Life Time Research Articles

Unravelling charge carrier dynamics for enhancement of photocatalytic performance in Pd/MoS2 nanocomposites for water remediation of real-world pollutants

In this study, Pd/MoS2 nanocomposites were successfully synthesized incorporating Pd nanoparticles into three-dimensional (3D) flower-like MoS2 nanostructures. The controlled introduction of Pd was aimed to optimize the photocatalytic performance of the resulting nanocomposites, which exhibited exceptional efficiency in degrading various organic pollutants and antibiotic tetracycline (TC) under simulated solar light irradiation. The nanocomposites with an optimized Pd concentration of 2.5 % demonstrated outstanding photocatalytic efficiency, achieving the degradation of Rhodamine B (RhB), Methylene blue (MB), TC by 98 %, 98 %, and 96 %, respectively, with specific interval of 40, 30 and 60 min. The reaction rate constant of the Pd/MoS2 nanocomposites was measured to be 0.7798 min−1 using pseudo first-order rate kinetics. The value is about 19 times higher than that of pure MoS2 (0.00414 min−1) for degradation of RhB. The improved photocatalytic performance of these nanocomposites can be attributed to several factors. Firstly, the incorporation of Pd nanoparticles substantially enhanced their light absorption capabilities, leading to an overall increase in photocatalytic efficiency. Moreover, the presence of Pd contributed to a large surface area, further enhancing the nanocomposite's photocatalytic potential. Importantly, the formation of a built-in electric field at Pd/MoS2 interface facilitated the efficient separation of the electron-hole pairs, extending the life time of these photoinduced charge carriers. This study offers valuable insights into development of MoS2-based photocatalyst, which hold significant promise for addressing water pollution challenges and making substantial contributions to the field of water purification and environmental remediation.

Current Understanding of Cardiovascular Calcification in Patients with Chronic Kidney Disease.

The burden of chronic kidney disease (CKD) is increasing, posing a serious threat to human health. Cardiovascular calcification (CVC) is one of the most common manifestations of CKD, which significantly influences the morbidity and mortality of patients. The manifestation of CVC is an unusual accumulation of mineral substances containing calcium and phosphate. The main component is hydroxyapatite. Many cells are involved in this process, such as smooth muscle cells (SMCs) and endothelial cells. CVC is an osteogenic process initiated by complex mechanisms such as metabolic disorders of calcium and phosphorus minerals, inflammation, extracellular vesicles, autophagy, and micro-RNAs with a variety of signaling pathways like Notch, STAT, and JAK. Although drug therapy and dialysis technology continue to advance, the survival time and quality of life of CVC patients still face challenges. Therefore, early diagnosis and prevention of CKD-related CVC, reducing its mortality rate, and improving patients' quality of life have become urgent issues in the field of public health. In this review, we try to summarize the state-of-the-art understanding of the progression of CVC and hope that it will help in the prevention and treatment of CVC in CKD.

Clinical predictors of poor outcome of bacterial meningitis in infants less than 90 days: a systematic review

Backgroundbacterial meningitis (BM) is more common in infants than at any other time in life and remains a devastating disease with considerable risk of death and morbidity. This article aims to gather the currently available evidence to perform a systematic review of clinical factors that may predict or be associated with BM death and/or sequelae in infants < 90 days of age.MethodsThe Medline/PubMed, Cochrane Library and Embase databases were systematically searched for prognostic studies that described risk factors for mortality and sequelae in infants aged <90d with BM. The databases were searched from the beginning of the database to December 31st, 2022.The quality of cohort studies was assessed by the Newcastle-Ottawa Scale (NOS). The quality of cross-section studies was assessed by the Agency for Healthcare Research and Quality (AHRQ). A systematic review was undertaken to ascertain the prognostic factors proven to be noteworthy.ResultsOf the 1,431 studies retrieved, 20 were eligible for the final analysis including 11 cohort and 9 cross-sectional studies were identified. Four risk factors predicting poor outcome were mentioned mostly in those studies, including prematurity or low birth weight (LBW), seizures, coma, and elevated CSF protein. But only preterm, coma and elevated CSF protein were identified by multivariate analyses in more than one study.ConclusionsThis study demonstrates several potential predictive factors to the poor outcomes of BM in infant. But with large heterogeneity, these predictors should be evaluated by further well-designed prospective studies.Systematic Review Registrationhttps://www.crd.york.ac.uk/, identifier CRD42017074949.

Sleep quality after autologous breast reconstruction

BackgroundSleep is a fundamental aspect of human health and well-being, but is often interrupted in a hospital setting. Especially after surgery, poor sleep quality can negatively affect postoperative recovery and quality of life. Therefore the aim of this study is to gain insight in the quality of sleep in patients after autologous breast reconstruction and evaluate factors associated with quality of sleep. Materials and methodsIn this single-center observational cohort study, participants completed a sleep diary, including the Pittsburgh Sleep Quality Index (PSQI) and the EQ-5D-5L quality of life questionnaire, before surgery, during hospital admission and two weeks and three months postoperative. Additional variables such as pain, and anesthesia time were collected. ResultsTwenty-nine patients were included. Before surgery, 58% of them experienced poor quality of sleep, with a median PSQI score of 5.0. During hospital admission, 83% of the patients had a poor quality of sleep, with a PSQI score of 6.0. The PSQI score two weeks postoperative increased to 7.0 and was decreased three months postoperative to 5.0. Patients with a pain score >4 (‘pain’ group), had a higher median PSQI score than patients with a pain score ≤4 (‘no pain’ group) at all postoperative time points previously mentioned. No correlation was observed between anesthesia time or quality of life. ConclusionPoor sleep quality is experienced by most women after autologous breast reconstruction, especially in those with higher postoperative pain scores. This knowledge offers an opportunity to improve the postoperative care for these patients.

Anagrammatical Time: on the Grammar of Temporal Harm in the Afterlife of Slavery

Abstract In this paper, I argue that lived time is anagrammatical. Anagrammatical time is a time that lands differently along race/gender/class lines. Its sens – its grammar – is rearranged by the context of its unfolding, at times effecting temporal harm while, at others, offering paths for temporal freedom. After introducing the notion of anagrammatical in part 1, in part 2, I turn to Merleau-Ponty’s notions of Stiftung and virtuality to account for the “nestedness” of anagrammatical time. The past and present of anagrammatical time, I show, co-exist in the present diachronically. In part 3, I focus on temporal harm. I show how, in the context of the afterlife of slavery, the immemorial functions as a traumatic, compulsive-repetitive temporality, as a thief of time temporalizing with the felt necessity and determinacy of the future anterior. In part 4, I briefly turn to the temporal grammar of the “could have been” to think through temporal freedom.

Experiences and beliefs related to sleep paralysis among the general population of the twin cities: A cross-sectional study

BackgroundSleep paralysis (SP) is a rapid eye movement (REM) parasomnia that occurs during the transition between wakefulness and sleep. During this brief state, a person is conscious but unable to move or speak, often experiencing hallucinations. It is ‘isolated’ when it occurs without other symptoms of narcolepsy or sleep disorders. Despite its prevalence, much remains unknown about its clinical features and associated beliefs. ObjectivesThis study examines the frequency of self-reported SP experiences and its associated demographic characteristics, along with participants' beliefs about the condition. MethodsA cross-sectional survey was conducted among visitors at a shopping mall, using the Unusual Sleep Experiences Questionnaire (USEQ) to assess the features of SP episodes and the common beliefs surrounding them. ResultsA total of 350 participants were surveyed (mean age = 25.5 ± 9.30 years; 55.4 % females). Participants who experienced SP at least once in their life time (39.1 %) reported feeling pressure on their chest (67.2 %), an inability to open their eyes (71.5 %), and difficulty speaking (81.0 %) during the episode. The majority of the individuals reported having their first episode at a young age (16–20 years). Most people (24.5 %) were unaware that this condition was known as sleep paralysis, and many (23.5 %) thought that it was just ‘a dream’. ConclusionIsolated sleep paralysis episodes are fairly prevalent, with many people experiencing their first episode at a young age. A typical episode entails a sense of pressure on the chest and difficulty in vocalizing. Misconceptions about the condition are common and wage further exploration.

About the Residual Time of Human Life

Many researchers believe that human lifetime in the interval from 20 to 80 years is approximately described by the Gompertz distribution. It is natural to consider the problem of the distribution of the residual human lifetime at the final stage, that is, after 80 years. To do this, in this study, a statistical analysis of some statistical models on real data is carried out. Several models are presented, which, according to the authors, can adequately describe data on mortality after 80 years.

End-of-life decision-making

The article begins with areflection on the intertwined nature of life and death; this reflection should also serve to sensitize us to the proactive and reactive expressions of aperson's life at the end of life. It will be shown that attachment to life can also manifest itself in the case of depression, fear and exhaustion: One must not lose sight of their potential existence. The existing commitment to life allows us to better understand why the remaining time of life may be perceived as something precious; this may be in contrast to statements made in the living will. Adistinction is made between subjectively, objectively and socially defined criteria for agood life in the borderline situation of aserious illness leading to death; their comparison is central to the end-of-life decision-making process. In addition to physical and neurocognitive illnesses, suicidality is at the centre of the article.

Living and Dying in Shadow Times

Normative time frameworks obscure the ontological ambiguities of lived time, particularly in relation to illness and death. These forms of ambiguous lived time constitute what we call ‘shadow time’ – the unnoticed and the unknowable in our dominant temporal order. We examine what we call ‘diagnostic time’, ‘prognostic time’, ‘terminal time’ and ‘mourning time’ as shades of shadow time that elude the ordering of time that orders life. A critical stance to temporality is necessary, we argue, in order to recognise the regulatory imperatives of normative time, to mark the slippages between the demands of normative time and how time is often lived (out) and, importantly, to do justice to those living in the complicated ontological ambiguities of lived shadow time – where we see the intricate folding of life and death

Deep learning-based energy prediction and tangent search remora optimization-based secure multi-path data communication mechanism in WSN

ABSTRACT Wireless Sensor Network (WSN) has been exploited in numerous regions which can be hardly accessed by humans. However, it is essential to convey the information accumulated by the sensing devices or nodes to the Base Station (BS) for further processing. Multipath routing protocols are found to address these challenges and provide reliable communication. This paper aims to find an optimal path to the gateway with minimum energy consumption and reduced error rate while meeting the end-to-end delay requirements. In this research, an effective multipath routing based on energy prediction and hybrid optimization is developed. Here, a Deep Q-Network (DQN) is applied to predict the energy, and the process is augmented by the usage of a proposed Tangent Search Remora Optimization (TSRO) algorithm. Further, the multipath routing is executed using the TSRO algorithm, considering a fitness function formulated using various factors, like residual energy, distance, throughput, reliability, trust factors, predicted energy, Link Life Time (LLT), delay, and traffic intensity. The devised TSRO-routing is scrutinized for its competence based on trust, throughput, energy, distance, and delay and has achieved superior values of energy of 0.402 J, throughput at 25.056Mbps, trust at 84.975, and minimal distance of 29.964 m, and delay of 0.750 ms.

Depression, anxiety, and student satisfaction with university life among college students: a cross-lagged study

Previous studies have shown that a high prevalence of depression and anxiety is a key factor leading to a decrease in student satisfaction with university life. Therefore, this study used two waves of longitudinal data to investigate the longitudinal relationships among depression, anxiety, and student satisfaction with university life among college students. We employed correlation analysis and cross-lagged models to analyze the correlation and cross-lagged relationships among depression, anxiety, and student satisfaction with university life. The results indicate a significant negative correlation between depression and student satisfaction with university life. The cross-lagged models indicate that depression (Time 1) negatively predicts student satisfaction with university life (Time 2). Anxiety (Time 1) does not have a significant predictive effect on student satisfaction with university life (Time 2). Moreover, student satisfaction with university life negatively predicts both depression (Time 2) and anxiety (Time 2). Improving student satisfaction with university life has a significant impact on reducing levels of depression and anxiety among college students. The research results can provide valuable information for mental health professionals, school administrators, and policymakers, enabling them to take more targeted measures to reduce depression and anxiety symptoms among university students and enhance student satisfaction with university life.

Does Knee Arthroplasty Have a Beneficial Effect on Return to Work in Patients with Knee Osteoarthritis who Receive Long-Term Disability Benefits in the Netherlands?

Optimal timing of knee arthroplasty (KA) is complex: operating at a younger age increases life time risk of revision, while delay results in an increased risk of job loss. This study evaluates whether disability benefits recipients due to knee osteoarthritis have an increased odds of returning to work (RTW) following KA. A retrospective cohort study was performed among long-term disability benefits recipients due to knee osteoarthritis using data of the Dutch Employee Insurance Agency. Logistic regression assessed whether recipients with KA had a higher odds of RTW in 10years following start of disability benefits, compared to those without KA. A total of 159 participants were included. During 10-year follow up, 42% had received KA and 37% had returned to work. No association was observed between KA and RTW (OR 1.39, 95% CI 0.62-3.12). Prognostic factors for RTW were being the main breadwinner (OR 7.93, 95% CI 2.95-21.32) and classification as 100% work disability (OR 0.20, 95% CI 0.09-0.45). KA has no beneficial effect on RTW among patients with knee osteoarthritis granted long-term disability in the Netherlands. For RTW, KA is probably best performed within the two years of paid sick leave before long-term disability is assessed in the Netherlands.

Quality of life and abdominal wall functionality after abdominal wall reconstruction: A prospective single center follow-up study

BackgroundFascial breakdown with the occurrence of an incisional hernia (IH) is an important and challenging complication of any laparotomy. For a long time, the success of the abdominal wall reconstruction (AWR) was measured only from the surgeon’s perspective by defining outcome measures such as wound morbidity and recurrence. The understanding that complete recovery is difficult to assess without considering patients has shifted the paradigm of optimal outcomes to Patient Reported Outcome Measures (PROMS) and Quality of Life (QoL), which are pivotal to evaluate the success and efficacy of AWR.MethodsWe conducted a prospective follow-up study of 91 patients undergoing mesh-augmented abdominal wall reconstruction for primary or recurrent incisional hernia between January 2021 and December 2023. Demographic data, comorbidities, and hernia characteristics were recorded. All patients were evaluated preoperatively by a native abdomino-pelvic CT scan to assess the characteristics of hernia (length, width, surface, and volume of the incisional hernia sac and of peritoneal cavity), the presence of mesh (if previously inserted), and abdominal wall muscles status. All intervention were performed by the same surgical team according to the techniques described by Rives – Stoppa (RS), Ramirez (ACS), and Novitsky (PCS). Abdominal wall function was assessed using trunk raising (TR) and double leg lowering (DLL) measurements performed preoperatively, 1 month, 6 months, and 1 year postoperatively. At the same time, pre- and post-operative quality of life was analysed using the EQ-5D score.ResultsMean age of 59.42 ± 12.28 years and a male/female ratio of 35/56 were recorded, most of them being obese. There were 36 (42%) patients with defects larger than 10 cm. The distribution of the type of surgical intervention was: RS 35 patients, ACS 13 patients, and PCS 43 patients. The mean value of combined score for the preoperative abdominal wall functionality was 4.41 ± 1.67 (2–8) while the mean value of preoperative EQ-5D index was 0.652 ± 0.026 (-0.32–1.00). QoL was poor and very poor for 48% (44) of the patients who recorded index values less than 0.56 (50% percentile). Preoperative EQ-5D index was highly correlated with Combined AWF score (r = 0.620; p < 0.0001) and the correlation was specific (AUC = 0.799; p < 0.0001; asymptotic 95%CI = 0.711–0.923). At 12 months, the AWF score increased to 8.13 ± 2.58 (1–10) and the QoL total score to 0.979 ± 0.007 (0.71–1). Good and very good total scores for QoL were recorded for 47 patients (84%) compared to 33 (36%) in the preoperative evaluation (χ2 with Yates continuity correction for two degrees of liberty = 46.04; p < 0.00001).ConclusionOur results suggest that patients can expect to see a significant overall improvement in all five components of QoL measured with the help of Eq. 5D questionnaire. This improvement is dependent by hernia size, and some individual patient’s factors (diabetes, cardiovascular diseases, and age over 60 years).

An energy‐efficient Chebyshev fire hawks optimization algorithm for energy balancing in sensor‐enabled Internet of Things

SummarySensor‐enabled systems have been used successfully in agricultural, healthcare, commercial, and military application domains. Recently, there has been significant interest in the intelligent applications of sensor‐enabled technologies, particularly in the domains of smart grid, Internet of Vehicles (IoV), body area networks, and the Internet of Things (IoT). In recent research, various protocols and algorithm are developed for effective energy‐efficient routing and energy balancing. These existing models have some issues like high energy consumption and minimum network life time. In order to overcome these existing issues, a novel cluster head selection and routing mechanism in a wireless sensor network (WSN) environment is proposed. The clustering process has been formed by an enhanced Taylor kernel fuzzy C‐means algorithm (TKFC‐means). The cluster head in the group of sensor nodes has been identified based on energy and distance calculation. Finally, the routing has been performed by a novel energy‐efficient Chebyshev fire hawks optimization‐based routing protocol to route data to the edge server, which helps to balance the energy effectively. This protocol takes into account various factors, including distance, cost, residual energy, load, temperature, latency, and overall energy. The proposed model can obtain a throughput value of 82 Mbps for the sensor nodes at 500 and an end‐to‐end delay of 3.6 at 500 sensor nodes. The packet delivery ratio and loss ratio attain 96.4% and 2.7%, respectively, with 500 sensor nodes in the proposed approach. The proposed method consumes 0.45 mJ of energy with 500 nodes. From this analysis, the proposed model can obtain better results than the existing compared models.

114 Prime Time of Life: A multimodal physical activity and health education programme for middle-aged and older adults

Abstract Prime Time of Life is inclusive of people living with clinical conditions and differing fitness and functional abilities. Health screening was conducted preprogramme, and specific clinical exercise advice and support was provided to participants by Dr Diane Cooper, Clinical Exercise Physiologist. Participants completed two 60-minute multimodal (cardiovascular fitness, strength, balance, flexibility) exercise classes per week and were also encouraged to complete additional classes in their purpose built on-demand exercise library. In all 60-minute exercise classes the exercise instructor demonstrated three different options for each exercise to cater for participants who were working at beginner, intermediate and advanced levels of fitness. Participants appreciated the adaptations and progressions that were available for all exercises as it enabled them to work to their ownability and progress and monitor progress throughout the programme. Each week a 20-minute health education workshop relevant to participants was delivered online via Zoom. The workshop was recorded, edited, and uploaded to YouTube to view on-demand. The link for each video was shared with participants weekly via email to support on-demand learning in addition to any other relevant supporting material such as a training diary. The Prime Time of Life programme increased participants upper and lower body strength, aerobic fitness and perceptions of physical and mental health (see chapter 3). This was in addition to increased confidence and feelings of positivity around the participants’ own management of healthy functional ageing (see chapter 3). Participants commented that they really enjoyed the Prime Time of Life programme. It increased their awareness on the importance of multimodal exercise for healthy ageing and that they felt empowered to continue training and improve their health in the long term. Following on from this successful programme a full train the trainer programme has been developed and piloted with 9 Local Sports Partnerships, 20 participants with further plans for upscaling.

Physical Activity in Pregnancy: The Role of Exercise in Promoting Maternal and Fetal Health

Introduction and Objective: There is no doubt that engaging in regular physical activity is beneficial for individuals of all ages. Pregnancy is a special time of life for most women. This period presents a unique opportunity for them to improve their lifestyle choices and adopt healthier habits such as exercise. The aim of this article is to find out if regular physical activity during pregnancy has a positive impact for both the mother and the baby.Review and Methods: Review and summary of available studies and meta-analyses found in open-access formats on Google Scholar and PubMed.State of Knowledge: The WHO defines physical activity as any bodily movement requiring energy expenditure, including during leisure, transport, work, and domestic activities. Regular exercise reduces the risk of noncommunicable diseases (NCDs) and poor health outcomes, while sedentary behavior contributes to this and burdens healthcare systems. For pregnant and postpartum women, physical movement decreases the risk of various complications, with no negative effects on birthweight or stillbirth risk. Conclusions: Studies show that physical activity decreased risk of pre-eclampsia, gestational hypertension, gestational diabetes, excessive gestational weight gain, delivery complications, postpartum depression and newborn complications.

Burden, consequences and associate factors of childhood maltreatment in Ethiopia: A systematic review and meta-analysis

IntroductionChild maltreatment is any type of abuse or child negligence which results the concrete or prospective hurt for those under age of eighteen. It is a global issue which severely endangered children's physical, emotional, behavioral, developmental and mental well-being for immediate and later in life. Although, its magnitude and devastating burden are difficult to comprehend, much remains to be done to know its prevalence and comprehensive impact. This meta-analysis and comprehensive review will provide important light on the burden, consequences, and contributing factors for child maltreatment. MethodsThis meta-analysis and comprehensive review was coded at Prospero number of CRD42024503799. Universal online databanks including PubMed, Cochrane, Google, Google Scholar, SCOPUS, and Web of Science and Global Health were used to search for articles. Microsoft Excel was used for data extraction, and STATA17 was used to analyze this systematic review and meta-analysis. A random effect model exploration was employed when heterogeneity among included studies were evidenced. ResultsThe pooled prevalence of childhood maltreatment was 57.0 % (95 % CI = 32.00, 83.00). Included studies revealed that childhood maltreatment has multiple child health-related consequences. Being female (AOR = 2.94, 95 % CI: 1.48, 4.41), being young (AOR = 1.22, 95%CI: 1.09, 3.35), paternal illiteracy (AOR = 2.16, 95%CI: 1.012, 3.302) and have an open family discussion about sexual matters (AOR = 0.381 (95%CI: 0.121, 0.884) were considerably associated with child maltreatment. ConclusionThis finding publicized that the burden and multiple consequences of childhood maltreatment need much attention. Childhood maltreatment has both immediate and life time consequences for children later in life. Being female, being young, having illiterate fathers, and open family discussion about sexual matters were associated factors of child maltreatment.

Clinician Wellbeing and Mental Health Assessment Across Two Acute Care Hospitals During the COVID-19 Pandemic.

The purposes of this study were to determine whether positive work environments affect clinician wellbeing and mental health, and to identify participants' priority interventions to improve clinician wellbeing. This study was designed to determine the potential benefit of modifying the aforementioned factors for clinicians and hospitals to impact positive patient outcomes. The SARS-CoV-2 virus pandemic has become one of the leading causes of death in the United States and worldwide, and has exacerbated widespread burnout among health care professionals. This has resulted in negative collateral implications for the stability of the clinician workforce. A Clinician Wellbeing study (CWS) was launched in two Magnet®-designated hospitals in the southeast. The CWS was part of a multi-site collaborative research project led by the Center for Health Outcomes and Policy Research (CHOPR) at the University of Pennsylvania School of Nursing. A cross-sectional observational study design was implemented. Data were collected through anonymous surveys of 708 registered nurses (RNs) and advanced practice providers (APPs) working in two Magnet hospitals in the southeastern United States. Each participant completed 8 surveys. Clinicians' self-reported level of burnout was higher for both RNs and APPs at Emory University Hospital than Emory Saint Joseph's Hospital including intent to leave and dissatisfaction with their jobs. RNs and APPs self-reported their overall health to be good or excellent and they reported sleep quality as fair. Both groups in both hospitals indicated that they experienced anxiety, depression, and stress. The APPs reported a higher percent that their work did not leave enough time for personal and family life. Data also indicated that the primary work environment concern was related to inadequate nurse staffing. The data illuminated opportunities for the two hospitals to employ continuous improvement interventions to positively transform the work environment.

Balancing Academic and Personal Life: Challenges for Medical StudentsPersonal Life in Medical Students

Medical students are found to experience stress with a considerable impact because of the academic studies they are undertaking. High demands compared to non-medical students can interfere with other life domains, such as personal life. This interference can manifest in several ways, such as diminished time for social interactions and leisure activities. The purpose of this study was to explore and understand the potential impact on the relationship between academic life and personal life. The research was conducted with a sample of 7 medical student participants from Universitas Padjadjaran. Participants completed a questionnaire with 5 open-ended questions designed to capture their experiences and perspectives in detail. The findings revealed that a significant number of participants struggle with time management, feeling that their academic commitments leave them with minimal time for free activities and social engagements. This imbalance contributes to a sense of inadequacy in maintaining a fulfilling personal life. The study highlighted that a well-rounded personal life is crucial for sustaining optimal academic performance. A good personal life can provide good academic conditions, but the lack of free time for personal life makes participants do other alternatives such as postponing, procrastinating, and causing stress. Addressing these issues requires a holistic approach that not only alleviates academic burdens but also promotes a healthy balance between professional and personal domains. It’s essential for ensuring the well-being and success of medical students in both their academic pursuits and personal life.

Bevacizumab reduces cerebral radiation necrosis due to stereotactic radiotherapy in non-small cell lung cancer patients with brain metastases: an inverse probability of treatment weighting analysis.

Cerebral radiation necrosis (RN), a severe complication of stereotactic radiotherapy (SRT), has been shown to significantly decrease patient survival time and quality of life. The purpose of this study was to analyze whether bevacizumab can prevent or reduce the occurrence of SRT-induced cerebral RN in non-small cell lung cancer (NSCLC) patients with brain metastases. We retrospectively reviewed the clinical records of NSCLC patients with brain metastases from March 2013 to June 2023 who were treated with SRT. Patients were divided into two groups: those in the bevacizumab group received SRT with four cycles of bevacizumab, and patients in the control group received SRT only. Inverse probability of treatment weighting (IPTW) was performed based on a multinomial propensity score model to balance the baseline characteristics. The chi-square test was used. A Cox model was used to evaluate overall survival (OS). A total of 80 patients were enrolled, namely, 28 patients in the bevacizumab group and 52 patients in the control group. The possibility of developing cerebral RN and/or symptomatic edema (RN/SE) was significantly decreased in patients treated with bevacizumab compared to those who did not receive bevacizumab before IPTW (p=0.036) and after IPTW (p=0.015) according to chi-square analysis. The IPTW-adjusted median OS was 47.7 months (95% CI 27.4-80.8) for patients in the bevacizumab group and 44.1 months (95% CI 36.7-68.0) (p=0.364) for patients in the control group. The application of bevacizumab concurrent with SRT may prevent or reduce the occurrence of cerebral RN in NSCLC patients with brain metastases.