Combined left and right atrial reservoir strain identifies a high-risk phenotype in patients with chronic heart failure.

Emerging biomarkers for early detection of colorectal cancer.

Metformin-associated lactic acidosis: Bridging pharmacokinetic determinants, metabolic pathways, and clinical outcomes.

Enzyme-powered PLGA micromotors for biofilm eradication and long-term regrowth inhibition.

The lncDR1 enhances drought tolerance in barley via the ceRNA mechanism of sponging miR4339 to induce stomatal closure.

Objective: To explore the efficacy of the implementation of quality control (QC) program for children with fulminant myocarditis (FM) on improving the survival rate, reducing mortality and complication rates, and to evaluate the feasibility of the QC protocol. Methods: A retrospective cohort study was conducted. A Clinical Medical Quality Control Scoring Scale for Pediatric Fulminant Myocarditis (the QC Scale) was implemented since January 2021. Clinical data and the QC Scale data of 187 children with FM admitted to 8 tertiary hospitals capable of pediatric extracorporeal membrane oxygenation (ECMO) treatment over 6 years were collected, including the pre-QC group (January 2018 to December 2020) and the post-QC group (January 2021 to December 2023). Independent-samples t-test, Mann-Whitney U test, Chi-square test or Fisher's exact test were used for intergroup comparisons; and multivariate Logistic regression was performed for risk factor analysis. The clinical characteristics of pediatric FM and the feasibility and clinical efficacy of the QC protocol were evaluated. Results: A total of 187 children with FM were enrolled, including 82 cases in the pre-QC period and 105 cases in the post-QC period. The age was (8±4) years, and the weight was (28±14) kg. There were 104 female cases (55.5%) and 83 male cases (44.5%). A total of 156 children survived and 31 died, with an overall in-hospital mortality rate of 16.6% (31/187). The completion rates of electrocardiogram or cardiac monitoring and echocardiography or non-invasive hemodynamic monitoring within 30 min after admission were 98.7% (81/82) and 92.6% (72/82) in the pre-QC group, compared with 96.2% (101/105) and 90.5% (95/105) in the post-QC group. The post-QC group showed significantly higher completion rates of blood lactate measurement and Glasgow Coma Scale assessment within 60 min of admission than the pre-QC group (86.5% (71/82) vs. 98.1% (103/105), 62.2% (51/82) vs. 81.9% (86/105), χ²=9.43, 8.72; P=0.002, 0.003). The pre-QC completion rates of reaching blood lactate ≤5 mmol/L, central venous oxygen saturation ≥65%, and urine output≥1 ml/(kg·h) at 12 h after treatment were 82.1%(46/56), 72.1%(31/43) and 72.7%(48/66), respectively, compared with 81.1%(77/95), 69.1%(47/68) and 80.9%(76/94) in the post-QC group. The time from admission to ECMO initiation was shorter in the post-QC group than in the pre-QC group ((11±17) vs. (7±10) h, t=2.09, P=0.037). The mortality rates were 22.0% (18/82) in the pre-QC group and 12.4% (13/105) in the post-QC group. Compared with the pre-QC group, the post-QC group presented decreased rates of pre-ECMO cardiopulmonary resuscitation, cerebral injury and severe renal injury (51.2% (42/82) vs. 28.6% (30/105), 19.5% (16/82) vs. 8.6% (9/105), 19.5% (16/82) vs. 8.6% (9/105); χ²=9.97, 4.76, 4.76, all P<0.05). Conclusions: The implementation of the QC protocol for pediatric FM improves the ability of organ injury identification and standardized treatment, facilitates timely ECMO initiation, reduces the occurrence of cardiac arrest and major complications, and is of great significance for improving long-term quality of life. The pilot hospitals achieves high completion rates of QC indicators, indicating good feasibility of the protocol.

Little is known about the outcomes of extracorporeal cardiopulmonary resuscitation (ECPR) for cardiopulmonary arrest occurring after major cardiac surgery. This study aimed to evaluate our institutional experience with ECPR in this setting. We retrospectively reviewed all adult patients who underwent extracorporeal membrane oxygenation (ECMO) for cardiopulmonary arrest within 30 days after major cardiac surgery outside the operating room between 2015 and 2023. Baseline characteristics, operative details, and clinical outcomes were analyzed. A total of 21 patients who underwent ECPR were identified. Index operations included valve surgery (n = 5), coronary artery bypass grafting (CABG) (n = 10), and others. The location of arrest was the intensive care unit (ICU) in 8 patients (38.1%) and the step-down unit in 13 patients (61.9%). Nine patients (42.9%) underwent central cannulation with an open chest, and 12 (57.1%) underwent femoral cannulation with chest compressions. Twelve patients (57.4%) were successfully decannulated, whereas nine (42.6%) died while on ECMO. In-hospital mortality was 47.6% (n = 10) and similar between central and femoral cannulation (44.4 vs. 50.0%; p = NS). Of the 11 in-hospital survivors, 7 (33.3%) were neurologically intact at discharge. Kaplan-Meier analysis showed a 1 year survival rate of 41.2%.

We explored the effects of continuation care based on trans-theoretical model (TTM) in adult patients with acute leukemia (AL). Patients with AL who had been discharged from our hospital were randomly assigned to the control group (n = 68) and intervention group (n = 74). The control group received routine nursing, while the intervention group received a structured psychoeducational follow-up program based on the Transtheoretical Model (TTM). 2 months after intervention, the quality of life (QoL), mood, self-care ability, and incidence of complications were assessed and compared. The patients were then followed up for 18 months to observe their long-term survival. The incidence of complications was significantly lower in the intervention group than in the control group, whereas the QoL scores, positive mood scores, and self-nursing ability scores were higher (P<0.05). At a median follow-up of 18 months, the overall survival was significantly better in the intervention group than in the control group (P = 0.013). The Program effectively reduced the incidence of complications and improved the QoL, emotional well-being, and self-nursing ability, thereby offering certain advantages in enhancing the AL patients' survival rates. The TTM-based continuation care can be implemented to improve the QoL in patients with AL, and is worth promoting.

Balamuthia mandrillaris is a highly lethal free-living ameba that primarily affects the skin and central nervous system, manifesting clinically as chronic granulomatous lesions and granulomatous encephalitis. Once the central nervous system is involved, the mortality rate exceeds 90%. No standardized treatment regimen has yet been established. In this review, we summarized 66 cases reported from China. The median patient age was 36 years (range 10 months-77 years); 62.12% patients were male and 37.88% female. Fifty-five (83.33%) patients were immunocompetent. For 42 (63.64%) patients, initial symptoms were cutaneous manifestations; of those, central nervous system involvement subsequently developed in 25 (59.52%) patients. Twenty-four (36.36%) patients were hospitalized initially with encephalitis. Among the 63 patients with a known outcome, 43 (68.25%) succumbed to infection. For patients with cutaneous-only disease, the survival rate was 93.75%, whereas once the central nervous system was affected, mortality reached 96.00%.

This study aimed to analyze prognostic factors associated with survival and recurrence in patients with Oral Cavity Squamous Cell Carcinoma (OCSCC) treated in São Paulo, Brazil. The investigation focused on evaluating the influence of clinical stage, treatment modality, age, and sex on overall and recurrence-free survival in a large cohort derived from a public cancer registry. Single-center retrospective observational study with a cross-sectional and quantitative design. São Paulo, Brazil. A retrospective analysis was conducted using data from 10,122 patients diagnosed with OCSCC between 2004 and 2014, obtained from the Oncocenter Foundation of São Paulo (FOSP) database. The primary endpoint was Overall Survival (OS), and secondary endpoints included Recurrence-Free Survival (RFS), Disease-Free Survival (DFS), and Local Recurrence-Free Survival (LRFS). Prognostic factors were assessed through univariable and multivariable Cox proportional hazards models. Kaplan-Meier curves were used to estimate survival, and comparisons were made using the log-rank test. The mean follow-up time was 39.37 ± 37.93 months. Age ranged from 11- to 104-years, with a mean age of 60.2 ± 12.6 years at diagnosis, and 78.3% were male. Most patients (61.97%) were diagnosed at an advanced stage (III-IV). Advanced stage and non-surgical treatment were independently associated with worse OS (HR = 4.253, 95% CI 3.883-4.659; 2.546, 95% CI 2.381-2.722, respectively). The 5-year overall survival rate was 50.3%, with a mean survival interval of 6.70 ± 0.06 years after diagnosis. Elderly patients and men had higher recurrence and mortality risks, whereas early-stage disease and surgical treatment were associated with better outcomes. Advanced clinical stage and non-surgical treatment were the strongest independent prognostic factors for decreased survival in OSCC. These findings underscore the importance of early detection and surgical management, as well as the need for public health strategies to reduce diagnostic and treatment delays in Brazil. 2B.

Malignant rhabdoid tumors (MRT) are highly aggressive tumors, primarily described in children, but also affecting adults. The objective was to identify independent prognostic factors to predict individual patients' risk and to establish an age-spanning risk stratification system for prospective trials. Data from the Surveillance, Epidemiology, and End Results Program (SEER 17), accruing patients with extracranial MRT as first malignancy 2000-2019 yielded 324 evaluable cases. The initial selection of probable predictive factors was conducted through univariate analysis, employing the Kaplan-Meier estimator. The Cox proportional-hazard regression model was employed to assess the independent risk of preselected factors. Besides a nomogram, a risk-scoring system was developed based on the sum of hazard ratios to create a 4-risk group and a 3-risk group stratification, respectively. 3-, 5-, and 10-year overall survival rates were 35.1%, 31.1%, and 27.9% respectively, with corresponding disease-specific survival rates of 38.7%, 34.8%, and 32.8%. Significant prognostic factors identified in the univariate analysis were age, size, site and disease stage, and consequently included in the Cox regression analysis. All factors remained significant. A nomogram was constructed to assess the patient's individual survival probability. Additionally, a risk score system was developed in which individual risk scores were determined by adding up the respective hazard ratios. Patients were stratified into four risk groups, with 3-year survival rates of 77.4%, 51.0%, 26.5%, and 9.0%, respectively. A categorization into three risk groups yielded survival rates of 61.9%, 26.3%, and 8.4%, respectively. This analysis identified subsets of eMRT patients who exhibited highly divergent survival probabilities. The derived nomogram may facilitate the estimation of individual survival outcomes. The proposed scoring system may be used to assign patients to risk-tailored therapy regimens. It is our hope that our approach will improve the survival of this aggressive disease.

Mantle cell lymphoma (MCL) is a heterogeneous disease with variable clinical presentations, pathological types, and molecular characteristics. Survival rates have improved with the emergence of novel therapies, but rates of relapsed and refractory disease remain high in developing countries due to lack of easy availability of newer therapeutic agents due to financial and logistical constraints. In this manuscript, we present a single-center retrospective data from an Egyptian tertiary care hospital and discuss our experience with managing MCL patients and factors affecting their outcomes. This was a retrospective study that has been conducted on 69 cases of newly diagnosed MCL patients who attended the Oncology Centre Mansoura University (OCMU) from April 2011 to April 2023. Detailed history, clinical examination, basic and advanced laboratory and radiological investigations were performed at diagnosis. Patients received treatment according to the institutional protocols in the form of RCHOP [rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone] and RDHAP [rituximab, dexamethasone, high dose cytarabine and cisplatin] as induction therapy and ICE [ifosfamide, carboplatin, etoposide], ESHAP [etoposide, methylprednisolone, high dose cytarabine and cisplatin], gemcitabine-based protocols, and others as second line therapies. Some patients received metronomic therapies or received the best supportive care (BSC). The response was evaluated based on Lugano response criteria. The primary end point is to evaluate characteristics of MCL patients in Egyptian center with determination of some prognostic factors and secondary end point is evaluation of the overall survival (OS) and the factors influencing it. In our study, we demonstrated many factors that had an impact on the OS, they were categorized into factors related to the patient, factors related to the clinical course of the disease, factors related to laboratory markers and treatment related factors. Old age (≥ 65 years) was associated with an inferior survival rate with a median of 29 months (95% CI;16-45.2) with p-value = 0.044 The patients who received R-CHOP ± R-DHAP had a superior OS with a median of 64mo (95% CI; 64-75.3) and 22mo (95% CI; 16-55) respectively than the patients who received other protocols, mainly the COP [cyclophosphamide, vincristine and prednisone]and best supportive care (BSC) who experienced the most inferior OS with a p-value = 0.0016. The relapse was associated also with an inferior median OS of 22mo (95% CI; 16-60) with a significant p-value = 0.025. The patients who received only one line of chemotherapy showed a superior OS with a median of 55mo (95% CI; 35-75.3) in comparison to patients who received more than one line of chemotherapy with a median OS of 22mo (95% CI; 16-43.2) with a significant p-value = 0.0012. SOX11 expression was associated with inferior OS with a median OS of 10mo (95% CI; 5-25.3) with p-value = 0.0052 . Cyclin D1 expression was associated with better OS than the patients associated with t(11:14) with a median OS of 55mo (95% CI; 34-75) and of p-value = 0.00063 . Lower hemoglobin levels ( p -value of 0.036) , lower platelet levels ( p -value of 0.0096) , and higher levels of lactate dehydrogenase (LDH) ( p -value of 0.012) were associated with dismal prognosis. We concluded that multiple clinical, laboratory, and molecular factors can affect the survival of MCL such as old age, low hemoglobin, platelets levels, high LDH levels, SOX11 expression and lack of CyclinD1 expression. Other important factors are the type of induction chemotherapy, the response to treatment, and relapse status. To overcome the limitations in our study, larger cohorts are needed to be studied with the evaluation of the novel therapies when feasible. Enhancing financial support is crucial to improve MCL patients' care in our country.

Extracorporeal Membrane Oxygenation (ECMO) serves as a temporary life support for critically ill patients, and with its advancing clinical application, survival rates have significantly improved. However, research focus is shifting from saving lives to improving survivors' quality of life. Currently, most studies concentrate on short-term outcomes such as in-hospital mortality, while long-term psychosocial adaptation after discharge remains understudied. Extracorporeal Membrane Oxygenation patients often face psychological distress during Intensive Care Unit stays and multiple challenges after discharge, which can profoundly affect their long-term quality of life and social reintegration. Therefore, it is necessary to conduct an in-depth study on the psychosocial adaptation of ECMO survivors and its influencing factors. To assess the long-term psychosocial adaptation status of survivors after Extracorporeal Membrane Oxygenation (ECMO) and to identify its key influencing factors. A multicentre cross-sectional study. This study utilized a convenience sampling method to recruit 205 patients discharged after Extracorporeal Membrane Oxygenation treatment from three tertiary hospitals, China. Data were collected using the Self-Report Psychosocial Adjustment to Illness Scale, general information questionnaire, the Connor-Davidson Resilience Scale and the Social Support Rating Scale. A total of 205 ECMO patients were included in this multicentre study. The psychosocial adaptation score of Extracorporeal Membrane Oxygenation patients was 48.40 ± 22.43. Multiple linear regression analysis revealed that age, income, residence, education level and time since discharge were significant influencing factors for psychosocial adaptation in these patients. The psychosocial adaptation of Extracorporeal Membrane Oxygenation patients was found to be at a moderate level, indicating a need for further improvement. Healthcare professionals should implement targeted interventions to enhance their psychosocial adaptation and promote better disease outcomes. For clinical nurses, these findings highlight the need to systematically assess not only patients' physical function but also their psychological resilience and ability to utilise social support during follow-up. Targeted interventions focusing on resilience-building and actively coaching patients on how to effectively seek and accept support should be integrated into post-ECMO care plans to improve long-term psychosocial adaptation. For patients and families, this underscores the importance of developing skills to actively engage with support networks and resources throughout the recovery journey.

Treatment outcomes of preformed metal crowns placed with the conventional versus hall techniques: One-year randomized controlled trial results.

Relapsed small cell lung cancer (SCLC) treatment has limited evidence-based options. Solvent-based paclitaxel (PTX) and albumin-bound nanoparticle paclitaxel (nab-PTX) are commonly prescribed though never comprehensively quantified. A systematic review and single-arm meta-analysis was conducted (PROSPERO Registration: CRD42024592475). PubMed, Web of Science, Cochrane Library, and EMBASE were searched for interventional or observational studies reporting PTX or nab-PTX monotherapy in relapsed SCLC. Primary outcomes were the pooled 3-month progression-free survival rate (PFS), 6-month overall survival rate (OS), objective response rate (ORR), and disease-control rate (DCR). Random-effects models generated pooled estimates; prespecified subgroup analyses compared Asian versus Euro-American cohorts, and PTX versus nab-PTX treatment. Fifteen studies (11 retrospective and 4 prospective) comprising 631 patients met the eligibility criteria of the study. Pooled efficacy estimates were: 3-month PFS 39% [95% confidence interval (CI)=28-50%, I2=84%], 6-month OS 46% (95%CI=32-61%, I2=91%), ORR 16% (95%CI=12-21%, I2=51%) and DCR 51% (95%CI=41-61%, I2=83%). Grade 3 or higher toxicities were infrequent - neutropenia 18% (95%CI=11-25%, I2=89%) and peripheral neuropathy 2% (95%CI=0-3%, I2=0%). Among 45 patients with pre-existing interstitial lung disease (ILD), treatment-related ILD exacerbations were 17% (95%CI=6-28%, I2=0%). Asian cohorts demonstrated greater neutropenia (26% vs. 5%) than Euro-American cohorts. Efficacy and safety were similar between PTX and nab-PTX monotherapy. Despite substantial heterogeneity, paclitaxel-based regimens demonstrated modest but clinically meaningful activity with generally favorable safety profile in relapsed SCLC, highlighting them as a pragmatic salvage option. In patients with ILD, their use warrants caution due to the risk of ILD exacerbation.

Hydroxyapatite nanoparticles improve vitrified bovine MII oocyte developmental competence by reducing ultrastructural damage and modulating gene expression.

The combined use of Veno-venous extracorporeal membrane oxygenation (VV-ECMO) and damage-control laparotomy/open abdomen (DCL/OA) is not well described in the literature. We hypothesized that the mortality with concurrent VV-ECMO and DCL/OA would not be statistically different from that reported for either intervention alone. Patients managed with a DCL/OA and VV-ECMO from March 2014 through March 2022 were retrospectively reviewed from a prospectively collected database at a single quaternary care center. The primary outcome was in-hospital mortality. Survivor and nonsurvivor cohorts were compared using univariate and bivariate analyses with a priori significance at p ≤ 0.05. A multivariable regression analyses was performed to identify independent predictors of mortality. Fifty-two patients were managed with VV-ECMO and concurrent DCL/OA. The majority of patients were male (58%), with a mean (SD) age of 41 (14) years. The primary indication for VV-ECMO was acute respiratory distress syndrome/pneumonia (83%). The primary indications for DCL/OA were abdominal compartment syndrome (37%) and trauma (19%). Sixty percent of the patients underwent VV-ECMO cannulation after DCL/OA. Survival at hospital discharge was 58%. Survivors had a lower mean Sequential Organ Failure Assessment score (12 vs. 14, p = 0.02), higher mean Respiratory ECMO Survival Prediction score (3.5 vs. 1.1, p = 0.004), lower mean preoperative lactic acid level (4 vs. 7, p = 0.04) and were more likely to receive anticoagulation while on VV-ECMO (70% vs. 30%, p = 0.012) than nonsurvivors. Postdischarge, survival rates at 3, 6, 9, and 12 months were 90%, 72%, 69%, and 62%, respectively. After adjusting for confounders, the use of anticoagulation (odds ratio, 0.08; 95% confidence interval, 0.01-0.42) and a higher Respiratory ECMO Survival Prediction score (odds ratio, 0.71; 95% confidence interval, 0.53-0.95) were associated with decreased mortality. Relatively favorable outcomes are often achieved in acute care surgery patients treated with concomitant VV-ECMO and DCL/OA. Veno-venous extracorporeal membrane oxygenation should not be considered a contraindication to DCL/OA and vice versa. ( J Trauma Acute Care Surg . 2026;101: 136-144. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.). Retrospective Cohort Study; Level III.

Particle therapy is gaining interest for treating esophageal cancer due to its ability to target tumors while minimizing radiation exposure to surrounding organs compared to X-ray therapy. While simulations show a favorable distribution with particle therapy, there is ongoing discussion regarding its impact on the prognosis of esophageal cancer. This study sought to assess the effectiveness of particle therapy in treating esophageal cancer by comparing it with previous clinical trials of X-ray therapy in Japan. This was a multicenter, prospective, observational registry study, and particle therapy was performed in accordance with a unified treatment policy. For stage I and II/III cases, cases that met the eligibility criteria for the Japan Clinical Oncology Group 0502 and 0909 clinical trials were extracted, and the clinical results were compared. The three-year overall survival rates were 94.7% and 84.9% for stage I and stage II/III cases, respectively. The three-year progression-free survival rates were 90.4% in stage I patients and 60.3% in stage II/III patients. No statistically significant differences were observed in overall survival or progression-free survival when comparing registry data with the two Japan Clinical Oncology Group studies. No grade 3 or higher cardiopulmonary toxicities were observed in the registry data. This study analyzed nationwide registry data, and particle therapy is a safe treatment regarding toxicity for esophageal cancer, although further investigation into its effectiveness is needed.

Study on the characteristics of W1/O/W2 emulsion delivery system stabilized by soybean protein isolate/(-)-epigallocatechin gallate/exopolysaccharides complex.

Screening of botanical drugs against Metschnikowia bicuspidata and preliminary application in the "milky disease" of Eriocheir sinensis.