapeutic approach that overcomes these limits might be of importance in plastic surgery. Method A comprehensive search is conducted on databases including Pubmed, Medline, Ovid, and Embase. Research studies are extracted and analysed using the PRISMA table. Results The bulge region serves as a vital reservoir of epidermal and melanocytic stem cells. The use of Rigenera® and autologous stem cell therapy has the capability to collect and separate these stem cells (SCs), leading to a 29% ± 5% augmentation in hair density over a span of 6 months. Additional types of multipotent stem cells, such as those found in adipose tissue, bone marrow, and human umbilical cord blood, might potentially be suitable for the purpose of hair regeneration. Possible advantages include a reduced number of biopsies, a shorter treatment duration, and not being limited by the number of donor follicles compared to surgical intervention. Conclusion Autologous stem cell therapy demonstrates potential effectiveness and warrants additional investigation to enhance the therapeutic efficacy of AGA.

The effect of different power radiofrequency ablations in treatment and postoperative pain in patients with atrial fibrillation: a retrospective study

BackgroundThere has been no consensus on what power of radiofrequency energy can be used to produce the best surgical results in patients with atrial fibrillation. In addition, patients undergoing local anesthesia and fentanyl analgesia may experience pain when radiofrequency ablation is performed. This study investigated the effect of different power radiofrequency ablations in treatment and postoperative pain in patients with atrial fibrillation.MethodsA retrospective study was performed with 60 patients who underwent radiofrequency ablation for atrial fibrillation between January and June 2023. Patients were divided into 2 groups according to the power of the radiofrequency ablation catheter used, with 30 patients in the conventional power group (35 W) and 30 patients in the high-power group (50 W). The cardiac electrophysiological indexes and postoperative pain of the 2 groups were compared.ResultsMost of the procedural key parameters between the 2 groups had no significant differences. However, the total application time during radiofrequency ablation and pulmonary vein isolation time in the high-power group were significantly shorter than those in the conventional power group (p < 0.001). Patients in the high-power group reported significantly less pain than those in the conventional power group in the immediate postoperative period and the late postoperative period (p < 0.001).ConclusionsHigh-power radiofrequency ablation showed a shorter treatment time, and could reduce postoperative pain compared to conventional power ablation.

Have orthodontists changed their retention and follow-up protocols due to contemporary orthodontics? An online survey.

With advancements in orthodontic technology, treatment durations have shortened, often concluding at earlier ages. This shift prompts scrutiny of contemporary retention and post-treatment protocols. The study aimed to assess current professional preferences, compare them against patient age and treatment duration, and investigate the potential impacts of reduced treatment times on professional protocols, particularly when treatment concludes before pubertal growth. A questionnaire comprising 12 multiple-choice questions focused on active treatment and retention phases was developed using an online survey platform. It was distributed to licensed orthodontists engaged in patient treatment. Bivariate analysis was conducted using ANOVA and the Kruskal-Wallis test, with pairwise comparisons facilitated by the Dwass-Steel-Critchlow-Fligner method. Of 743 respondents, representing a 32% response rate, approximately 70% reported initiating treatment with fixed appliances in pre-pubertal patients. The most prevalent treatment combination involved commencing treatment during early permanent dentition and lasting between 12 to 24 months, resulting in treatment completion before full growth maturation. No discernible individualization was observed in retention protocols or post-retention follow-ups. Traditional retainer prescription post-orthodontic therapy was unanimous among respondents. Notably, experienced orthodontists tended to prefer regular patient visits for follow-up, while less experienced counterparts discharged patients after 12 months. Contemporary orthodontic treatments are characterized by shorter durations, yet orthodontists have not adopted retention and post-treatment follow-up practices accordingly. There is a pressing need for evidence-based guidelines to develop protocols tailored to the shorter treatment durations and the increasing prevalence of younger patients completing treatment.

Pharmacoeconomic evaluation of treatments for Poly Cystic Ovarian Syndrome (PCOS)

BackgroundTreatment cost and high prevalence of Poly Cystic Ovarian Syndrome (PCOS) is a very challenging issue globally. Due to this reason; current study was conducted to determine pharmaco-economy of conventional and non-conventional treatments for the management of PCOS.MethodsProspective Cross-Sectional study was conducted in the metropolitan city of Karachi from January – December 2019. Primary data of 200 PCOS patients were collected from different hospitals and clinics. An instrument was used to collect data pertaining to the direct and indirect cost associated with the disease management. Collected data was analyzed by the tools for cost analysis and software called Statistical Package of Social Sciences (SPSS) – 22.ResultsIn Cost Minimization Analysis (CMA); Allopathic treatment [Mean cost/month: PKR:4479.32 ± 350.95 (USD:27.46 ± 2.15)], Herbal treatment [Mean cost/month: PKR:1527.78 ± 78.15 (USD:9.37 ± 0.48)], Combination treatment [Mean cost/month: PKR:2803.09 ± 654.22 (USD:17.18 ± 4.01)], and Homoeopathic treatment [Mean cost/month: PKR:976.95 ± 46.19 (USD:5.99 ± 0.28)]. Incremental cost/month for Allopathic treatment is 358%, Herbal treatment is 56%, Combination treatment is 187%. In Cost Effectiveness Analysis (CEA); Allopathic treatment (Incremental cost-effectiveness ratio/month: 1334.24), Herbal treatment (Incremental cost-effectiveness ratio/month: 936.41), Combination treatment (Incremental cost-effectiveness ratio/month: 1017.09). Due to lowest cost of Homeopathic treatment, cost of Homeopathic treatment was considered as a threshold value. In-direct cost/month of Allopathic treatment is PKR:593.33 ± 24.00 (USD:3.64 ± 0.15), Herbal treatment is PKR:307.84 ± 26.69 (USD:1.89 ± 0.16), Combination treatment is PKR:409.09 ± 45.63 (USD:2.51 ± 0.28) and Homoeopathic treatment is PKR:300.00 ± 26.39 (USD:1.84 ± 0.16).ConclusionThe most cost-effective is treatment is Homeopathic; Herbal treatment is second most cost-effective option for the treatment of PCOS. Lowest direct and indirect costs and short treatment duration collaboratively lessen the %incremental cost per year and incremental cost effectiveness ratio per year.

Effectiveness of short treatment duration for carbapenemase-producing Enterobacterales in bloodstream-infections: A retrospective cohort study

ObjectiveWe analyse the effectiveness of short courses of adequate treatment in patients with episodes of carbapenemase-producing Enterobacterales bloodstream-infections (CPE-BSI). MethodsPatients with first monomicrobial CPE-BSI episodes who received ≥72 h of appropriate treatment from 2014–2022 were selected. Detection of CPE was established on the basis of phenotypic antibiogram and confirmation by PCR and/or immunochromatographic methods. Patients were classified in short treatment group (STG) those who received 3–10 days of appropriate treatment, and long treatment (LTG) those receiving >10 days. Unfavourable outcome consisted in a composite of global 30-day mortality and/or persistent bacteremia and/or recurrent bacteremia. Inverse probability of treatment weighting (IPTW) analysis was performed to compare the outcome between the two study groups. ResultsWe included 105 CPE-BSI episodes: 99 were caused by OXA-48-like, 4 VIM and 2 KPC carbapenemases. Thirty-nine patients (37.1%) were included in the STG and 66 (62.9%) in LTG. The STG group presented frequent treatment with ceftazidime-avibactam (43.6% vs. 24.2%, P = 0.03) and lower in-hospital stay (21 days vs. 32 days, P = 0.02). Overall, 28 patients (26.7%) presented unfavourable outcome: IPTW analysis showed no differences in the outcome between STG to LTG groups (24.2% vs. 30.8%, weighted-risk difference 6.6%, P = 0.44). Patients with unfavourable outcome presented more frequently source other than urinary-biliary (46.4% vs. 23.4%, P = 0.02), received less frequently ceftazidime-avibactam (14.3% vs. 37.7%, P = 0.02) and presented frequently with absence of source control when indicated (28.6% vs. 13.0%, P = 0.06). ConclusionsShort treatment durations for CPE-BSI episodes may be effective, as long as they are appropriate and source control is performed.

Subcutaneous Immunotherapy of Food Allergy.

While there are compelling arguments for developing subcutaneous allergen-specific immunotherapy for alleviation of food allergies, there is a limited number of studies in the public domain. The review seeks to present the approaches taken, to explain the paucity of studies, and to identify new roads for development. A literature search revealed clinical trials of immunotherapy of food allergies to fish and peanut, but studies had limited patient numbers, short treatment courses and follow-up periods. Indications, but no clearcut effects, were seen with both classical allergen extracts and hypo-allergenic preparations. A special case is the influence on cross-reactive food allergies, when subcutaneously administered birch-pollen extracts are used for treatment of birch pollen hayfever and/or asthma. Again indications, but no convincing efficacy has been registered. Newer developments include recombinant hypoallergens and DNA-technologies. Subcutaneous immunotherapy for food allergies has not matured to provide clinically relevant treatment opportunities.

Effect of prolactin concentration during the dry period on the subsequent milk production of dairy cows

Shortening the dry period has a negative impact on milk production of the following lactation. One possible explanation is that a period of low prolactin (PRL) concentration is necessary to restore mammary gland milk production capacity. Therefore, the objective of this study was to determine the effect of lowering blood PRL level on subsequent lactation milk production. In this experiment, quinagolide was used to inhibit PRL secretion during the dry period. Thirty Holstein cows were randomly assigned one of 3 dry period managements: a conventional (60 d) dry period (CD) and 2 short (35 d) dry period treatments (SD). Short dry period cows received either water (SDwater) or quinagolide (2 mg, SDquin) injections twice daily from dry-off until 14 d before calving. Cows were followed during the first 20 wks of the subsequent lactation. When CD cows were dry but SD cows were lactating, concentration of PRL was lower in the CD cows than in the SD cows. During the injection period, PRL of SDquin cows was lower than that of the other treatments and was greater in the blood of SDwater than in that of CD cows. After the injection period until calving, no difference in PRL concentration was observed between treatments. After calving, PRL concentration of the SDquin cows was greater than those of CD and SDwater cows. During the first 20 wks of lactation, energy corrected milk (ECM) was lower in SDwater cows than in CD and SDquin cows. The ECM of the latter groups were not different. During the same period, mammary expression of genes related to milk synthesis, pro-apoptotic genes, as well as the expression of the short and long isoforms of the PRLR genes were not affected; however, the expression of SOCS3 gene tended to be lower for the SDquin than the SDwater cows. Lowering the PRL level during short dry period restored milk production to the level normally observed after a conventional dry period, which suggests that higher PRL levels during short dry period are the cause of the lower milk production after a short dry period. Ultimately, strategies to lower blood PRL level may help the adoption of short dry period.

Algorithm-based Management of Infantile Hemangiomas: Reducing Sequelae and Surgical Interventions

Background: In Japan, oral propranolol (PPL) and pulsed dye laser are available for infantile hemangioma (IH) treatment without patient cost-sharing. However, no standardized algorithm exists to guide treatment selection that balances efficacy, potential side effects, and aesthetic risks. This study presents a comprehensive approach utilizing a treatment algorithm and aesthetic risk scoring system. Methods: This retrospective study analyzed outcomes from 156 patients with IHs. Oral PPL was used in IH patients with functional issues, whereas the rest underwent an aesthetic risk assessment that categorized them into low-, moderate-, or high-risk groups to guide treatment choices. Final treatment decisions depended on parental preference. The outcomes of algorithm-compliant and noncompliant patients were compared statistically. Results: The risk score's interrater reliability was 0.973 (95% confidence interval 0.933–0.992), with a mean intrarater reliability of 0.968 ± 0.027 and a mean evaluation time of 14.1 ± 5.0 seconds per case. Among the 156 patients, 88% pursued the algorithm-recommended treatment, whereas 12% opted for different approaches. Algorithm-compliant patients experienced significantly fewer sequelae than did noncompliant patients (5% versus 33%, P &lt; 0.001). Compared with noncompliant patients, algorithm-compliant patients tended to require shorter treatment durations (17.9 versus 25.4 mo, P = 0.08) and fewer laser sessions (5.8 versus 7.2, P = 0.30), with a younger age at resolution (21.3 versus 29.0 mo, P = 0.08). Conclusions: Aesthetic concerns can be crucial for patients with IHs. This study introduces a comprehensive IH management algorithm to reduce the sequelae requiring surgical interventions and improve patients’ quality of life.

Financial Improvements From Short Course Adjuvant Vaginal Cuff Brachytherapy in Early Endometrial Cancer Compared With Standard of Care, “SAVE” Trial

Early-stage endometrial cancer is often treated with hysterectomy followed by adjuvant vaginal cuff brachytherapy (VCB). Financial toxicity from cancer treatment can impact treatment completion. The Short Course Adjuvant Vaginal Cuff Brachytherapy in Early Endometrial Cancer Compared to Standard of Care trial is a multicenter, prospective randomized trial of standard of care (SoC) VCB doses delivered in 3 to 5 fractions per the physician's discretion compared with a 2-fraction course. We report on secondary cost endpoints, quantifying the financial impacts of shorter treatment courses on institutions and participating patients. Technical (TechCs), professional, and total charges (TotCs) were collected prospectively and are reported as raw and Medicare-adjusted charges per patient. Distance to the treatment center and the median income for each patient's zip code were estimated. The Mann-Whitney U statistic, t test, and X2 test were used to compare characteristics between the 2 groups. One hundred eight patients were analyzed. SoC VCB was delivered in 3, 4, and 5 fractions for 27 of 54 patients (50%), 11 of 54 (20%), and 16 of 54 (30%), respectively. The median total distance traveled per patient for SoC versus experimental arms was 213 versus 137 miles (p = .12), and the median cost of commute for patients was $36.3 versus $18.0 (p = .11). Compared with 2-fraction treatment, 5-fraction treatment resulted in longer travel distances (median, 462 vs 137 miles; p < .01) and increased travel costs (median, $59.3 vs $18.0; p ≤ .01). Unadjusted raw professional charges in USD per patient did not differ between SoC versus experimental arms ($9159 vs $7532; p = .19). TechCs were significantly higher in the SoC arm ($35,734 vs $24,696; p ≤ .01), as were TotCs ($44,892 vs $32,228; p < .01;). Medicare-adjusted TechCs and TotCs were higher for the SoC arm. Two-fraction VCB resulted in fewer treatments per patient, reduced cost of travel compared with longer courses, and an adjusted reduction in health care expenditures compared with SoC.

Combination Therapy for Post-Kala-Azar Dermal Leishmaniasis: A Literature Review of Current Evidence

Abstract Post-kala-azar dermal leishmaniasis (PKDL) is a neglected skin disease that has tremendous epidemiological significance as a reservoir of Leishmania parasites. Relapse, drug resistance, non-compliance to prolonged treatment, poor health-seeking behaviour, along with limited therapeutic options pose a significant impact on the management of PKDL. In this study, we aimed to review the efficacy, safety and tolerability data of combination therapies for PKDL in the published literature. We have also described patients’ compliance with treatment and associated co-infections in PKDL. A comprehensive literature search was conducted in PubMed, Scopus and Google Scholar to identify the relevant articles. A total of nine studies were eligible for inclusion in this review. Drug combinations used in India were miltefosine-liposomal amphotericin-B, miltefosine-paromomycin, miltefosine-amphotericin-B, sodium stibogluconate (SSG)-immunotherapy and SSG-rifampicin. However, in Sudan, except one, all studies have used SSG-based combinations viz. SSG-rifampicin, SSG-paromomycin and SSG-immunotherapy. The efficacy and safety of miltefosine in combination with liposomal amphotericin-B as well as conventional amphotericin-B were found to be excellent in a limited number of patients. These combinations are said to have better patient compliance and shorter treatment duration. Another combination of miltefosine and paromomycin was found to be satisfactory with a final cure rate of 83.3%. SSG in combination with paromomycin had a good clinical outcome among severe PKDL patients in Sudan, though pain at the injection site was experienced by all patients. There is a lack of data on combination therapies for PKDL through large-scale randomised controlled trials (RCTs). Therefore, multicentric randomized controlled trials with a sufficiently large sample size are urgently needed to verify the efficacy, safety, and other advantages of combination therapies for PKDL. With the availability of liposomal amphotericin-B, miltefosine and immunotherapy, clinical management of PKDL appears promising.

Retrospective cohort study of video-assisted thoracoscopic precise positioning reduction and internal fixation and thoracotomy reduction and internal fixation in treating multiple rib fractures.

This study aimed to assess the clinical effect of video-assisted thoracoscopic precise positioning reduction and internal fixation and thoracotomy reduction and internal fixation in the therapy of multiple rib fractures. A total of 80 patients with multiple rib fractures in First People's Hospital of Jingzhou from January 2021 to December 2022 were separated into control group (CG, 40 cases) and research group (RG, 40 cases) by random number table method. Patients in the CG received thoracotomy reduction and internal fixation. Patients in the RG received video-assisted thoracoscopic precise positioning reduction and internal fixation. Surgery-related indexes, serum interleukin, visual analogue scale (VAS) was used to evaluate postoperative pain, arterial oxygen saturation (SaO2) and oxygenation index (PaO2/FiO2), and pulmonary function indexes were measured in the two groups. After surgery, Visual analog scale (VAS) scores at 24 hour after surgery were reduced compared to six hour and 12 hour after surgery (P<0.05). VAS score at 12 hour after surgery was increased relative to 6 h after surgery (P<0.05), and VAS score at six hour, 12 hour as well as 24 hour after surgery in the RG was lessened in comparison with the CG (P<0.05). One day after surgery, SaO2 and PaO2/FiO2 in two groups were elevated compared to before surgery, and those in RG was increased in contrast to the CG (P<0.05). forced expiratory volume (FEV1), forced vital capacity (FVC), peak expiratory flow velocity (PEF) along with FEV1/FVC levels in two groups were increased (P<0.05). Compared with thoracotomy reduction and internal fixation, video-assisted thoracoscopic accurate positioning and internal fixation in treating patients with multiple rib fractures had a short treatment time, obvious advantages, and strong feasibility.

Evaluation of effects of different sizes and shapes of attachments during rotation, tipping, and torquing in clear aligner therapy - A finite element study.

To evaluate the effect of different shapes and sizes of attachments used for rotation, tipping, and torquing tooth movement in clear aligner therapy. Using computer-aided design/computer-aided manufacturing technology, 15 replicas of the upper right human canines were produced. Finite element analysis (FEA) was utilized to mimic tooth movement by applying a constant force of 2.942 N to these models, which contained various forms and sizes of composite attachments. Analysis was done on the stress on different dental structures and the displacement of the attachments. The outcomes demonstrated that tooth movement during clear aligner treatment was considerably impacted by attachment size and shape. Rectangular beveled attachments with dimensions of 3.5 mm × 1.2 mm × 3.5 mm showed the greatest rotating mobility. Triangular beveled attachments with dimensions of 5 mm by 0.8 mm by 2 mm produced the most displacement during tipping motion. For torquing motions, rectangular power ridge attachments with dimensions of 0.5 mm × 0.5 mm × 5 mm worked well. The size and geometry of composite attachments were shown to be extremely important in regulating tooth movement during clear aligner treatment, according to this FEA research. Greater displacement is produced when smaller attachments with less surface area dissipate more force. When using clear aligner therapy, orthodontists may optimize treatment plans, shorten treatment times, and provide more predictable results by having a better understanding of the biomechanics of various attachment designs.

Is Bevacizumab a Cost-Effective Regimen for Treating Cerebral Radiation Necrosis in the United States?

BackgroundBevacizumab has been demonstrated to have superior efficacy in the treatment of cerebral radiation necrosis (CRN), but its high cost may exacerbate the disease burden. This study aimed to assess the cost-effectiveness of bevacizumab in comparison to corticosteroids for treating CRN from the US payers’ perspective. MethodsDecision tree models were constructed to simulate the process of bevacizumab and corticosteroids in CRN short-term and long-term therapy. Critical clinical data were derived from the NCT01621880 trial. Costs and utility values were obtained from the US official websites and published literature. The main outcomes were total costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were performed to assess the robustness of the models. ResultsIn the short-term and long-term models, bevacizumab added 0.11 (0.46 vs 0.35) and 0.16 (0.54 vs 0.38) QALYs compared with corticosteroids therapy, with corresponding incremental costs of $12,351 and $23,253, respectively. The resultant ICERs were $112,987/QALY and $150,245/QALY for short-term and long-term treatment, respectively. The one-way sensitivity analysis indicated that utility value of nonrecurrence status, body weight, and bevacizumab price per cycle were the most influential factors for ICER of both models. At the willingness-to-pay threshold of $150,000/QALY in the United States, the probabilities of bevacizumab being cost-effective for CRN short and long-term treatment were 63.9% and 49%, respectively. ConclusionsCompared with corticosteroids, bevacizumab is an economical alternative for CRN short-term treatment from the US payers’ perspective, whereas long-term therapy draws an opposite conclusion.

Regeneration of Antifog Performance of Laser-Induced Copper-Based Micro-Nano Structured Surfaces by Rapid Thermal Treatment.

In this investigation, the laser marker ablation technique was employed on Cu-coated glass to fabricate micro-nanostructured antifog glass. The resulting surfaces exhibited a quasi-periodic micron hillock-hollow structure with dispersed nanoparticles distributed throughout, which played a role in the antifog property and superhydrophilicity. However, airborne organic pollutant deposition degraded the superhydrophilicity of ablated glass surfaces and, therefore, their antifog performance, which cannot be circumvented. Conventionally, furnace annealing for at least 1 h was used to decompose the organic pollutants and restore the superhydrophilicity, limiting the throughput and application scenario. Remarkably, the rapid regeneration of this property was achieved through either a 5 min rapid thermal treatment at 400 °C or a 1 s flame treatment. These are interventions that are hitherto unreported. Such short and simple treatment methods underscore the potential of laser-ablated glass for diverse practical applications.

Effects of cold atmospheric plasma‐treated medium on HaCaT and HUVEC cells in vitro

AbstractCold atmospheric plasma (CAP) is an emerging technology that can generate various reactive oxygen and nitrogen species (RONS) at room temperature and shows promising applications for skin wound healing. The effects of plasma‐treated medium (PTM) promoting cell proliferation have been verified, but the biological mechanisms involved are not well known. This study aims to assess the proliferation effect and mechanism induced by PTM on human keratinocyte cells (HaCaT) and human umbilical vein endothelial cells (HUVEC) in vitro. The results showed that the concentrations of H2O2 and NO2− inside PTM increased in a time‐dependent manner as the atmospheric pressure plasma jet (APPJ) treatment time was prolonged. The biological outcomes were determined by cell counting kit, wound healing assay, flow cytometry, enzyme‐linked immunosorbent assay (ELISA), and western blot analysis. The cell viability and motility assays indicated that appropriate plasma conditions of short treatment time (15s‐, 30s‐ and 45s‐PTM) could promote cell proliferation, while long treatment time would inhibit cell proliferation (60s‐PTM). With an appropriate time of PTM treatment, the secretion of vascular endothelial growth factor‐α (VEGF‐α) and transforming growth factor alpha (TGF‐α) was promoted and the extracellular signal‐regulated kinase/serine‐threonine protein kinase pathways were activated, which induced HaCaT and HUVEC cell proliferation eventually. These behaviors of cells were mainly related to the enhancement of intracellular reactive oxygen species levels. These findings established a theoretical foundation for potential clinical applications of PTM in wound healing.