Treatment Time Research Articles

Clinical and immunophenotype correlating with response to immunotherapy in paediatric patients with primary liver carcinoma. A case series

Paediatric hepatocellular carcinomas (HCC) traditionally arise in the context of a normal structural and functional liver and carry a dismal prognosis. While chemotherapy is the frontline standard, there is emerging interest in the study of immunotherapies for paediatric patients with relapsed/refractory disease. There is limited data to support whether immunotherapies will be of utility in this patient population. Six paediatric patients (median age:16 years, range: 12-17at the time of treatment) with advanced hepatocellular neosplams, either conventional hepatocellular or fibrolamellar carcinoma, were treated with immunotherapy. Patients were consented to institutional genomic profiling and biobanking protocols. Baseline samples and serial tissue samples, when available, were evaluated for somatic mutation rate, actionable gene mutations, and pan-immune bulk RNA expression profiling. Results were correlated with clinical course. Three patients responded to checkpoint inhibition: one achieved a complete, durable response and the other two, prolonged stable disease. Three additional patients progressed. Diagnostic tissue from the complete responder demonstrated a higher relative mutational burden and robust immune infiltrate. Pre-treatment samples from the three responders demonstrated decreased expression of genes associated with T-cell dysfunction. A subset of patients with primary paediatric hepatocellular tumours will respond to immunotherapy. Immunotherapies are currently under prospective study for relapsed/refractory liver tumours in paediatric patients. Results from this report support the prospective collection of serial serum and tissue samples which may further identify genomic and immunophenotypic patterns predictive of response. This work was supported by Philanthropic funds (Pan Mass Challenge, Team Angus and Team Perspective).

Posterior crossbite corrections in the early mixed dentition with quad helix or rapid maxillary expander: a cost-effectiveness analysis of a randomized controlled trial.

Unilateral posterior crossbite is a common malocclusion, and early treatment is recommended to enable normal growth. There are several possibilities regarding choice of appliances used for correcting this malocclusion; however, when treatment is financed by public funds the decision needs to be based not only on the effects but also on the effect in relation to the costs. The aim was to perform a cost-effectiveness analysis comparing quad helix (QH) and rapid maxillary expanders (RME; hyrax-type) in children in the early mixed dentition. Seventy-two patients were randomized to treatment with either QH or RME, at two different centres. Data were collected from the patient's medical records regarding success rate, number of visits, total treatment time, emergency visits, and so forth, together with answers from patient questionnaires concerning absence from school and use of analgesics. A cost-effectiveness analysis with both an intention-to-treat (ITT) and a per-protocol approach was performed, as well as a deterministic sensitivity analysis. The success rate, one year after the completion of the expansion, was equal between groups according to the ITT approach. From a healthcare perspective, the mean cost difference between RME and QH was €32.05 in favour of QH (P = 0.583; NS). From a societal perspective, the mean cost difference was €32.61 in favour of QH (P = 0.742; NS). The total appliance cost alone was higher in the RME group €202.67 resp. €155.58 in the QH group (P = 0.001). The probability of RME having a higher cost was 71% from a healthcare perspective and 62.7% from a societal perspective. The total treatment time was 97 days longer in the QH group. In the deterministic sensitivity analysis, when using a higher valuation of the children's educational loss, the QH becomes €58 more costly than the RME. There was a statistically significant difference in chair time and visits between centres (P < 0.001). The difference in costs between RME and QH is not statistically significant, however, there is a slightly higher probability that RME is more expensive than QH with a mean cost of an additional €32 per patient from a healthcare perspective. Different work procedures at different centres indicate that logistics around the patient's treatment is a more important aspect than appliance used to decrease the number of visits and save chair time and thereby also costs.

New molecules of importance in the prevention and treatment of acne: A systematic patent review (2016-2020).

Acne is a highly prevalent disease that mainly affects the pilosebaceous units associated with sebaceous glands, causing inflammatory skin lesions and affecting the self-esteem, mental health, and quality of life of those who suffer from this disease. Different treatments exist today to prevent, reduce, and improve symptoms; however, over the years, there have been problems with bacterial resistance and slight effectiveness with prolonged use. The purpose of this article is based on the review of patents of new products of principal topical administration for the treatment of acne in recent years 2016-2020, to evaluate and analyze novel synthetic molecules and semi-synthetics with potential therapeutic and preventive in the acne treatment. A systematic review of patents was conducted through the official database of the European Patent Office - Espacenet, where the search focused on the keywords: "acne and bacteria" in the title or abstract. Only patents granted between the years 2016-2020 were included, with products having molecules with a synthetic and semi-synthetic origin, without considering natural, biological products or those used as diagnostic means. A total of 19 patents were selected, most with principally antimicrobial and anti-inflammatory action, where the reduction in the appearance of resistance by C. acnes is verified, and its action is complemented by inhibiting the different pathophysiological mechanisms that lead to the worsening of the disease. Novel approaches in the treatment and prevention of acne, mainly topically, are focused on the reduction of bacterial resistance and irritation compared to current treatments. The use of combined formulations provides better results with additional benefits, improving treatment times and patient adherence.

Modulated Arc Therapy for hippocampal-avoidance whole brain radiation therapy: planning comparison with intensity modulated Radiation Therapy.

This study aimed to evaluate the modulated arc therapy (mARC) technique as a planning and treatment option for hippocampal sparing whole brain radiotherapy (HS-WBRT) following the Radiation Therapy Oncology Group (RTOG) 0933 dosimetric criteria. Computed tomography (CT) and magnetic resonance imaging (MRI) were selected retrospectively for 15 patients. Two types of plans were created for each patient, namely an intensity-modulated radiation therapy (IMRT) and a mARC plan. IMRT and mARC plans were compared in terms of plan quality indices, absorbed dose to organs at risk (OARs), number of monitor units (MUs), and treatment time. All plans in both techniques were considered clinically acceptable for treatment. However, IMRT plans presented a higher conformity (p = 0.01) as well as a higher homogeneity as compared to mARC plans, but this difference was not statistically significant (p > 0.05). In terms of the preservation of the hippocampus, it was observed that the IMRT plans achieved significantly lower doses for both 100% of its volume and for its maximum dose (p < 0.001). The evaluation of the remaining OARs showed that the IMRT technique resulted in lower doses, and significant differences were observed for the following organs: left cochlea (p < 0.001), left eye (p < 0.001), right eye (p = 0.03), both lenses of the eye (p < 0.001), and right optic nerve (p = 0.02). Despite these differences, the absolute differences in all dosimetric parameters were low enough to bear any clinical relevance. A drastic (close to 65%) and significant (p < 0.001) decrease was observed in the number of MUs for the mARC plans. This resulted in a substantial decrease in treatment time (60.45%, p < 0.001). It is concluded that the mARC technique is a feasible planning and treatment solution for HS-WBRT that meets the RTOG 0933 criteria. The main advantage of using mARC over IMRT for HS-WBRT is the considerable reduction in MUs and treatment time.

Modifications on the Processing Parameters of Traditional Pineapple Slices by Stabilized Sound Pressure of Multiple Frequency Ultrasonic-Assisted Osmotic Dehydration

This study investigated the practical feasibility of synergistically and optimally applying ultrasound-assisted osmotic dehydration (UAOD) practices for the pineapple slice picking process (in sugar osmotic solution), with potential implications for improving current practices. This study was carried out to evaluate the effects of different treatment conditions of single (40 and 80 kHz)/multiple (40/80 kHz) frequencies, output powers (300, 450, and 600 W), and treatment time (5–40 min) at 30, 45, and 60 °Brix applied, respectively, on the pineapple slices picking process. The sound pressure of the UA was also measured to confirm that it provided the corresponding effect stably under different conditions. The ideal UAOD operating condition for pineapple slices is a 45 °Brix sugar osmotic solution, with frequency multiplexing at 40/80 kHz and an output power of 450 W for 25 min, which yields the optimal solids gain (SG) rate of 7.58%. The above results of this study indicated that UAOD could improve the accelerated quality transfer of pineapple slices and enhance the final product quality, thereby increasing the efficiency of the dehydration process and saving processing costs and time.

Efficacy of a full management model in daytime surgery for gastrointestinal polyps based on WeChat: A study protocol for randomized controlled trials.

The objective of this study is to improve the efficiency of daytime surgery for gastrointestinal polyp and ensure the safety of patients. We tried an information management method based on WeChat platform in patients undergoing daytime gastrointestinal polypectomy and to explore the feasibility and effectiveness of a full management model. Five hundred and ninety-three patients were randomly divided into two groups: the control group was treated with traditional management methods and the experimental group was treated with the whole-process management mode based on the WeChat platform. The WeChat platform-based full management model included establishing a day surgery management WeChat group, developing multidisciplinary, full-management protocols and processes for day surgery, establishing an information-based surgical scheduling system and adopting diverse forms of day surgery education and continuity of care. This feature included illustrated brochures, vivid verbal presentations, WeChat public numbers and Internet management platforms. The treatment time, hospitalization cost and patient satisfaction of the two groups were counted. In the experimental group, 408 patients were enrolled. The preoperative waiting time and patients' length of stay were 3 days and 1 day, respectively. The medical and nursing intake time was 7 min. The procedure cancellation rate and postoperative complications rate was 0.07% and 0.02%. In the control group, 185 patients were enrolled in the study, The preoperative waiting time and patients' length of stay was 7 days and 3 days. The medical and nursing intake time was 28 min. The procedure cancellation rate and postoperative complications rate were 0.13% and 0.05%, respectively. The hospitalization costs were reduced by an average of $140/person and the satisfaction scores were higher than the control group. In summary, the preoperative waiting time, medical reception time, surgical cancellation rate, length of hospital stay and hospitalization cost in the observation group were less than those in the control group (p < 0.05). Patient satisfaction scores were significantly higher than those in the control group (p < 0.05). Through the full management model based on WeChat, the preoperative waiting time, medical reception time, surgical cancellation rate, length of hospital stay and hospitalization cost in the experimental group were less than those in the control group. Patient satisfaction scores were significantly higher than those in the control group and the difference was statistically significant.

Influence of radiotherapy interruption on esophageal cancer with intensity-modulated radiotherapy: a retrospective study

BackgroundRadiotherapy interruption (RTI) prolongs the overall total treatment time and leads to local control loss in many cancers, but it is unclear in esophageal cancer. We aimed to evaluate the influence of RTI on the overall survival (OS), progression-free survival (PFS), and local-regional recurrence-free survival (LRFS) of patients with esophageal cancer undergoing chemoradiotherapy.MethodsA total of 299 patients with esophageal squamous cell carcinoma from 2017 to 2019 were retrospectively analyzed to investigate the effect of RTI on OS, PFS, and LRFS. The delayed time of radiotherapy interruption was calculated as the actual radiation treatment time minus the scheduled time. The univariate and multivariate analyses were performed by the COX proportional hazards regression models, and the survival analysis was performed through the Kaplan‒Meier method, and compared with the log-rank test.ResultsThe 3-year OS, PFS, and LRFS rates were 53.0%, 42.0%, and 48.0%, respectively. The univariate and multivariate analyses showed that the delayed time > 3 days was an independent adverse prognostic factor for OS (HR = 1.68, 95% CI 1.10–2.55, p = 0.016), and LRFS (HR = 1.74, 95% CI 1.18–2.57, p = 0.006). The patient with a delayed time of > 3 days had poorer survival rates of OS, and LRFS than patients with a delayed time of ≤ 3 days (OS, p = 0.047; LRFS, p = 0.013), and the survival outcomes of patients with shorter delayed time (1–3 days) were slightly different from the patients without interruptions. The impact of delay time on PFS is not statistically significant, but the survival outcomes of the two groups were slightly different.ConclusionThere was a significant correlation between delayed time and local control of esophageal cancer. The delayed time for more than 3 days might decrease the survival outcome, and increase the local recurrence risk.

The Expression of Hypoxia-Inducible Factor-1 Alpha (HIF-1α) as a Potential Target for Hypoxic Therapy in COVID-19 Cases

Background: The cellular response to hypoxia is characterized by the stabilization of the HIF-1α protein, which will form a transcription factor that activates genes for low oxygen adaptation. Positive cases of COVID-19 are often characterized by hypoxia, especially in patients with comorbidities. This hypoxic condition will mediate drug resistance or weaken the patient's condition, resulting in lengthening treatment time and even causing death. This study aims to analyze the cellular expression of the HIF-1α gene in patients confirmed positive for COVID-19 with the alpha, beta, delta, and omicron variants. Methods: The research design used was observational, with parameters measuring HIF-1 mRNA expression (RT-PCR, protein (ELISA), and its correlation. The samples used were nose-throat swabs from COVID-19 patients. Results: The expression of HIF-1α mRNA and protein levels produced in variants of COVID-19 patients was compared with controls (times; ng/mL): alpha (0.53; 18.08), beta (0.92; 19.98), delta (0.65; 25.83), and omicron (0.73; 19.85) (Kruskal-Wallis test, p &lt;0.01). The correlation between mRNA expression of HIF-1α and HIF-1α proteins was found to be significantly negative (Pearson Correlation test R = -0.589). Conclusion: In this study, it was found that a decrease in HIF-1α mRNA expression (the result of transcription) increased the levels of HIF-1α protein (the result of translation) and stable HIF-1α expression. Moreover, cellular hypoxia occurred in patients with confirmed positive for COVID-19, with the alpha, beta, delta, and omicron variants. This study can be used as a basis for therapy to control viruses that cause hypoxia in the future. result: The expression of HIF-1α mRNA and protein levels produced in variants of COVID-19 patients compared with controls (times; ng/mL): alpha (0.53; 18.08), beta (0.92; 19.98), delta (0.65 ; 25.83), omicron (0.73; 19.85) (Kruskal Wallis test, p &lt;0.01); The correlation between mRNA expression of HIF-1α and HIF-1α proteins obtained strong negative results (Pearson Correlation test R = -0.589 ).

Comparison of dehydration systems in quality and chemical effects on sunflower seeds

The present work investigates the quality and the chemical effects of dehydration, using a novel dehydration system based on an electromagnetic induction and low pressures technique, comparing it with the thermo-solar drying system. High oleic sunflower seeds, which are an important oil seed crop, were used due to the fact that they have a special place in the food industry. The seed samples were exposed to electromagnetic induction and low pressures by 0.5 and 1 h, then several chemical characterizations were carried out, in the electrophoresis study, it was found that most proteins in the hull were degraded or denatured, some of them were lost during the time in the thermosolar dryer while in kernel keeps 94.9% of the concentration in control proteins. Otherwise, the electromagnetic induction dryer did not lose the most of proteins in the kernel keeping 99.1% in 0.5 h and 98.4% in 1 h, just degrading its concentration. Germination viability results did not show changes after 0.5 h in the electromagnetic fields, but they decreased in 1 h from 66 to 40% until the thermosolar method fell to 24% in 4 h, both analysis results change proportionally with the treatment time and moisture content and the amount of the oxygen.

Dynamic Magnetic Field Analysis and Delivery Strategy Optimization for Scanning Magnet in Proton Therapy System

In pencil beam scanning proton therapy, the regulation and stabilization of the scanning magnetic field between two spots should be completed as quickly as possible in order to reduce treatment time. Because of the eddy current effect, the dynamic magnetic field lags behind the excitation current. It is significant to analyze the dynamic field and reduce the field stability time to minimize the delivery time and improve the therapy efficiency. In this paper, dynamic magnetic field simulation is carried out with a full lamination model of the scanning magnet in the Huazhong University of Science and Technology Proton Therapy Facility. In addition, a single lamination model instead of a full lamination model is explored to reduce time cost and memory for lamination of no more than 1-mm thickness. The eddy current diffusion trend and the influence of lamination on the eddy current are investigated. Moreover, the effect of lamination thickness (ranging from 5 to 0.1 mm) and current ramp rate (ranging from 20 to 100 A/ms) on the magnetic field stability time is studied. In addition, the characteristic of magnetic stability time for various spot steps is analyzed. Considering two spot patterns with discrete or clustered spots, an optimized delivery strategy with various scanning dead times according to the step is presented. When the lamination is 1 mm, the scanning time can be reduced by 39.2% for a clustered pattern and 38.4% for a discrete pattern using a genetic algorithm based on the different scanning dead-time strategy instead of the fixed dead-time strategy. With a thinner 0.1-mm lamination, the scanning time can be reduced by 49.8% for the clustered pattern and 43.3% for the discrete pattern, compared to that of the 1-mm lamination.

Enhancing CO2 transport with plasma-functionalized ionic liquid membranes

The ionic liquid (IL) 1-butyl-3-methylimidazolium tetrafluoroborate treated with radiofrequency plasma is proposed for functionalization and immobilization on polyethersulfone supports to form supported ionic liquid membranes for CO2 separation. The effects of treatment time and transmembrane pressure difference on CO2 permeance were evaluated. The best gas permeation performance was obtained with a treatment time of 10 min and the transmembrane pressure difference was 0.25 MPa. Characterization of the materials by Fourier transform infrared spectroscopy, x-ray photoelectron spectroscopy and nuclear magnetic resonance spectroscopy demonstrates that the IL is grafted with carboxyl groups and deprotonated through plasma treatment. A preliminary mechanism for the plasma treatment and facilitated transport of CO2 has been proposed on this basis.

A Bulk Oxygen Vacancy Dominating WO3−x Photocatalyst for Carbamazepine Degradation

Creating oxygen vacancy in tungsten trioxide (WO3) has been considered as an effective strategy to improve the photocatalytic performance for degrading organic pollutants. In this study, oxygen vacancies were introduced into WO3 by thermal treatment under Ar atmosphere and their proportion was changed by setting different treatment times. WO3−x samples show better photoelectric properties and photocatalytic degradation performance for carbamazepine (CBZ) than an oxygen-vacancy-free sample, and WO3−x with the optimal proportion of oxygen vacancies is obtained by thermal treatment for 3 h in 550 °C. Furthermore, it discovers that the surface oxygen vacancies on WO3−x would be recovered when it is exposed to air, resulting in a bulk oxygen vacancy dominating WO3−x (bulk-WO3−x). The bulk-WO3−x exhibited much higher degradation efficiency for CBZ than WO3−x with both surface and bulk oxygen vacancies. The mechanism study shows bulk-WO3−x mainly degrades the CBZ by producing OH radicals and superoxide radicals, while oxygen-vacancy-free sample mainly oxidizes the CBZ by the photoexcited hole, which requires the CBZ to be adsorbed on the surface for degradation. The radical generated by bulk-WO3−x exhibits stronger oxidizing capacity by migrating to the solution for CBZ degradation. In summary, the influence of oxygen vacancy on photocatalytic degradation performance depends on both the proportion and location distribution and could lie in the optimization of the photodegradation mechanism. The results of this study could potentially broaden our understanding of the role of oxygen vacancies and provide optimal directions and methods for oxygen vacancy regulation for photocatalysts.

Effects of aging heat treatment on the mechanical properties of NiTi triply periodic minimal surface

This study investigated the impact of aging heat treatment time on the mechanical properties of NiTi triply periodic minimal surface structures fabricated through laser powder bed fusion. X-ray diffraction analysis results indicate that with increasing aging time, the NiTi2 phase precipitates while the content of the B19&amp;rsquo; phase decreases. At 10 h of aging time, the Ni4Ti3 phase becomes evident in the sample. The differential scanning calorimeter results show that R phase transformation occurs, and the phase transformation temperature increases when the aging time reaches 6 h. Microhardness increases with aging time, peaking at 477.8 HV after 10 h. Compression experiment results reveal a maximum elastic modulus of 1262.82 MPa for the gyroid sheet-shaped structure achieved after 2 h. In addition, the superelasticity test indicates the highest recoverable strains at 2%, 4%, and 6% compressive strain for the gyroid rod-shaped structure after aging for 10 h. In cyclic compression experiments, the ratio of shape memory recovery increases from 40% at 0 h to 97% at 6 h. Fracture analysis results show that the transition in the fracture mechanism from brittle fracture to quasi-cleavage fracture occurs after aging heat treatment.

Investigation of Kinetic, Equilibrium, and Thermodynamic Modeling of Perfluorooctanoic Acid (PFOA) Adsorption in the Presence of Natural Organic Matter (NOM) by Dielectric Barrier Discharge Plasma-Modified Granular Activated Carbon (GAC)

Perfluorooctanoic acid (PFOA) contamination in water sources poses significant environmental and health concerns. The kinetic, equilibrium, and thermodynamic features of PFOA adsorption in the existence of natural organic matter (NOM) were thoroughly investigated in this work using granular activated carbon (GAC) modified by dielectric barrier discharge (DBD) plasma. The impacts of DBD plasma parameters on the adsorption process were systematically examined. The results demonstrated that GAC modified by DBD plasma exhibited enhanced adsorption performance for PFOA, even in the presence of NOM. The optimal condition for plasma-treated GAC was achieved with 20 min of plasma treatment time and 100 W of plasma power, resulting in 92% PFOA removal efficiency in deionized water (DIW) and 97% removal efficiency in Chao Phraya River water (CPRW). A kinetic investigation using the pseudo-first-order model (PFOM), the pseudo-second-order model (PSOM), and the Elovich model (EM) indicated that plasma treatment time and NOM presence influenced the adsorption capacity and rate constants of PFOA with the PSOM having emerged as the most fitting kinetic model. The Langmuir isotherm model indicates monolayer adsorption of PFOA on plasma-treated GAC, with higher maximum adsorption capacity while NOM is present. The Redlich–Peterson and Sips isotherm models indicated varying adsorption capacity and heterogeneity in the adsorption system. The Sips model was determined as the most fitting isotherm model. Furthermore, the favorable and spontaneous character of PFOA adsorption onto plasma-treated GAC was validated by thermodynamic analysis, with endothermic heat absorption during the process. Overall, this comprehensive investigation provides valuable insights into the adsorption characteristics of PFOA in the existence of NOM using GAC modified by DBD plasma.

Ceramic soft tissue trimming bur gingival depigmentation: clinical performance and patient experience. A split mouth randomized controlled trial

BackgroundThe ceramic soft tissue trimming bur (CeraTip™) was initially introduced for use in gingivoplasty but has recently been used for gingival depigmentation. The aim of this study is to compare the efficacy of depigmentation between the novel CeraTip™ and the gold-standard surgical scalpel technique.MethodsEight healthy, nonsmokers with moderate to severe gingival hyperpigmentation in both arches were randomly assigned for CeraTip™ depigmentation in one arch as the test group (TG) and scalpel depigmentation in the opposite arch as the control group (CG). Pigmentation indices were used to assess clinical performance. Treatment time, pain level, and esthetic satisfaction were the parameters of patient experience. The assessments were performed at baseline, one week, one month, and three months.ResultsAt all assessment visits, pigmentation intensity represented by the Dummet oral pigmentation index (DOPI), and pigmentation distribution represented by the Hedin melanin index (MI), were significantly lower than those at baseline (p < 0.001) in both groups. When comparing the two groups, Scalpel depigmentation had better initial clinical outcomes, while CeraTip™ had less visible repigmentation, pain scores, treatment time, and greater esthetic satisfaction. However, none of the differences were statistically significant.ConclusionBoth techniques successfully removed gingival hyperpigmentation with comparable clinical performance. The patients preferred CeraTip™ depigmentation.Trial registrationThe study protocol was registered on 11/09/2023 on the www.clinicaltrials.gov database (NCT06031116) after the approval of the Ethics Committee, Faculty of Dentistry, Ain Shams University (FDASU-Rec012124).

Repetitive transcranial magnetic stimulation focusing on patients with neuropathic pain in the upper limb: a randomized sham-controlled parallel trial

This study aimed to evaluate the efficacy and safety of navigation-guided repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex in patients with neuropathic pain in the upper limb. This randomized, blinded, sham-controlled, parallel trial included a rTMS protocol (10-Hz, 2000 pulses/session) consisting of five daily sessions, followed by one session per week for the next seven weeks. Pain intensity, as well as pain-related disability, quality of life, and psychological status, were assessed. For the primary outcome, pain intensity was measured daily using a numerical rating scale as a pain diary. Thirty patients were randomly assigned to the active rTMS or sham-stimulation groups. In the primary outcome, the decrease (least square [LS] mean ± standard error) in the weekly average of a pain diary at week 9 compared to the baseline was 0.84 ± 0.31 in the active rTMS group and 0.58 ± 0.29 in the sham group (LS mean difference, 0.26; 95% confidence interval, − 0.60 to 1.13). There was no significant effect on the interaction between the treatment group and time point. Pain-related disability score improved, but other assessments showed no differences. No serious adverse events were observed. This study did not show significant pain relief; however, active rTMS tended to provide better results than sham. rTMS has the potential to improve pain-related disability in addition to pain relief.Clinical Trial Registration number: jRCTs052190110 (20/02/2020).

#867 Calciprotein particles and phosphorus in conventional and extended-hours hemodialysis

Abstract Background and Aims Extended-hours hemodialysis (HD) has better clinical outcomes than conventional HD. Previous studies have shown that a prolonged dialysis treatment time is associated with lower serum phosphorus levels, but the impact of extended-hours HD on calciprotein particles (CPP) is unknown. We investigated whether extended-hour HD and conventional HD have varying effects on blood levels of CPP and phosphorus, which have been identified as the main pathogenic molecules for vascular calcification. Method We performed a cross-sectional study of patients with extended-hours HD or conventional HD between January and March 2020. Blood CPP levels were measured in plasma and serum predialysis samples using a previously reported "gel filtration method". Linear and nonlinear associations between CPP and serum phosphorus levels were examined across dialysis modalities. Results A total of 382 participants (185 with extended-hours HD and 197 with conventional HD) were included in the analysis. The median age of participants was 71 years, 65% of the patients were men, and the mean phosphorus level was 5.4 mg/dL. Extended-hours HD was associated with lower plasma CPP levels (Extended-hours HD vs Conventional HD; 40,018 AU vs 75,728 AU) and serum CPP levels (Extended-hours HD vs Conventional HD; 66,524 AU vs 100,812 AU), regardless of similar serum phosphorus levels. Multivariable linear regression analysis showed that extended-hours HD was associated with lower natural logarithmic plasma CPP levels: -0.64 (95% CI: -0.74 to -0.55). Restricted cubic spline function indicated that extended-hours HD was associated with lower plasma CPP levels across levels of serum phosphorus, with significant differences observed between groups, especially in hyperphosphatemic conditions (P for interaction &amp;lt;0.01). Conclusion The patients with extended-hours HD had lower CPP levels than those with the conventional HD group despite no significant differences in serum phosphorus levels, which may contribute to better clinical outcomes in patients on extended-hours HD.

Plasma treatment of nafion membranes: Understanding the trade-off between surface modification and electrochemical degradation

Nafion is a polymer commonly used in electrochemical devices due to its excellent ionic conductivity. In applications such as proton-exchange membranes for fuel cells (PEMFCs) and ionomeric polymer metal composites (IPMCs), the interfacial properties are critical to device performance. Several studies use plasma treatment to modify the Nafion surface aiming for adhesion improvement through nanoroughness, however, most of them neglect the effects of this treatment on the membrane chemical structure and electrochemical performance. This work comprehensively investigates the Nafion properties, evaluating chemical, morphological, and electrochemical modifications trhough relevant characterization methods. Atomic force (AFM) and scanning electron microscopies (SEM) showed increased nanoroughness with plasma treatment time. Also, Fourier-transform infrared spectroscopy (FTIR) and X-ray photoelectron spectroscopy (XPS) analyses showed fluorine and sulfur abstraction, associated with side chain breakage. This effect was prejudicial to the water uptake and decreased the ionic conductivity, measured by Electrochemical Impedance Spectroscopy (EIS), from 140.8 to 1.0 μS cm−1 in the plasma-treated Nafion. Also, an applied electrochemical device was prepared and confirmed the ionic transport reduction using plasma-treated Nafion. This phenomenon is crucial for electrochemical devices, as fewer ionic channels remain on the treated membrane surface reducing water absorption, ionic conductivity, and charge density.

Impact of quality of life on mortality risk in patients with esophageal cancer: a systematic review and meta-analysis.

This systematic review and meta-analysis investigated the impact of quality of life (QoL) on mortality risk in patients with esophageal cancer. A literature search was conducted using the CINAHL, PubMed/MEDLINE, and Scopus databases for articles published from inception to December 2022. Observational studies that examined the association between QoL and mortality risk in patients with esophageal cancer were included. Subgroup analyses were performed for time points of QoL assessment and for types of treatment. Seven studies were included in the final analysis. Overall, global QoL was significantly associated with mortality risk (hazard ratio 1.02, 95% confidence interval 1.01-1.04; p < 0.00004). Among the QoL subscales of QoL, physical, emotional, role, cognitive, and social QoL were significantly associated with mortality risk. A subgroup analysis by timepoints of QoL assessment demonstrated that pre- and posttreatment global and physical, pretreatment role, and posttreatment cognitive QoL were significantly associated with mortality risk. Moreover, another subgroup analysis by types of treatment demonstrated that the role QoL in patients with surgery, and the global, physical, role, and social QoL in those with other treatments were significantly associated with mortality risk. These findings indicate that the assessment of QoL in patients with esophageal cancer before and after treatment not only provides information on patients' condition at the time of treatment but may also serve as an outcome for predicting life expectancy. Therefore, it is important to conduct regular QoL assessments and take a proactive approach to improve QoL based on the results of these assessments.

Evaluation of treatment of methicillin-resistant Staphylococcus aureus biofilms with intermittent electrochemically generated H2O2 or HOCl.

Chronic wound infections can be difficult to treat and may lead to impaired healing and worsened patient outcomes. Novel treatment strategies are needed. This study evaluated the effects of intermittently produced hydrogen peroxide (H2O2) and hypochlorous acid (HOCl), generated via an electrochemical bandage (e-bandage), against methicillin-resistant Staphylococcus aureus biofilms in an agar membrane biofilm model. By changing the working electrode potential, the e-bandage generated either HOCl (1.5 VAg/AgCl) or H2O2 (-0.6 VAg/AgCl). The degree of biocidal activity of intermittent treatment with HOCl and H2O2 correlated with HOCl treatment time; HOCl treatment durations of 0, 1.5, 3, 4.5, and 6 hours (with the rest of the 6-hour total treatment time devoted to H2O2 generation) resulted in mean biofilm reductions of 1.36 ± 0.2, 2.22 ± 0.16, 3.46 ± 0.38, 4.63 ± 0.74, and 7.66 ± 0.5 log CFU/cm2, respectively, vs. non-polarized controls, respectively. However, application of H2O2 immediately after HOCl treatment was detrimental to biofilm removal. For example, 3 hours HOCl treatment followed by 3 hours H2O2 resulted in a 1.90 ± 0.84 log CFU/cm2 lower mean biofilm reduction than 3 hours HOCl treatment followed by 3 hours non-polarization. HOCl generated over 3 hours exhibited biocidal activity for at least 7.5 hours after e-bandage operation ceased; 3 hours of HOCl generation followed by 7.5 hours of non-polarization resulted in a biofilm cell reduction of 7.92 ± 0.12 log CFU/cm2 vs. non-polarized controls. Finally, intermittent treatment with HOCl (i.e., interspersed with periods of e-bandage non-polarization) for various intervals showed similar effects (approximately 6 log CFU/cm2 reduction vs. non-polarized control) to continuous treatment with HOCl for 3 hours, followed by 3 hours of non-polarization. These findings suggest that timing and sequencing of HOCl and H2O2 treatments are crucial for maximizing biofilm control when using an e-bandage strategy.