Subjective Assessment Research Articles

Fall risk factors and mitigation strategies for hematological malignancy patients: insights from a qualitative study using the reason model.

Our study aim was to understand the (human and organizational) factors influencing fall risk among people with hematological malignancies using the Reason model as a framework, providing insights that can inform the development of safe and effective fall management strategies. Purposive sampling was employed to conduct semi-structured interviews with 13 people with hematological malignancies and 12 nurses from the hematology department of a tertiary grade A hospital in Guangzhou from December 2023 to February 2024. The topic analysis method was utilized to analyze the interview data. Factors influencing fall risk among people with hematological malignancies were categorized into four themes: (1) precondition of unsafe arts (lack of workexperience in junior nurses, poor patient compliance, adverse drug reactions, inadequate ward facilities); (2) unsafe supervision (inadequate inspectionmanagement, inadequateaccompanying capacity); (3) unsafe arts (variability in subjective assessment, lack of bidirectional education); and (4) organizational influences (limited nursing human resources, lack of organizational process management models). The specific fall risk factors among people with hematological malignancies, as summarized based on the Reason model framework, provide a theoretical basis and direction for the construction of specialized fall risk assessment tools, aiming to improve the quality of fall management for inpatients and reduce the incidence of falls.

Injection of hyaluronic acid versus platelet rich plasma for treatment of vulvovaginal atrophy in post-menopausal females.

Female sexual dysfunction is highly prevalent among postmenopausal females approaching 50%, with vulvovaginal atrophy (VVA) being a cardinal sign. For decades, hormone replacement therapy was the only solution to relieve symptoms associated with this atrophy. However, it was limited by its serious side effects, raising the need for new treatment strategies. This study aims to compare the efficacy and safety of injection of hyaluronic acid (HA) versus platelet rich plasma (PRP) in post-menopausal females presented with VVA to improve female sexual dysfunction. Twenty post-menopausal females presented with VVA were randomly divided into two groups, 10 patients in each group. Both groups received three sessions of injections into the vulva and vagina, one month apart. Group I was injected with non cross linked HA while Group II received PRP injection. Subjective assessment was carried out through female sexual function index questionnaire and global aesthetic improvement scale.While objective assessment was carried out by measuring the labia majora length and reviewing the histopathological changes occurring in the vulva through skin biopsies before and after treatment. The change in vaginal thickness was estimated by transvaginal ultrasound. Results showed that both HA as well as PRP were effective in the treatment of post-menopausal vulvovaginal atrophy. However, HA showed more significant improvement in female sexual dysfunction. There were also higher values in vaginal wall thickness as measured by transvaginal ultrasound in favor of HA injected group. Histopathological assessment showed more collagen deposition in papillary dermis in HA treated group. No complications were reported in both groups.

Pre-operative subjective functional capacity and postoperative outcomes in adult non-cardiac surgery: asystematic review and meta-analysis.

Assessment of functional capacity is an essential part of peri-operative risk stratification. Subjective functional capacity is easier to examine than objective tests of patient fitness. However, the association between subjective functional capacity and postoperative outcomes has not been established. Four databases were searched for studies describing the associations between subjective functional capacity and postoperative outcomes in adults undergoing non-cardiac surgery. Meta-analysis was conducted among studies where functional capacity was expressed in metabolic equivalents. The primary outcome was postoperative major adverse cardiovascular events. Secondary outcomes were mortality and postoperative overall complications. We estimated the ORs of the outcomes in patients with poor functional capacity (< 4 metabolic equivalents) as compared with those with good functional capacity (≥ 4 metabolic equivalents). Random-effects models were used for the meta-analysis. We identified 7835 abstracts. After screening and a full-text review, 23 studies were selected. Evaluation methods of functional capacity included: questionnaires (n = 7); specific questions (n = 6); and subjective assessment by anaesthetists (n = 5). The probability of major postoperative adverse cardiovascular events was significantly higher in patients with poor functional capacity (OR 1.84, 95%CI 1.62-2.08) than in those with good functional capacity. Patients with poor functional capacity also had higher odds of mortality (OR 2.48, 95%CI 1.45-4.25) and postoperative complications (OR 1.85, 95%CI 1.34-2.55). Subjective functional capacity of < 4 metabolic equivalents was associated with postoperative complications including cardiovascular events and other serious outcomes. The results need to be interpreted with caution due to the diverse measures used to assess functional capacity.

Potassium titanyl phosphate laser resection of tongue T1/T2 squamous cell carcinoma - a cross-sectional study of quality of life and nutritional outcomes.

Increasing emphasis has been placed on measurement of quality of life (QOL) as a central criterion for assessment of success of any medical treatment. The aim of our study was to assess the nutritional and quality of life of patient-reported outcomes among patients who have undergone laser resection of tongue cancer. A cross-sectional study was undertaken of patients treated with KTP laser resection of T1/T2 tongue squamous cell carcinoma (SCC) between 2011-2019. University of Washington Quality of life 4 questionnaire (UW-QOL) and the abridged scored patient-generated subjective global assessment (AB PG-SGA) were used. Scores were correlated to analyse the QOL and nutritional status. 20 patients participated and were categorised into three groups based on AB PG-SGA score. The physical and social-emotional QOL scores were higher for patients who had a better nutritional status. There was a linear negative correlation between the AB PG-SGA score, physical and social-emotional domains of the QOL. No association was found between histopathological differentiation, neck dissection surgeries and the AB PG-SGA score. The use of the KTP laser to excise tongue T1 and T2 SCC yields acceptable results in terms of QOL and patient-reported nutritional outcomes. There is a significant trend identifying that as a patient's nutritional status improves quality of life is enhanced and vice versa. The QOL and the nutritional status of patients were not affected by the different histopathological grades of SCC or whether they had undergone a neck dissection or not.

Improving the early detection of aphasia in the acute phase of stroke: the contribution of a screening test

ABSTRACT Background Aphasia is one of the most common and most debilitating after-effects of a stroke. In the acute phase of a stroke, referrals to speech-language pathology (SLP) are frequently guided by clinical impressions rather than validated tests. Objectives This study aimed to evaluate the advantages of incorporating the Screening test for language disorders in adults and the elderly (DTLA) into clinical practice for detecting language disorders during the acute phase of stroke. Methods The study includes a retrospective and a prospective component, including a questionnaire on the acceptability, feasibility and usefulness of using the DTLA in patients in the acute phase of stroke. Results Sixty-one patients admitted for stroke were recruited for each of the two components. The introduction of the DTLA in the prospective component of the study had a significant impact on the detection of language impairment, as more notes about language were found in patients’ medical records and more referrals were made to SLP. Conclusions Using a screening test can improve the detection of aphasia during the acute phase of stroke, particularly in patients whose impairments might not be easily identified through subjective assessments.

Novel Objective Tool to Assess Tremor Reveals Unilateral Focused Ultrasound Improves Tremor Bilaterally.

Tremor in essential tremor and in tremor-dominant Parkinson's disease is assessed by subjective observations in patients undergoing focused ultrasound thalamotomy, a minimally invasive procedure intended to alleviate tremor in these patients. To develop an objective tool for tremor analysis to be used before and after focused ultrasound thalamotomy treatment in the treated hand (contralateral to ablation) and non-treated (ipsilateral to ablation). Using image processing and signal processing that utilized images of a Archimedes spiral drawing, we created a tool to analyze tremor. First, we showed that the proposed tool reproduces known clinical dynamics on the treated hand, and then we used it to evaluate the clinical dynamics on the non-treated hand. Using the tool we developed, we were able to demonstrate a significant reduction in tremor following focused ultrasound thalamotomy among 132 essential tremor and 26 tremor-dominant Parkinson's disease patients in the treated hand using drawings of Archimedes spirals up to 1 year following the procedure. Thus, we reproduced known clinical data and therefore validated the proposed tool. In addition, we were able to demonstrate a significant improvement in the non-treated hand as well as a significant deterioration in the efficacy of focused ultrasound thalamotomy over time. Our objective method, which incorporated image processing and signal processing, provided a quantitative measure of tremor reduction following focused ultrasound thalamotomy. It demonstrated significant improvement in tremors in the treated and non-treated hands following focused ultrasound thalamotomy as well as deterioration in the efficacy of treatment over time. If replicated in other studies, this method may complement current subjective assessments.

Comparison of Patient-Generated Subjective Global Assessment (PG-SGA) and Mini Nutritional Assessment (MNA) for nutritional assessment in hepatocellular carcinoma patients.

Malnutrition affects the prognosis and response to treatment in cancer patients. There is no gold standard for nutritional assessment in patients with hepatocellular carcinoma (HCC). This study aimed to compare Patient-Generated Subjective Global Assessment (PG-SGA) and Mini Nutritional Assessment (MNA) in predicting mortality in HCC patients. We included HCC patients in the outpatient clinic at HRH Maha Chakri Sirindhorn Medical Center. The nutritional status was assessed according to PG-SGA and MNA. Patients were followed up for 1year to verify the incidence of death and complications. Eighty-nine HCC patients were included. The mean age was 62.2years. Most of the patients were treated with transarterial chemoembolization. Malnutrition identified by PG-SGA and MNA was 53.9% and 51.7%, respectively. The mortality rate was 2.65 cases per 100 persons. Overall survival rate was 90% and 81.5% at 12 and 24months, respectively. Patients with malnutrition assessed by PG-SGA and MNA had significantly higher mortality than patients without malnutrition. PG-SGA had a sensitivity of 80% for predicting mortality. PG-SGA had higher accuracy for predicting the mortality of HCC patients than MNA (AUROC PG-SGA 0.7148 and MNA 0.7098). HCC patients with malnutrition were evaluated by PG-SGA and MNA had higher mortality than HCC patients without malnutrition. PG-SGA had higher accuracy in predicting mortality than MNA.

Machine Learning-Based Diagnosis of Chronic Subjective Tinnitus With Altered Cognitive Function: An Event-Related Potential Study.

Due to the absence of objective diagnostic criteria, tinnitus diagnosis primarily relies on subjective assessments. However, its neuropathological features can be objectively quantified using electroencephalography (EEG). Despite the existing research, the pathophysiology of tinnitus remains unclear. The objective of this study was to gain a deeper comprehension of the neural mechanisms underlying tinnitus through the comparison of cognitive event-related potentials in patients with tinnitus and healthy controls (HCs). Furthermore, we explored the potential of EEG-derived features as biomarkers for tinnitus using machine learning techniques. Forty-eight participants (24 patients with tinnitus and 24 HCs) underwent comprehensive audiological assessments and EEG recordings. We extracted N2 and P3 components of the midline electrodes using an auditory oddball paradigm, to explore the relationship between tinnitus and cognitive function. In addition, the current source density for N2- and P3-related regions of interest was computed. A linear support vector machine classifier was used to distinguish patients with tinnitus from HCs. The P3 peak amplitudes were significantly diminished in patients with tinnitus at the AFz, Fz, Cz, and Pz electrodes, whereas the N2 peak latencies were significantly delayed at Cz electrode. Source analysis revealed notably reduced N2 activities in bilateral fusiform gyrus, bilateral cuneus, bilateral temporal gyrus, and bilateral insula of patients with tinnitus. Correlation analysis revealed significant associations between the Hospital Anxiety and Depression Scale-Depression scores and N2 source activities at left insula, right insula, and left inferior temporal gyrus. The best classification performance showed a validation accuracy of 85.42%, validation sensitivity of 87.50%, and validation specificity of 83.33% in distinguishing between patients with tinnitus and HCs by using a total of 18 features in both sensor- and source-level. This study demonstrated that patients with tinnitus exhibited significantly altered neural processing during the cognitive-related oddball paradigm, including lower P3 amplitudes, delayed N2 latency, and reduced source activities in specific brain regions in cognitive-related oddball paradigm. The correlations between N2 source activities and Hospital Anxiety and Depression Scale-Depression scores suggest a potential link between the physiological symptoms of tinnitus and their neural impact on patients with tinnitus. Such findings underscore the potential diagnostic relevance of N2- and P3-related features in tinnitus, while also highlighting the interplay between the temporal lobe and occipital lobe in tinnitus. Furthermore, the application of machine learning techniques has shown reliable results in distinguishing tinnitus patients from HCs, reinforcing the viability of N2 and P3 features as biomarkers for tinnitus.

Gustatory-Visual Interaction in Human Brain Cortex: fNIRS Study.

Many studies, for example, on taste-visual dissonance, have shown that the influence of the visual cortex on taste sensation is enormous. The presented work aims to investigate, using fNIRS, whether a taste stimulus, in this case, the taste of bitter, also causes stimulation of the visual cortex in the fNIRS study. fNIRS was used to examine 51 participants (204 examinations, 9996 records), collecting signals from the left hemisphere. Differences between the maximum and minimum changes in oxyHb concentrations (ΔoxyHb) for the areas of the brain cortex considered responsible for recording visual and gustatory signals were analyzed. Protocols I, II, III, and IV-activation with distillate water, coffee with lower concentration, reference (no stimulation), and coffee with higher concentration, respectively, were used. We recorded high signals for teste activation on channels covering the gustatory cortex, which confirms the correctness of the choice of research method. As expected, a significant statistical difference was observed between protocols I, II, and IV and reference III (without stimulation). What seems important is the fact that we also received high signals for the channels 45-49, which cover the visual cortex. The statistical analysis shows no differences between protocols I, II, and IV (different taste activation-water, coffee A, and coffee B) for specific channels for analyzing regions of interest. As a result of the analysis of the correlation between the subjective bitterness assessment solutions and the signal ΔoxyHb height, it was observed that a statistically significant correlation, although weak, occurs only for 14 and gustatory channels, only for coffee with a higher concentration. Additionally, the only statistically significant difference between women and men was observed in Protocol I (water), where the ΔoxyHb signal was twice as high in women compared to men. In conclusion, we can clearly state that the senses of sight and taste work closely together. Moreover, this cooperation is not one-sided: while visual activation influences taste perception, interestingly, a taste stimulus can also generate a hemodynamic response, activating the visual cortex.

Efficacy of Using Photobiomodulation Therapy in Allergic Rhinitis: A Placebo-Controlled Randomized Clinical Trial.

Recent studies have extensively explored new non-invasive and side-effect-free therapeutic strategies for the treatment of allergic rhinitis (AR). Photobiomodulation therapy (PBMT) utilizes photons from the red to infrared spectrum to modulate biological processes, exhibiting anti-inflammatory and regenerative properties. The objective of our study was to evaluate the efficacy of PBMT in patients with AR. This study was a randomized, placebo-controlled, double-blind clinical trial involving 62 patients with AR. Participants underwent PBMT twice weekly, totaling eight sessions over the course of 1 month. The control group consisted of 29 patients who received treatment with a non-light-emitting device, while 33 patients in the laser therapy group received a protocol of 6 J of red and infrared light administered intranasally, along with 1 J of infrared light applied externally to the nose. Objective, psychophysical, and subjective assessments of nasal obstruction and olfactory function were conducted both before and after the treatment. PBMT contributed to significant improvements in various nasal and respiratory parameters. The peak nasal inspiratory flow demonstrated significant improvement (p < 0.001), and the Nasal Obstruction Symptom Evaluation scale indicated notable enhancement in nasal obstruction (p = 0.048). Additionally, the Rhinitis Control Assessment Test reflected significant symptom improvement over the past week (p = 0.035). However, the University of Pennsylvania Smell Identification Test showed no significant change in olfactory function (p = 0.251). Our data suggest that PBMT may serve as a promising therapeutic option for individuals with AR, providing an alternative for those who are unable to tolerate conventional medications. Furthermore, it demonstrates efficacy and safety as a viable treatment alternative.

The effect of different timings of protein supplementation on variable outcomes in hemodialysis patients: a randomized clinical trial.

Oral nutritional supplements (ONS) are commonly prescribed to provide protein and energy to hemodialysis (HD) patients. There is a debate about the appropriate timing to administer ONS. We aimed to study the effect of different timings of ONS on variable outcomes in HD patients. This research is a prospective, randomized, multicentric clinical trial (RCT) that included 120 patients on regular HD. Patients were allocated to receive ONS (25 gm protein powder/HD session) for 8weeks either predialytic (1h before the start of the session), intradialytic (2h after the start of the session), or interdialytic (on non-dialysis days). Laboratory parameters, blood pressure (BP), dialysis adequacy, and nutritional parameters were assessed during the study. At study end, BP at the end of HD dropped significantly in the intradialytic group compared to the other groups (p < 0.001). Serum albumin improved significantly in the predialytic (p < 0.001) and intradialytic (p = 0.039) groups. The mean subjective global assessment score increased significantly in the interdialytic group (p = 0.040). The Kt/V and urea reduction ratio decreased significantly only in the intradialytic group (p value < 0.001 and 0.001). Serum sodium, potassium, phosphorus, cholesterol, triglycerides, and adverse events did not significantly differ between the different groups. Predialytic ONS supplementation is a favorable option due to improved serum albumin with minimal effects on hemodynamics and dialysis adequacy compared to intradialytic and interdialytic supplementation. ClinicalTrials.gov NCT05953636. First registration date: 1/07/2023.

Discrepancies between subjective and objective sleep assessments revealed by in-home electroencephalography during real-world sleep

Sleep insufficiency and sleep disorders pose serious health challenges. This study aimed to determine the potential discrepancy between subjective and objective sleep assessments, including the latter made by physicians, by analyzing a 421-participant dataset in Japan comprising multiple nights of in-home sleep electroencephalogram (EEG) data and questionnaire responses on sleep habits or subjective experiences. We employed logistic regression models to examine which subjective and objective sleep parameters physicians are paying attention to when assessing sleep insufficiency, insomnia, sleep quality, and sleep apnea. Questionnaire responses, including subjective sleep assessments, exhibited poor performance predicting physicians' assessments, whereas objective data demonstrated good predictive performance, indicating a discrepancy between subjective and objective sleep assessments. Although the in-home sleep EEG measurements had minimal first night effects, incorporating measurements over multiple nights can improve the detection of objective insomnia. Moreover, we found that participants with severe sleep insufficiency overestimated their sleep duration, whereas those with subjective insomnia but without objective insomnia underestimated it. Additionally, subjective sleep quality reflected sleep efficiency but not the frequency of short awakenings or objective sleep depth. In particular, the effects of apnea on objective sleep quality were not subjectively perceived. Collectively, our findings suggest that subjective sleep assessments alone are insufficient for evaluating sleep health and that health checkups and advice based on sleep EEG measurements may be useful in improving sleep habits and for early detection of sleep disorders.

Validation the modified subjective global nutrition assessment (mSGNA) for assessing malnutrition among hospitalized children.

To validate a modified Subjective Global Nutritional Assessment (mSGNA) for assessing nutritional status among Vietnamese children. A cross-sectional study was conducted at the National Children's Hospital in Vietnam, where 200 children were assessed using mSGNA, Subjective Global Nutritional Assessment (SGNA), and a standardized method developed by the Academy of Nutrition and Dietetics (AND) and the American Society for Parenteral and Enteral Nutrition (ASPEN). The mSGNA showed high accuracy with 82.9% sensitivity and 90.8% specificity when compared to SGNA, and moderate accuracy (72.0% sensitivity, 77.3% specificity) against AND/ASPEN. The kappa value for mSGNA-SGNA agreement was 0.8 (95% CI 0.686-0.849), indicating substantial agreement, while the kappa value for mSGNA-AND/ASPEN agreement was 0.5 (95%CI 0.304-0.567), reflecting moderate agreement. The results suggest that mSGNA is a reliable tool for identifying malnutrition in Vietnamese pediatric patients, with high sensitivity and specificity in comparison to SGNA and moderate effectiveness against AND/ASPEN standards.

Progression of nutritional impact symptoms in cancer patients undergoing radiotherapy.

To analyze the presence of nutritional impact symptoms (NIS) throughout radiotherapy treatment in the head and neck, thorax, abdomen, and pelvis areas. A prospective cohort study was conducted with individuals undergoing radiotherapy for cancer. Three assessments were carried out: at the start of radiotherapy, midway through, and in the last week of treatment. Clinical, anthropometric data, and the Patient-Generated Subjective Global Assessment (PG-SGA) were used to assess symptoms. A total of 254 participants were evaluated at the start, 165 at the midpoint, and 120 at the end of the treatment. More than half of the participants at all stages were elderly. At the start, 51.6% were women, while at the end, 57.5% were men. Pelvic tumors were the most common, followed by tumors in the head and neck and thorax. The prevalence of NIS increased from 58.2% at the beginning to 76.9% at the midpoint (RR 1.32; 95% CI 1.17-1.48; p = < 0.001) and 78.3% at the end of treatment (RR 1.34; 95% CI 1.18-1.52; p = < 0.001). Odynophagia was the most reported symptom among patients with head and neck tumors, increasing from 24.5 to 66.6%, and from 3.0 to 22.2% by the end of treatment in patients with thoracic tumors. Diarrhea was common at the end of treatment among those with abdominal (69.2%) and pelvic (35.8%) tumors. NIS increased during radiotherapy. The location of tumors influences symptom prevalence, highlighting the need for continuous nutritional support.

Intensive Speech Therapy for Hypokinetic Dysarthria in Parkinson's Disease: Targeting the Five Subsystems of Speech Production with Clinical and Instrumental Evaluation.

Background: Hypokinetic dysarthria is a speech disorder observed in almost 90% of PD patients that can appear at any stage of the disease, usually worsening as the disease progresses. Today, speech therapy intervention in PD is seen as a possible therapeutic option to alleviate and slow down the progression of symptoms. This study aims to investigate the validity of traditional speech therapy in dysarthria with the aim of improving the quality of life of PD patients, by comparing subjective clinical assessment with objective instrumental measures (IOPI and voice analysis). Methods: This is an observational study of 30 patients with hypokinetic dysarthria due to PD. The patients underwent speech therapy treatment with a frequency of three times per week for 12 consecutive weeks. Patients were evaluated at the time of enrollment (T0), at the start of treatment (T1), and at the end of the same (T2). Six months after the end of treatment (T3), a follow-up was performed based on disability and phonatory evaluation. Results: This study showed significant improvements (<0.001) from the start (T1) to the end of treatment (T2), with increases in the Barthel Index score, Robertson Dysarthria Profile, and IOPI measurements for tongue and lip strength, along with enhanced phonometer scores and tongue endurance. Correlations highlighted that tongue endurance decreased with age, CIRS, and MDS-UPDRS, while showing a positive association with MoCA scores. Conclusions: Significant improvements were observed in tongue and lip strength, phonatory duration, intensity, and vocal quality between pre- (T1) and post-treatment (T2). This study underscores the importance of early and continuous speech therapy treatment for comprehensive speech function enhancement.

Biomarkers of disease progression in progressive supranuclear palsy for use in clinical trials

Abstract Progressive supranuclear palsy is a rare neurodegenerative disease with no current disease-modifying treatments approved. Longitudinal research and clinical trials for progressive supranuclear palsy are ongoing and require reliable measures which are sensitive to disease progression. Despite susceptibility to subjective limitations clinical and cognitive assessments are the most used instruments in therapeutic trials in progressive supranuclear palsy. The objective of this review is to identify measures which have been studied longitudinally as measures of progression and which are suitable for use as clinical trial endpoints. We reviewed the measures currently used as trial endpoints, identifying the clinical, cognitive, fluid and imaging measures which have previously been studied longitudinally, and discussing current diagnostic and emerging measures which are yet to be studied longitudinally but which may be sensitive to disease progression. We found that many fluid and imaging measures require further research to validate their use as longitudinal measures of change, including emerging measures which have not yet been studied specifically in progressive supranuclear palsy. We also summarise the sample size estimates required to detect changes in a 2-arm, 52-week therapeutic trial and found that specific MRI volumes require the smallest sample sizes to detect change.

The dynamic effects of nutritional status on chemotherapy-related toxicity in patients with non-Hodgkin's lymphoma.

Understanding the dynamic changes in nutritional status of patients with non-Hodgkin's lymphoma (NHL) during chemotherapy is crucial, as it significantly impacts chemotherapy-related toxicity and survival outcomes. This multi-center study included newly diagnosed NHL patients. Nutritional status and chemotherapy-related toxic effects were assessed over the first five chemotherapy sessions, with follow-ups conducted every 3 months. Patients were categorized into three groups based on pre-chemotherapy Patient-Generated Subjective Global Assessment (PG-SGA) scores: Group A (0-1), Group B (2-8), and Group C (>9). Repeated-measures ANOVA and Generalized Estimating Equations (GEE) models were used for analysis, with survival outcomes evaluated via Kaplan-Meier and Cox regression. A total of 143 patients (mean age 50.26 ± 15.02 years) completed the study, over a median follow-up of 18.8 months. PG-SGA scores were highest in Group C during chemotherapy (P < 0.001), with significant time-group interaction effects (P < 0.001). Liver and kidney impairments worsened across all groups (P < 0.05), while gastrointestinal toxicity and bone marrow suppression initially decreased before increasing. GEE analysis showed that nutritional status positively influenced gastrointestinal toxicity (β = 0.05, P = 0.001) and bone marrow suppression (β = 0.04, P = 0.014). Malnourished patients exhibited worse pulmonary infection-free survival and overall survival (P < 0.05). NHL patients are highly susceptible to malnutrition during chemotherapy, which exacerbates chemotherapy-related toxicities, particularly gastrointestinal effects and myelosuppression. Maintaining good initial nutrition is vital for reducing toxicities and improving survival outcomes.

A combination treatment protocol using PEGylated hyaluronic acid hydrogel, non-ablative laser and hyaluronic acid skin boosters for rejuvenation of the perioral area

Personalized treatment with a combination of aesthetic protocols targets the different root causes, contributing to the patient’s aesthetic concerns and optimizes outcomes. This report presents the outcomes of a new protocol combining PEGylated hyaluronic acid (HA) hydrogel, non-ablative laser, and non-crosslinked HA skin booster to rejuvenate the perioral area within a single treatment session. This was a retrospective analysis of medical data from subjects who had undergone treatment with the perioral rejuvenation protocol at Kalea Clinic in the Netherlands. All subjects had been treated with the 3-step protocol involving: (i) injection with PEGylated HA hydrogel 24 mg/ml to contour and shape the lips; (ii) full-face treatment with a non-ablative, fractional diode laser with a wavelength of 1470 nm to smooth and tighten the skin; and (iii) full-face mesotherapy treatment with injection of non-crosslinked HA (18 mg/mL) with 0.01% calcium hydroxyapatite, glycine, and L-proline to improve skin quality. Follow-up visits took place at 6 (Visit 1) and 12 weeks (Visit 2), at which point physicians and patients assessed lip fullness and skin wrinkling on separate validated rating scales. Additional subjective assessment of treatment results was performed by both physicians and patients using the 5-point Global Aesthetic Improvement Scale (GAIS). Physician and patient satisfaction with treatment results was also assessed. Data were analyzed retrospectively for 14 female subjects with a mean age of 39.1 years. At baseline, lip fullness was rated as moderate by 71% of physicians and 64% of patients. At visit 2, 71% of lips were rated as thick and 14% as full by both physicians and patients. The mean skin wrinkle score improved from 1.30 (visible wrinkles with clear indentation) at baseline to 0.79 (fine wrinkle, slight indentation) at Visit 2. Mean GAIS scores for both physicians and patients indicated appearance was ‘improved’ at Visit 1 (mean scores of 3.0 and 2.7, respectively) and ‘much improved’ at Visit 2 (mean scores of 2.4 and 2.3, respectively). All treatments in the protocol were well tolerated. Both physicians and patients were satisfied with the combination protocol, and all patients reported they would be ‘likely’ or ‘very likely’ to recommend it. The combination of three different treatment modalities (PEGylated HA hydrogel, non-ablative laser, and HA mesotherapy) in a single treatment session demonstrated effectiveness in rejuvenating lips and perioral area. The complementary treatments were tailored to the individual for a natural-looking effect.

Computer vision based automatic evaluation method of Y2O3 steel coating performance with SEM image

This study introduces a deep learning-based automatic evaluation method for analyzing the microstructure of steel with scanning electron microscopy (SEM), aiming to address the limitations of manual marking and subjective assessments by researchers. By leveraging advanced computer vision algorithms, specifically a suitable model for long-term dendritic solidifications named Tang Rui Detect (TRD), the method achieves efficient and accurate detection and quantification of microstructure features. This approach not only enhances the training process but also simplifies loss function design, ultimately leading to a proper evaluation of surface modifications in steel materials. The results demonstrate the method’s potential in automating and improving the reliability of microstructural analysis in materials science.

Chinese Expert Consensus for Assessment of Vocal Function (2024): Guidelines of the Subspecialty Group of Voice, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association; Subspecialty Group of Laryngopharyngology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery.

The assessment of vocal function plays an important role in the diagnosis of voice disorders. With the continuous development of voice medicine in China, the evaluation, diagnosis, and treatment of voice disorders are gradually professionalized and standardized. Experts of the Subspecialty Group of Voice, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association; Subspecialty Group of Laryngopharyngology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery reached the expert consensus through clinical research, literature search, and quality evaluation, as well as two meetings and two rounds of questionnaire voting. It includes the baseline information of patients, subjective and objective assessment of voice quality, voice-related quality of life assessment, laryngoscopy and vocal fold vibration evaluation, aerodynamic analysis, laryngeal neuromuscular electrophysiological function evaluation, and many other aspects. This is the first expert consensus on vocal function assessment in China and provides appropriate guidance recommendations to voice specialists, otolaryngologists, and primary care practitioners in China.