Study Group Research Articles

Effect of rapid rehabilitation surgical nursing on patients' gastrointestinal function recovery and sleep quality after laparoscopic appendectomy

BACKGROUND Appendicitis is a common acute abdominal pain disorder. Laparoscopic appendectomy, a commonly used modality, is associated with less trauma and faster recovery than traditional open appendectomy. However, postoperative recovery remains an important issue that affects rehabilitation quality and surgical results. AIM To explore the effects of rapid rehabilitation and surgical nursing care on gastrointestinal function recovery and sleep quality among patients undergoing laparoscopic appendectomy. METHODS A total of 120 patients who underwent laparoscopic appendectomy at our hospital between January 2019 and March 2024 and for whom complete clinical data were available were selected. Patients were randomly assigned to two groups (n = 60 each) using the random number table method. The control group received routine nursing care, while the experimental group received rapid rehabilitation surgical nursing care; all patients continued to receive nursing care until discharge. The recovery of gastrointestinal function, length of hospital stay, complications, Pittsburgh sleep quality index, and nursing satisfaction were compared between groups. RESULTS Following the implementation of effective nursing measures, the times to bowel sound recovery, first exhaust, first defecation, and first feeding were notably shorter in the study vs control group (P < 0.05). Additionally, the duration of the first postoperative activity and the length of hospital stay were significantly shorter in the study vs control group (P < 0.05). Furthermore, the study group exhibited better sleep quality than the control group (P < 0.05). The postoperative complication rate was significantly lower and the nursing satisfaction rate significantly higher in the study vs control group (P < 0.05). CONCLUSION Rapid rehabilitation surgical nursing interventions provided to patients after laparoscopic appendectomy can accelerate their postoperative recovery, reduce the occurrence of complications, and improve their sleep quality and nursing satisfaction.

Abstract 4686: Efficacy and safety of efbemalenograstim alfa as primary prophylaxisfor concurrent chemo-radiotherapy induced neutropenia

Background: Concurrent chemo-radiotherapy (CCRT) occupies a pivotal position in the therapeutic management of various malignant tumors and frequently causes significant hematologic toxicity, particularly leukopenia and neutropenia. Nonetheless, granulocyte-macrophage colony-stimulating factor (GM-CSF) is not recommended for preventing CCRT, while granulocyte colony-stimulating factor (G-CSF) is seldom investigated in this setting. This study aims to evaluate the effectiveness and safety of efbemalenograstim alfa, a novel long-acting G-CSF, as a primary prophylaxis during CCRT. Method: This multicenter, open-label, randomized controlled trial will enroll 120 patients who are scheduled to undergo definitive CCRT for malignancies, including non-small cell lung cancer, small cell lung cancer, esophageal cancer, nasopharyngeal carcinoma, head and neck squamous cell carcinoma, or cervical cancer. Patients will be randomized 1:1 to study group or control group. In the study group, patients will receive efbemalenograstim alfa approximately 48 hours post-chemotherapy. In the control group, patients will receive rhG-CSF upon an absolute neutrophil count (ANC) drop below 1.0 × 109/L. Patients who developed febrile neutropenia (FN) or dose-limiting neutropenic event in the control group will receive efbemalenograstim alfa in the subsequent chemotherapy cycles. The primary endpoint is the incidence of 3/4 grade neutropenia (ANC < 1.0 × 109/L) throughout the CCRT period. Result: Efbemalenograstim alfa administration significantly reduced the incidence of grade 3/4 neutropenia during the CCRT period. Four patients (12.90%) in the efbemalenograstim alfa group experienced grade 3/4 neutropenia, compared to 14 (45.16%) in the control group, resulting in a difference of -32.26% (90% CI: -49.20%, -13.66%, p= 0.0035). The incidence of grade 3/4 neutropenia was 9.68% (study group) vs 45.16% (control group) (p=0.0009) across first chemotherapy cycle, and 3.23% (study group) vs 16.13% (control group) (p=0.0881) across second cycle. Efbemalenograstim alfa administration also resulted in shorter duration of grade 3/4 neutropenia, with a median duration of 0 day (IQR: 0-0) in study group and 0 day (IQR: 0-5) in control group (p=0.008). The depth of ANC nadir is higher in study group than that in control group (3.19 (0.26-8.45) × 109/L vs 1.00 (0.06-4.43) × 109/L, p < 0.001), the mean difference was 2.10 (1.39, 2.71) × 109/L. Efbemalenograstim alfa was well-tolerated, as no≥3 grade treatment-related adverse event (TRAE) was reported in both group. The most common treatment-emergent AEs in study group included thrombocytopenia (48.39%), anemia (45.16%) and hypokalemia (35.48%). Conclusion: Primary prophylaxis with efbemalenograstim alfa provide effective neutrophil support to patients undergoing CCRT, with good safety. Citation Format: Yuanyuan Chen, Qiwen Li, Zunbei Wen, Yi Ouyang, Shuzhen Lai, Rong Huang, Minying Li, Xuefang Zhang, Yongling Ji, Chen Wang, Ming Chen. Efficacy and safety of efbemalenograstim alfa as primary prophylaxisfor concurrent chemo-radiotherapy induced neutropenia [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4686.

Early Nutritional Intervention in Patients with Non-Small Cell Lung Cancer Receiving Concurrent Chemoradiotherapy: A Phase II Prospective Study

Aims: This phase II study aimed to evaluate the impact of early nutritional intervention on the nutritional status and survival of locally advanced non-small cell lung cancer (LANSCLC) patients undergoing concurrent chemoradiotherapy (CCRT). Methods: LANSCLC patients treated with CCRT were enrolled in the study group and received early nutritional intervention, including individualized nutrition counseling and oral nutritional supplements, from the initiation of CCRT to 2 weeks after its completion. The primary endpoint was the incidence of weight loss ≥5% during the CCRT. For comparison with the study group, a matched control group was retrieved from previous trials by the 1:1 propensity score matching method. Results: Sixty-seven patients were enrolled in the study group with a median follow-up of 52.4 months. Compared with the control group, the study group exhibited a lower incidence of weight loss ≥5% (p = 0.032), higher body mass index (p = 0.034) and prealbumin levels (p = 0.014) at the end of CCRT, as well as lower patient-generated subjective global assessments scores at the end of CCRT (p < 0.001) and 6 months after CCRT (p = 0.007). The study group also had a lower incidence of grade 2+ radiation pneumonitis (p = 0.023) and longer progression-free survival (13.5 vs. 11.3 months, p = 0.032). Patients who responded well to oral nutritional supplements had a higher Firmicutes/Bacteroidetes ratio at baseline (p = 0.036). Conclusions: Early nutritional intervention in LANSCLC patients undergoing CCRT improved nutritional status and reduced radiation pneumonitis. Gut microbiota was associated with the response to oral nutritional supplements.

Study Protocol: Association of Platelet-Rich Plasma (PRP) with Endometrium Thickness and Pregnancy Outcome in Women with Recurrent Implantation Failure (RIF)

ABSTRACT Background: This study, conducted in the Wardha district, Recurrent implantation failure (RIF) and thin endometrium are significant challenges in IVF success. Various techniques have been explored to enhance endometrial receptivity. Platelet-rich Plasma (PRP) is an emerging technique that can enhance the endometrium lining and clinical pregnancy rate. This study will demonstrate the effectiveness of the infusion of the Platelet-rich Plasma (PRP) intra utrine for increasing the endometrium lining and compare the success rate in clinical pregnancy outcome in patients after infusing PRP and not infusing PRP undergoing frozen-thawed embryo transfer. Objective: The objective of the study will be to investigate the role of PRP in addressing recurrent implantation failure due to thin endometrium and to assess the success rate of clinical pregnancy outcome in frozen-thawed embryo transfer after inducing PRP in the patient with RIF. Methodology: A total of 190 patients will be selected for the study. The experimental population will be divided into two groups, i.e., 95 patients will be in the Study group, which will be exposed to PRP infusion, and 95 patients will be in the Control group, which will be exposed to the placebo. The study will be conducted on the population with thin endometrium and recurrent implantation failure (RIF) and females below 50 years of age. In this study, the control group and the study group will be compared, and the result of the intervention given to the study group. This study will also demonstrate how PRP is prepared and then injected in the patient. Expected Result: Therefore, the study will demonstrate that PRP improves the endometrium thickness, reduces the recurrent implantation failure, and also increases the clinical pregnancy rate in the patients who are infused with the PRP. It will demonstrate that PRP is very cost-effective as it is an affordable and low-risk adjunct to improve endometrium receptivity.

Evaluation of the Effects of Hemp Fiber Addition on Fracture Strength, Acrylic Tooth Bonding and Water Absorption of Polymethyl Methacrylate

ABSTRACT Background: In this study, it was aimed to evaluate the effect of adding hemp fiber to polymethyl methacrylate (PMMA), the most commonly used heat-polymerized base material for dental prosthesis, on the fracture strength of the denture, its connection to the acrylic tooth and water absorption. Methods: Three main working groups were formed in this study: PMMA (group-A) with the addition of raw hemp fiber, PMMA (group-B) with the addition of lignin and pectin removed hemp fiber, and PMMA without added fiber (group-C). Shear bond strength test was performed to evaluate how the addition of hemp fiber to PMMA affects the connection to the acrylic tooth. Three-point bending test was applied to measure the breaking strength of the base material. The effect of adding hemp fiber to PMMA on water absorption was evaluated. Results: There was no statistically significant difference between the study groups in terms of shear bond strength test mean values (p=0.122). There was no statistically significant difference between the study groups in terms of three-point bending test mean values (p=0.140). In this study, it was determined that the addition of raw and chemically treated hemp fiber significantly reduced the water absorption of the acrylic base material (p

Differences in cerebrospinal fluid microRNA profiles in patients with remitting multiple sclerosis and patients with other neurological diseases

Objective: to compare microRNA profiles in cerebrospinal fluid (CSF) of patients with remitting multiple sclerosis (RMS) in remission and patients with other neurological diseases. Material and methods. Eight patients with RMS in remission (4 males and 4 females) and 8 patients with other neurological diseases (4 males and 4 females) were included in the study. We compared the microRNA profiles in the CSF of the patients in the two study groups. Profiling was performed by sequencing small RNAs with the MGISEQ-200 device. The differences in microRNA levels were analyzed using the DESeq2 package for the R programming language. For microRNAs whose levels in CSF differed between the analyzed patient groups, a network of interactions with their target genes was created using the miRNet web service. Common targets were identified from the whole set of targets; for the resulting set of targets, an overrepresentation analysis of the pathways annotated in the KEGG database was performed.Results. The level of 30 microRNAs differed significantly (padj<0.05; |log2FC|>1) in the analyzed patient groups, the concentration of 13 microRNAs was higher and of 17 – lower in the CSF of patients with multiple sclerosis (MS). The search for common targets of these microRNAs allowed us to identify 8 protein-coding genes, each of which is a target of at least 5 microRNAs from the selected group: MIDN, MDM2, CDKN1A, TMEM184B, TAOK1, HNRNPA, NFIC and ZNF460. Conclusion. MicroRNA profiles in CSF distinguish patients with MS from patients with other neurological diseases. The possibility of using changes in the concentration of detected microRNAs in CSF as a diagnostic marker for MS needs to be confirmed in independent samples.

Assessment of Thyroid Function and Cortisol Levels in Iraqi Patients with Vitiligo

Background: The loss of functioning melanocytes in the skin causes vitiligo, an acquired autoimmune condition that manifests as big, white, unsightly patches on the skin. Melanocyte loss is caused by several reasons, including oxidative stress, inflammation, autoimmune, and metabolic problems, while the exact etiopathology of the condition remains unknown. There is a relationship between vitiligo, thyroid hormones, and cortisol levels. Objective: The study aims to measure cortisol hormone levels in the serum of vitiligo patients and examine the thyroid hormones (T3, T4, and TSH). Cases and methods: In this case-control study, 80 vitiligo patients diagnosed between November 2023 and February 2024 by dermatologists at the Dermatology and Venereology Center in Medical City, Baghdad, were included. The control group consisted of 40 healthy people. Everyone had a venous blood sample. Cortisol levels and thyroid hormones were assessed using the electrochemiluminescence immunoassay method. Results: The control group's mean age was 29.5 ± 13.28, whereas the patient group was 28.9 ± 14.15. There were no statistically significant differences in age between study groups. Age and gender differences were not considered between the two groups. The patient group had significantly higher mean T3, TSH, and cortisol levels than the control group. The two groups did not differ significantly regarding T4 (P>0.05). Conclusion: A comparison of T3, TSH, and Cortisol levels revealed a difference between the two groups, but no difference in T4 levels was observed. More extensive research with larger sample sizes is required to clarify these findings. levels showed up. More extensive research with larger sample sizes is required to clarify these findings.

Efficacy and safety of image-guided hypofractionated radiotherapy for hepatocellular carcinoma with portal vein tumor thrombosis: a retrospective, multicenter study

BackgroundExternal beam radiation therapy (RT) has shown promising effects for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) in recent studies. However, there is still a lack of consensus on the optimal RT scheme for PVTT treatment. We evaluated the efficacy and safety of image-guided 10-fraction hypofractionated RT in these patients.MethodsBetween January 2016 and March 2022, a total of 95 HCC patients with PVTT received 10-fraction hypofractionated image-guided radiation therapy (IGRT) at two institutes, and 69 patients were analyzed. Follow-up imaging was performed at three-month intervals after the completion of RT. The extent of PVTT was described according to the Liver Cancer Study Group of Japan classification: Vp1 = segmental portal vein branch, Vp2 = right/left anterior/posterior portal vein, Vp3 = right/left portal vein, and Vp4 = main portal vein. Response evaluation was performed using Response Evaluation Criteria in Solid Tumors, version 1.1. Freedom from local progression (FFLP), progression-free survival (PFS), and overall survival (OS) were calculated from the start date of RT.ResultsThe median prescribed dose of 50 Gy (range: 40-50 Gy; biologically effective dose [BED]: 56-75Gy10) was delivered in 10 fractions. In this cohort, 4.3% of patients had Vp1, 20.3% had Vp2, 37.7% had Vp3, and 37.7% had Vp4. Median Planning target volume was 105.3 cc (interquartile range [IQR], 74.1–179.4 cc). Fifty-two (75.4%) patients received 50 Gy. With a median follow-up of 10.2 months (IQR, 6–21 months), the median OS was 20.3 months, and 1-year FFLP, PFS, and OS rates were 88.7%, 26.9%, and 62.2%, respectively. At 3 months follow-up, 13.0% had a complete response, 36.2% had a partial response, 46.4% had a stable disease and 4.4% had a progressive disease. In the multivariate analysis, alpha-fetoprotein level ≥ 600 IU/ml (hazard ratio [HR] 2.06, p = 0.03), Child–Pugh Class B or C (HR 2.30, p = 0.02), and stage IVA or IVB (4.05, p = 0.02) were significantly related to OS. During the follow-up period, there were 2 (2.9%) cases of grade ≥ 3 toxicity: grade 3 liver enzyme elevation (n = 1), and acute cholangitis (n = 1).ConclusionsHypofractionated RT demonstrated promising local PVTT control and OS rates with acceptable toxicity. These data suggest that 10-fraction image-guided hypofractionated RT (BED: 56–75 Gy10) is a feasible treatment option for PVTT in HCC patients.

Abstract 7161: HMGA2 predicts treatment outcome in pancreatic cancer

Abstract The recognition of distinct transcriptional subtypes in pancreatic ductal adenocarcinoma (PDAC) has defined a group of poorly differentiated tumors with worse prognosis, but these findings have yet to reach clinical application. These tumors, termed “basal, ” are unique for their loss of epithelial identity and relative chemoresistance compared to “classical” tumors. To develop a prognostic biomarker for the basal subtype, we have identified that the chromatin architectural protein HMGA2 is highly expressed in this subset of cancers. Using a tumor microarray of 580 primary biopsies from a diverse set of PDAC patients undergoing surgical resection, we performed multiplex immunohistochemistry for HMGA2, previously published markers of basal and classical disease, and immune subsets. We then associated patient outcome and known clinical data from 491 of these samples to staining patterns. We found that expression of HMGA2, but not published basal markers CK5 or CK17, predicted overall survival in our cohort. Combination of HMGA2 status with GATA6 status allowed for identification of two key study groups: an HMGA2+/GATA6- cohort with worse survival, decreased CD8+ T cells, and poorer response to gemcitabine-based chemotherapies (n=94, median survival = 11.2 months post-surgery); and an HMGA2-/GATA6+ cohort with improved survival, increased CD8+ T cell infiltrate, and improved survival with gemcitabine-based chemotherapy (n=198, median survival = 21.7 months post-surgery). Importantly, these findings were also true for Black patients, who have been underrepresented in previous subtyping studies. HMGA2 was also predictive of overall survival in RNA sequencing from metastatic tumors in an independent cohort. As a positive nuclear marker for basal disease, HMGA2 complements GATA6 as a dual-indicator test for disease subtype in PDAC. We aim to introduce this novel biomarker in a prospective multi-center clinical trial to further validate its use in selecting chemotherapy regimens and across other under-represented racial groups. Citation Format: Naomi Yamamoto, Stephanie Dobersch, Ian Loveless, Annie Samraj, Gun Ho Jang, Miki Haraguchi, Ryan Fields, David DeNardo, Faiyaz Notta, Howard Crawford, Nina Steele, Sita Kugel. HMGA2 predicts treatment outcome in pancreatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 7161.

Group Guidance Services in Improving Social Interaction of Class IX Students with Special Intelligence at SMP Negeri 5, Tasikmalaya City

Social Interaction is a way of building reciprocal relationships that influence each other between individuals, individuals and groups, or groups and groups in these reciprocal relationships can form behavior. Efforts are needed to improve social interaction by providing study group guidance services. The purpose of this study is to determine the effectiveness of study group guidance services in improving social interaction of class IX Smart Special students at SMP Negeri 5 Tasikmalaya. The type of research used is experimental research using a one group pretest-posttest design. The subjects of this study were 19 students. Based on the calculation of the pre-test score, 9 students were selected as research subjects with levels of social interaction in the medium and low categories. Validity test analysis with the product moment formula and reliability test analysis with the alpha cronbach formula. Data collection using social interaction questionnaire instruments and observation sheets. Data analysis techniques using the Wilcoxon signed ranks test analysis. The results of the study showed that the Z value obtained was -2.668 with a p value of Asymp. Sig (2-Tailed) of 0.008 where the value is less than the critical limit of the study, which is 0.05. The average score of students' social interaction before the study group guidance was carried out was 100.66 which is in the low category, after the study group guidance was carried out it increased by an average of 39.1 points to 139.78 which is in the high category. Based on the explanation above, it can be concluded that the study group guidance service is effective in improving the interaction of class IX Smart Special students at SMP Negeri 5 Tasikmalaya.

Noticeable Behavioral Differences Observed in Turkish Students Following Online Education

The COVID-19 pandemic, which posed a global threat, led many countries, including Turkey, to implement changes in their educational practices. In response to the “stay at home” directive aimed at preventing the spread of the virus, face-to-face education was suspended, and online education was adopted. As a result, children were unable to attend school for nearly two years. This sudden shift posed significant challenges for children, who were in the process of socialization and learning, as adapting to this new educational norm was not in alignment with their natural developmental needs. This study examines how staying at home affected the behaviors of children who were supposed to attend school, interact with their teachers and peers, socialize, and engage in learning. The research follows a qualitative phenomenological design, with the study group selected through criterion sampling. The collected data were analyzed using content analysis, leading to the identification of themes, categories, and codes. Particular attention was paid to participant and data saturation during the analysis process. The findings indicate that noticeable behavioral patterns were categorized under discipline, cognitive skills, social skills, motor skills, emotional skills, digital addiction, and personality traits across different educational levels. It is suggested that the type and frequency of these prominent behaviors observed in students may be associated with the shift to online education following the suspension of face-to-face learning due to COVID-19. Factors such as reduced peer interaction, diminished social engagement, and a lack of communication and interaction are considered to have played a role in these behavioral changes.

Preferential impact of processing speed and memory on Rey Auditory Verbal Learning Test and Brief Visuospatial Memory Test-revised embedded performance validity tests

This study evaluated the impact of single-domain impairment in processing speed and memory versus multidomain impairment on the Rey Auditory Verbal Learning Test Forced Choice (RAVLT FC) and Brief Visuospatial Memory Test-Revised Recognition Discrimination (BVMT-R RD) PVTs among a sample of 385 nonconsecutive mixed clinical patients referred for outpatient neuropsychological evaluation. The sample was dichotomized to form valid (n = 307) and invalid (n = 78) groups. The valid study group was subdivided into an intact cognition group (n = 174), single-domain processing speed (n = 27) and memory (n = 59) groups, and a combined speed and memory impairment group (n = 47). The impaired memory group showed acceptable classification accuracy for the RAVLT FC (≤12; 35% sensitivity/90% specificity) and BVMT RD (≤4; 33% sensitivity/90% specificity). The impaired speed group evidenced excellent classification for the RAVLT FC (≤14; 64% sensitivity/96% specificity) and acceptable accuracy for the BVMT RD (≤4; 33% sensitivity/96% specificity). For the impaired speed and memory group, classification accuracy was acceptable for the RAVLT FC (≤12; 35% sensitivity/92% specificity) and poor (although still statistically significant) for the BVMT RD (≤3; 24% sensitivity/94% specificity). Therefore, use of adjusted cut-scores among neuropsychological conditions associated with deficits in memory and/or speed is needed when using these PVTs in clinical practice.

Monitoring of endotracheal tube cuff pressure in occurrence of ventilator associated pneumonia in neuro-critically ill patients

BackgroundVentilator-associated pneumonia (VAP) is a significant complication in mechanically ventilated patients, increasing morbidity and mortality. Maintaining optimal endotracheal tube cuff pressure is crucial for prevention.ObjectiveTo evaluate the impact of 4-h versus 8-h endotracheal tube cuff pressure monitoring on VAP incidence in neuro-critically ill patients.MethodsEighty neuro-critically ill patients in the intensive care units of Alexandria university hospitals who received endotracheal intubation and underwent mechanical ventilation for more than 48 h were divided into two equal groups of 40 cases. Endotracheal tube cuff pressure was monitored in the observation group at 8-h intervals, and in the study group every 4 h, and adjusted to 30 cmH2O. Incidence of ventilator-associated pneumonia (VAP) was compared between the two groups for 7 days.ResultsBy day 7, VAP incidence was 40% (16/40) in the observation group and 25% (10/40) in the study group (p > 0.05). No significant difference was found between groups regarding the proportion of time with acceptable cuff pressure.ConclusionIn neuro-critically ill patients, 8-h endotracheal tube cuff pressure monitoring appears feasible for VAP management without a statistically significant increase in incidence compared to 4-h monitoring.

The photobiomodulation effects of continuous and pulsed blue diode laser on proliferation and osteogenic differentiation of periodontal ligament stem cells.

This study investigated the photobiomodulation effect of pulsed and continuous blue diode laser on osteogenic differentiation and proliferation of periodontal ligament mesenchymal stem cells. Periodontal Ligament Stem cells were seeded in 96-well plates, and 450 nm blue laser irradiation procedure was performed a day after cell seeding. Each experimental group was divided into two subgroups according to their energy density and irradiation duration: Continuous wave (100 mW, 10s, 2 J/cm2 and 100 mW, 20 s, 4 J/cm2) and pulse wave (200 mW, 10 s, 2 J/cm2 and 200 mW, 20 s, 4 J/cm2 and duty cycle 50% for both). Then, all groups were evaluated with a cell viability test (MTT), cell apoptosis (Annexin V) on the second and fourth days after irradiation, Alizarin Red staining on the 14th day after irradiation based on genes. Real-time PCR was conducted 7 and 14 days after irradiation. GAPD gene primers were used as internal control, and OPN, OCN, ALP, and RUNX2 gene primers were used as tests. The one-way ANOVA statistical analysis revealed that cell proliferation in the continuous-irradiated groups was significantly higher than in pulsed groups. However, there is no significant difference in comparison with the control group. Also, pulsed-irradiated groups demonstrated a higher rate of necrosis. The osteogenic differentiation in the continuous groups was more substantial than in the pulsed and the control groups. In comparison to all other study groups, the group that received continuous mode irradiation at an energy density of 2 J/cm2, power of 100 mW, and a radiation time of 10 s exhibited significantly higher numbers of calcified nodules and increased expression of OPN, OCN, and ALP genes (p < 0.05). Overall, treating periodontal ligament stem cells with a continuous blue diode laser and appropriate parameters can enhance their osteogenic differentiation and proliferation, accelerating the regeneration of periodontal tissues.

Clinical impact of tirzepatide on patients with obstructive sleep apnea and obesity.

Clinical impact of tirzepatide on patients with obstructive sleep apnea and obesity.

Efficacy of treating Helicobacter pylori infection on seizure frequency in children with drug-resistant idiopathic generalized epilepsy: a randomized controlled trial

BackgroundHelicobacter pylori (H. pylori) causes chronic infection in more than half of the population worldwide. Accumulating body of evidence indicates the possible role of H. Pylori infection in extra-intestinal health problems, including epilepsy. This study aims to investigate the efficacy of treating H. pylori infection on seizure frequency among children with drug-resistant idiopathic generalized epilepsy (IGE).MethodsA parallel, two-arm, open-label, randomized controlled trial was conducted on 126 children with drug-resistant IGE and positive H. pylori stool antigen test who were randomly assigned to study and comparison groups in 1.2:1 ratio. Only the study group received H. pylori eradication therapy (esomeprazole, amoxicillin, and clarithromycin) for two weeks. The primary outcome was seizure improvement (≥ 50% seizure frequency reduction compared with baseline) after 2.5 months. Secondary outcomes were occurrence of status epilepticus, escalation of antiseizure medication (ASMs), and adverse effects. Outcomes between the two groups were compared using Chi-square/Fisher exact tests on an intention-to-treat principle. Logistic regression analysis was performed to investigate possible effects of baseline variables on primary outcome.ResultsSeizure improvement occurred in 23 (33%) children in the study group compared with seven (12%) children in the comparison group (Risk ratio [RR] 2.7, 95% confidence interval [CI]: 1.3–5.9; p 0.006). The study group had lower occurrence of status epilepticus (2.9% vs. 14%; RR 0.21, 95%CI: 0.05–0.93; p 0.042) and lesser need for ASMs escalation (4.4% vs. 19.3%; RR 0.23, 95%CI: 0.07–0.77; p 0.010). Adverse effects were more frequent among subjects in the study group, including nausea (15.9% vs. 10.5%) vomiting (8.7% vs. 3.5%), diarrhea (11.6% vs. 5.3%), and skin rash (4.4% vs. 1.8%), but the differences were not statistically significant (p > 0.05). None of baseline participants’ variables was significantly associated with the primary outcome.ConclusionTreating H. pylori infection may improve seizure control in children with drug-resistant IGE, but further studies are warranted to confirm our findings and explore mechanisms behind seizure improvement following H. pylori eradication therapy.Trial registrationRegistered on www.clinicaltrials.gov (identifier: NCT05297695) on 17 March 2022. https://clinicaltrials.gov/study/NCT05297695.

Advanced glycation end products are biomolecular biomarkers for proliferative diabetic retinopathy.

The present study examines the role of advanced glycation end products (AGEs) as biomolecular biomarkers for proliferative diabetic retinopathy (PDR). A cross-sectional study with a total of 80 consecutive cases of type 2 diabetes mellitus (DM) was divided into no retinopathy (NoDR) (n = 20), non-proliferative diabetic retinopathy (NPDR) (n = 20), PDR (n = 20), and controls (n = 20). AGEs were assessed by assay of N-carboxymethyl-lysine (Nε-CML). Nε- CML was evaluated using receiver operating characteristic curve (ROC) curve analysis, and the area under curve (AUC) was determined. The mean levels of Nε-CML were 31.3 ± 21.2 ng/mL, 73.9 ± 35.0 ng/mL, 91.2 ± 66.7 ng/mL, and 132.0 ± 84.0 ng/mL in control, NoDR, NPDR, and PDR, respectively. On analysis of variance (ANOVA), the Ne-CML level was significantly different between the study groups (control, NoDR, NPDR, and PDR) (P < 0.001). Best-corrected visual acuity decreased with disease progression and increased levels of Ne-CML (P < 0.001). On AUC analysis, the following values were obtained NoDR = 0.67, NPDR = 0.69, and PDR = 0.84, showing that AGEs are the most sensitive biomarkers for PDR in DR. AGEs serve as biomolecular biomarkers for PDR and can indicate disease conversion from NPDR to PDR. They are new-age tools of translational medicine.

Reducing readmissions with pharmacist-integrated care in Medicare value-based programs.

Pharmacy transitions of care (ToC) programs have been shown to decrease 30-day hospital readmissions and improve patient outcomes, but there is limited published data on the impact of pharmacist-integrated ToC services beyond 30 days. The objective of this study was to evaluate the impact of pharmacist-integrated ToC and population health services on 30-, 60-, and 90-day all-cause readmissions in a Medicare value-based program (MV-BP) population and to compare mean times to first readmission with and without pharmacist care. A retrospective observational chart review was conducted to identify eligible hospital discharge encounters (DEs). Patients 18 years of age or older enrolled in an MV-BP were assigned to 4 study groups (a control group or one of 3 intervention arms) based on the pharmacy ToC services they received from either an inpatient ToC pharmacist or a dedicated population health pharmacist (PHP). Among 1,065 eligible DEs, 90-day follow-up was completed in 1,039 cases. The control group (n = 213) had a 90-day readmission rate of 34.74%. Intervention arm 1 (n = 201) had no significant reduction in 90-day readmissions, with a rate of 29.85% (odds ratio [OR], 0.94; 95% CI, 0.61-1.47; P = 0.80), while intervention arms 2 (n = 209), and 3 (n = 416) had significantly lower rates of readmission: 9.57% (OR, 0.26; 95% CI, 0.15-0.46; P < 0.01), and 17.07% (OR, 0.41; 95% CI, 0.27-0.61; P < 0.01), respectively. A combination of ToC and PHP services reduced 30-, 60-, and 90-day readmission rates in an MV-BP population. These results support the expansion of pharmacy-based ToC to minimize readmissions within 90 days for this Medicare population.

Cost-effectiveness analysis of aducanumab versus placebo for patients with mild cognitive impairment and mild Alzheimer’s disease

ObjectivesTo assess the cost-effectiveness of aducanumab at its updated price for treating patients with mild cognitive impairment (MCI) and mild Alzheimer’s disease (AD).DesignCost-effectiveness analysis.SettingsA five-state Markov model was constructed using...

Stem design affects templating adherence in total hip arthroplasty - a retrospective cohort study comparing two types of cementless short stems.

BackgroundPreoperative templating is crucial when performing total hip arthroplasty (THA) as it facilitates the correct restoration of the joint biomechanics and reduces the risk of adverse events associated with component under- or over-sizing. Templating and execution of stem placement is highly dependent on the actual stem design. Therefore, we aimed to compare the templating adherence between a neck-resecting and a partially neck-sparing cementless short stem and to evaluate the influence of patient-specific factors like sex and Dorr type on the templating adherence.MethodsThis retrospective cohort study evaluated the preoperative templates of 345 consecutive THAs performed by a single surgeon. A neck-resecting short stem (Fitmore, ZimmerBiomet) combined with a bi-hemispherical cup (Allofit, ZimmerBiomet; Group A) was used in 160 cases and a partially neck-sparing short stem (ANA NOVA alpha proxy, ImplanTec GmbH) combined with a bi-hemispherical cup (ANA NOVA alpha cup, ImplanTec GmbH; Group B) in 185 cases. The templating adherence was evaluated for stem size and offset option as well as cup size.ResultsGroup A showed a lower overall templating adherence with regard to stem size compared to Group B (26.9% vs. 36.2% exact match, p = 0.063; 57.5% vs. 71.4% ± 1 size, p = 0.007). In female patients templating adherence with regard to stem size was significantly lower in Group A (26.5% vs. 44.4% exact match, p = 0.012). For Dorr type B femora, significantly lower templating adherence was observed within Group A with regard to stem size (26.4% vs. 39.6% exact match, p = 0.013). No significant differences between both study groups were found with regard to adherence to the templated offset option (60.6% vs. 60.5% exact match, p = 0.987) and cup size (43.1% vs. 40.0% exact match, p = 0.557).ConclusionsFor both stem types, the overall rate of exactly matching the templated stem sizes was relatively low. However, templating adherence was significantly higher in female patients and in Dorr type B femora with a partially neck-sparing stem, which should be considered by surgeons performing THA using cementless short stems.Trial registrationThis trial was registered at the local ethics committee (Registration Number: 1094/2023).