Unpaired T-test Research Articles

Assessing the impact of the COVID-19 pandemic on patients referred to a lung cancer rapid assessment clinic in Ontario, Canada

RATIONALE The COVID-19 pandemic negatively impacted lung cancer (LC) outcomes. The Lung Diagnostic Assessment Program (LDAP) in Southeastern Ontario is a rapid assessment clinic for patients with suspected LC. OBJECTIVE Characterize the impact of COVID-19 on presentations and timeliness of care within LDAP. METHODS Retrospective study of LDAP-referred patients pre-COVID-19 (December 2019–March 2020) with matched cohorts post-COVID-19 Year 1 (December 2020–March 2021), and Year 2 (December 2021–March 2022). Data included: patient demographics, LC diagnosis, stage, timeliness of care and symptoms. Statistical analysis included unpaired t-tests and chi-squared tests. MEASUREMENTS AND MAIN RESULTS We reviewed 273 patients pre-COVID-19, 287 post-COVID-19 Year 1 and 218 Year 2. Post-COVID-19, more patients were suspected to have cancer at referral (pre-COVID-19, 28.6% vs. post-COVID-19 Year 2, 37.2%, p = 0.03), and more patients did not attend consultation (9.8%, 10.7% vs 1.0% pre-COVID-19, p = 0.0002) due to hospitalization or declining assessment. Average time from referral to consultation was longer during post-COVID-19 Year 1 (12.2 vs. 17.0 days, p = 0.003) but unchanged by Year 2; times from referral to diagnosis and treatment were unchanged across cohorts (42.7 vs. 44.1 vs. 40.9, p = NS) and (74.0 vs. 66.2, vs. 70.3, p = NS, respectively). Post-COVID-19 patients reported longer symptom duration (5.0 vs. 3.5 months, p = 0.04). CONCLUSIONS During the COVID-19 pandemic, patient characteristics and timeliness of care within LDAP were unchanged, but more patients experienced clinical decline and longer symptom duration prior to consultation. While care within LDAP was relatively insulated, barriers to care prior to referral may have contributed to later presentation.

Effect of Different Primers on the Shear Bond Strength of Orthodontic Brackets Bonded to Reinforced Polyetheretherketone (PEEK) Substrate.

This in vitro study assessed the effect of different primers on the shear bond strength (SBS) and adhesive remnant index (ARI) of orthodontic brackets bonded to reinforced polyetheretherketone (PEEK) substrate. A total of 40 specimens were randomly distributed to two groups based on the primer used for orthodontic bonding: group 1 (control)-Transbond XT adhesive with Visio.link primer and group 2 (test)-orthodontic adhesive (Transbond XT) with traditional orthodontic primer. After bonding, specimens were thermocycled followed by SBS testing and ARI scoring of debonded specimens. Data were analyzed using the unpaired independent t-test and the Chi-square test. Group 1 specimens showed significantly higher SBS values (21.38 ± 1.48 MPa) compared to group 2 specimens (18.63 ± 1.29 MPa) (p < 0.0001). Adhesive remnant index scores showed no significant variations in bond failure modes and distributions between groups. The SBS obtained by the tested primers exceeded the clinically recommended value. Consequently, there is a comparable clinical application for both tested primers in orthodontic bonding, especially the traditional orthodontic primer, where the availability of Visio.link in clinical practice is not ensured.

Efficacy of Conventional versus Cordless Displacement System on Gingival Retraction for Use with Intra-Oral Scanner: A Clinical Study.

The present clinical study aimed to assess the efficacy of conventional versus cordless displacement systems on gingival retraction for use with an intra-oral scanner and changes in periodontal indices. A total of 20 participants were selected for a split-mouth study (20 sites - Group Sc, 20 sites - Group Es). The outcomes were measured at day 0, day 1, and day 7 of follow-up in terms of Immediate horizontal displacement, Plaque Index, and Bleeding Index. Unpaired and Paired t-test was used as the parametric tests and statistical analysis was performed. A statistically significant change was observed in terms of BI on day 0, but no statistically significant change was observed for either group in terms of IHD and PI. The cordless material caused the least trauma to gingival tissue and was more compatible with intra-oral scanning devices.

Does the Mixing Method of AH Plus Jet Affect its Physicochemical and Mechanical Properties?

IntroductionThe purpose of this study was to evaluate whether the mixing method of AH Plus Jet sealer affects its physicochemical and mechanical properties. MethodsThe properties of AH Plus Jet sealer were analyzed when mixed using either the Auto Mix Tip or manual mixing. The evaluated properties included radiopacity (n = 5), initial and final setting times (n = 5), flow (n = 5), and solubility (n = 3), following specifications outlined in ISO 6876/2012 and ADA Nº 57/2000. pH levels were measured at intervals of 3, 24, 72, and 168 hours (n = 10). The push-out bond strength test was conducted using a universal testing machine and using bovine teeth (n = 30). Failure modes were analyzed with stereomicroscopy. Porosity was evaluated under micro-CT (n = 5), and scanning electron microscopy was also performed (n = 5). One-way analysis of variance and Tukey, unpaired t-tests, or Mann–Whitney tests were used with a significance level of 5%. ResultsThe Auto Mix exhibited a radiopacity value of 12.11 mmAl, whereas manual mixing resulted in 12.55 mmAl (P > .05). For initial and final setting times, Auto Mix showed 901 minutes and 1779 minutes, respectively, while manual mixing recorded values of 631 minutes and 1504 minutes (P < .05). In terms of flow, Auto Mix demonstrated higher values (25.26 mm) than manual mixing (21.71 mm) (P < .05). No statistical differences were observed between the two methods for solubility and pH (P > .05). Manual mixing presented a higher bond strength value (14.52 MPa) than Auto Mix (9.81 MPa) (P < .05). The mixed failure mode was the most frequent outcome for both methods. The highest porosity was observed for Auto Mix (P < .05). Scanning electron microscopy analysis revealed that manual mixing resulted in a smoother surface with fewer pores and smaller, more evenly distributed agglomerates compared to automatic mixing. ConclusionThe mixing method employed for AH Plus Jet sealer influences some physicochemical and mechanical properties of the material.

The burdens of sitting on the bench – comparison of absolute and relative match physical load between handball players with high and low court time and implications for compensatory training

ABSTRACT Wearables quantify the activity in team sports and indicate that players experience peak physical loads during competitions. Accordingly, players with limited court time in competitions will miss important training stimuli. The present study aimed to quantify these gaps in physical load in professional handball players. Activity of all players competing in the 2021/2022 Bundesliga (Germany) was tracked using Kinexon LPS sensors. Gaps in physical load were quantified comparing the 25% of appearances with the highest (HIGH; 51.8 ± 5.2 mins) and lowest court times (LOW; 10.1 ± 4.3 mins). Distances, accumulated acceleration, jumps, sprints, impacts, accelerations, and decelerations were analysed as absolute and relative (per minute) outcomes. Players were grouped into wings, backcourts, and pivots. Unpaired t-tests between HIGH and LOW were performed (p < .05), and effect sizes were calculated (Cohen´s d). Analyses revealed significant effects of court time on activity. While absolute activity increased for HIGH, relative activity increased for LOW (p < .05). In addition, effect sizes revealed position-specific gaps in physical load, particularly for acyclic activities (jumps, accelerations). Gaps in physical load resulting from limited court time are highly position-specific. Our observations may provide benchmarks for the position-specific calibration of compensatory training.

Frequency Domain Parameters of Heart Rate Variability in Patients with Gastro-Oesophageal Reflux Disease

Background: Gastro-oesophageal reflux disease (GERD) has been associated with autonomicnervous dysfunction along with reduced Heart Rate Variability.Objective: To observe cardiac autonomic nerve function status by heart rate variability analysis inpatients with Gastro-oesophageal reflux disease (GERD).Methods: This cross-sectional study was carried out in the Department of Physiology, SirSalimullah Medical College (SSMC), Dhaka from 1st January, 2017 to 31st December, 2017.Forthis, total 30 male and female diagnosed GERD patients from the Out Patient Department(OPD) of Gastroenterology, BSMMU aged 20-35 years were included in the study group. LowFrequency norm (LF norm),High Frequency norm (HF norm) and LF/HF ratio of HRV parameterswere recorded. Thirty age and BMI matched healthy subject also included as control. For statisticalanalysis, unpaired t-test was done as applicable.Results: The mean LF norm was 72.10±13.97 n.u. and the mean LF/HF was 3.34±1.14. Whichwere significantly (p&lt;0.001) higher in GERD patients in comparison to that of healthy subjects.Which indicate sympathetic overactivity in GERD patients. However, the mean HF norm was24.54±10.56 n.u. Which was significantly (p&lt;0.001) lower in GERD patients as compared to that of apparently healthy subjects. Which indicate decreased parasympathetic activity in GERDpatients.Conclusion: Parasympathetic hypofunction and sympathetic over activity were found in GERDpatients.

Evaluation of comparative efficacy of Celastrus paniculatus (Jyotishmati) capsule versus sertraline capsule in the management of Chittodvega (generalized anxiety disorder): protocol for a randomized controlled trial.

Generalized anxiety disorder (GAD) (Chittodvega) is one among many types of mental disorders explained in Ayurveda. It can be defined as a Chitta (mind) + Udvega (anxiety)= Chittodvega- Anxious status of a mind. Celastrus paniculatus also known as Jyotishmati. stimulates and improves the digestive fire and metabolism at a cellular level ( Jatharagni and Majja dhatwagni). It can be correlated to GAD. GAD is characterized by feelings of threat, restlessness, irritability, sleep disturbance, and tension, and symptoms such as palpitations, dry mouth, and sweating. It affects women more frequently than men and prevalence rates are high in midlife (prevalence in females over age 35: 10%) and older subjects. In modern medicine the first-line psychological and pharmaceutical treatments are selective serotonin reuptake inhibitors (SSRIs) like sertraline (SNRIs). To evaluate the comparative efficacy of Jyotishmati versus sertraline in the management of Chittodvega. In this randomized active controlled double blind equivalence trial a total of 70 patients will be enrolled and divided into two equal groups. Patients between 20-50 years age of either gender having symptoms of Chittodvega and a Hamilton anxiety rating (HAM-A) scale score less than 24 (i.e., mild to moderate) will be selected for the study. In Group A, sertraline capsules 25 mg for first 7 days and then dose increased to 50 mg at bedtime for next 53 days and in Group B Jyotishmati Capsules 500 mg will be given twice a day after food with water for 60 days. The patients will be assessed on the HAM-A scale, serum cortisol and WHO Quality of Life on day 0, 30, 60 and 90 and data will be analyzed using paired and unpaired t-tests for continuous variables and chi-square tests for categorical variables to evaluate whether treatments are equivalent. CTRI No. REF/2023/07/069880 Date - 15/09/2023.

Heparin is an effective treatment for preventing liver failure after hepatectomy.

Posthepatectomy liver failure (PHLF) is one of the most important causes of death following liver resection. Heparin, an established anticoagulant, can protect liver function through a number of mechanisms, and thus, prevent liver failure. To look at the safety and efficacy of heparin in preventing hepatic dysfunction after hepatectomy. The data was extracted from Multiparameter Intelligent Monitoring in Intensive Care III (MIMIC-III) v1. 4 pinpointed patients who had undergone hepatectomy for liver cancer, subdividing them into two cohorts: Those who were injected with heparin and those who were not. The statistical evaluations used were unpaired t-tests, Mann-Whitney U tests, chi-square tests, and Fisher's exact tests to assess the effect of heparin administration on PHLF, duration of intensive care unit (ICU) stay, need for mechanical ventilation, use of continuous renal replacement therapy (CRRT), incidence of hypoxemia, development of acute kidney injury, and ICU mortality. Logistic regression was utilized to analyze the factors related to PHLF, with propensity score matching (PSM) aiming to balance the preoperative disparities between the two groups. In this study, 1388 patients who underwent liver cancer hepatectomy were analyzed. PSM yielded 213 matched pairs from the heparin-treated and control groups. Initial univariate analyses indicated that heparin potentially reduces the risk of PHLF in both matched and unmatched samples. Further analysis in the matched cohorts confirmed a significant association, with heparin reducing the risk of PHLF (odds ratio: 0.518; 95% confidence interval: 0.295-0.910; P = 0.022). Additionally, heparin treatment correlated with improved short-term postoperative outcomes such as reduced ICU stay durations, diminished requirements for respiratory support and CRRT, and lower incidences of hypoxemia and ICU mortality. Liver failure is an important hazard following hepatic surgery. During ICU care heparin administration has been proved to decrease the occurrence of hepatectomy induced liver failure. This indicates that heparin may provide a hopeful option for controlling PHLF.

Longitudinal analysis of echocardiographic and cardiac biomarker variables in dogs with atrial fibrillation: The optimal rate control in dogs with atrial fibrillation II study.

Rate control (RC; meanHRHolter ≤ 125 bpm) increases survival in dogs with atrial fibrillation (AF). The mechanisms remain unclear. Investigate echocardiographic and biomarker differences between RC and non-RC (NRC) dogs. Determine if changes post-anti-arrhythmic drugs (AAD) predict successful RC in subsequent Holter monitoring. Evaluate if early vs late RC affects survival. Fifty-two dogs with AF. Holter-derived mean heart rate, echocardiographic and biomarker variables from dogs receiving AAD were analyzed prospectively at each re-evaluation and grouped into RC or NRC. The primary endpoint was successful RC. Between group comparisons of absolute values, magnitude of change from admission to re-evaluations and end of study were performed using Mann-Whitney tests or unpaired t-tests. Logistic regression explored variables associated with inability to achieve RC at subsequent visits. Kaplan-Meier survival analysis was used to compare survival time of early vs late RC. At visit 2, 11/52 dogs were RC; at visit 3, 14/52 were RC; and at visit 4, 4/52 were RC. At the end of study, 25/52 remained NRC. At visit 2, both groups had increased cardiac dimensions, but NRC dogs had larger dimensions; biomarkers did not differ. At the end of study, RC showed decreased cardiac dimensions and end-terminal pro-brain natriuretic peptide (NT-proBNP) compared with NRC. No variables were useful at predicting RC success in subsequent visits. Survival analysis found no differences between early vs late RC. The RC dogs had decreased cardiac dimensions and NT-proBNP, suggesting HR-mediated reverse-remodeling might benefit survival, even with delayed RC achievement. Pursuit of RC is crucial despite initial failures.

Evaluation of Mandibular Projection in Class II Division 2 Subjects Following Orthodontic Treatment Using Clear Aligners.

The purpose of this study was to evaluate the mandibular growth and/or projection following maxillary incisor proclination, overbite correction, and maxillary dentoalveolar expansion without the use of any class II mechanics, in growing class II division 2 patients treated with clear aligners. Before and after treatment cone-beam computed tomographic (CBCT) generated lateral and posteroanterior cephalograms of thirty-two patients with skeletal class II division 2, 16 in the treatment group and 16 in the untreated group, were reviewed to evaluate treatment-related changes. Upper incisors were proclined and protruded, as well as upper arch expansion and overbite correction were performed as part of their regular treatment. Cephalometric analysis was performed to evaluate skeletal and dental changes. Unpaired statistical t-tests were performed to determine if significant skeletal class II correction was achieved in the treatment group. In the treatment group, after treatment, the upper incisors became more proclined and protruded, and the inter-molar width increased while the overbite was reduced compared to the control group. An increase in skeletal mandibular growth and forward projection was also observed, thus contributing to an improvement of the sagittal skeletal relationship as evidenced by ANB and Wits values compared to the control group. A combination of upper incisor proclination, correction of deep overbite, and maxillary dentoalveolar expansion using clear aligners appears to contribute to an improvement of the skeletal class II relationship in growing patients with class II division 2. This study shows that unlocking the mandible by correcting a deep overbite, proclining upper incisors, and expanding the upper arch in growing class II division 2 patients can improve skeletal class II using clear aligners. How to cite this article: Mirzasoleiman P, El-Bialy T, Wiltshire WA, et al. Evaluation of Mandibular Projection in Class II Division 2 Subjects Following Orthodontic Treatment Using Clear Aligners. J Contemp Dent Pract 2024;25(4):295-302.

A facile method to obtain colloidal dispersions of nickel hydroxide: Improving the processing of nickel oxide and facilitating its upscaling for perovskite-type solar devices

Nickel hydroxide has been successfully employed as a precursor to the widely used, inorganic hole transport material (HTM) nickel oxide (NiOx). However, manufacturing NiOx HTM layers from nickel hydroxide is more complicated than those involving organometallic precursors due to its poor solubility/dispersibility. We report here a substantial increase in nickel hydroxide dispersibility in organic solvents by complexing it with monoethanolamine. These improvements have enabled us to develop a simpler method for processing nickel hydroxide that resemble the known sol-gel method. The new metal complex remains dispersed for months and converts to nickel oxide at a temperature similar to that of nickel hydroxide (270–300 ºC). An extensive characterisation of NiOx films obtained from the deposited precursor has been carried out. Perovskites solar cells have also been built with these films as a proof of concept, showing promising results for the layers sintered at low (270 ºC) and high (500 ºC) temperatures. The pixel with highest efficiency for both sintering temperatures were 14.7 % and 16.7 %, respectively, which are close to or surpass the ones of the control samples (15.4 % and 15.7 %, respectively). The applied unpaired t-test statistical method showed that the mean efficiency values for our thick samples prepared at 270 °C are not statistically different from those of the control cells. Furthermore, the samples prepared at 500 °C presented a significant statistical difference with the control cells, showing higher average efficiencies (12.8 % and 13.3 % versus 11.4 % and 11.7 %, reverse and forward measurements, respectively). The simplicity of the manufacturing method developed, together with the use of non-toxic organic compounds for its preparation and the promising results observed in solar devices, makes it suitable for being upscaled.

A Comparison of the Edge Testing of Indirect Composite Layered Zirconia Crowns and Monolithic Zirconia Crowns Without Aging: An In Vitro Study.

Introduction The main reason veneered zirconia restorations fail is due to porcelain veneer chipping. This chipping usually starts from wear marks on the chewing surface. As a result, small cracks under the contact area can grow into larger ones across the veneer layer. The veneer ceramic layer is more vulnerable to fractures because it has lower toughness and slightly lower stiffness compared to the base framework material. Thus, even when there's significant chipping, the main framework material usually stays protected with a thin layer of veneer ceramic on top. The aim of this in vitro study is to compare the edge strength of Monolithic Zirconia Crowns with that of Indirect Composite Layered Zirconia Crowns without aging. Materials and methods This research involved creating 12 hand-layered all-ceramic crowns and 12 indirect composite layered zirconia crowns. The sample size was determined using a G*Power calculation (Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany). The zirconia frameworks (Upcera HT White; UPCERA Dental America Inc., Cerritos, CA, US) were milled and sintered following the manufacturer's instructions. For the all-ceramic group, veneering porcelain (e.max Ceram; Ivoclar Vivadent, Schaan, Liechtenstein) was hand-applied. In contrast, the indirect composite group utilized Ceramage (Shofu, Kyoto, Japan). An Instron 4501 universal testing machine (Instron Corp., Canton, MA, USA) was employed for the edge chipping tests, and a Vickers indenter (Shanghai Toyo Diamond Tools Co., LTD, Shanghai, China) was used to apply the load. The mean value for edge chipping was analyzed using an unpaired t-test with IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, NY, USA). The normality of the data was confirmed, and statistical significance was set at 0.05. Results Monolithic Zirconia Crowns (Group 1) require significantly more force (mean: 405 N) to induce an edge chip compared to Indirect Composite Layered Zirconia Crowns (Group 2) (mean: 300 N). The 95% confidence interval (83.43261 N to 109.90072 N) confirms the statistical significance of this difference. Conclusion In conclusion, when evaluating restorative materials based on both esthetic and functional criteria, monolithic zirconia stands out due to its combination of strength, esthetic potential, biocompatibility, and versatility.

Comparison of the effectiveness of sodium hypochlorite, citric acid, and diode laser in disinfection of the root canal system

Introduction: To achieve a proper disinfection of the root canal system, besides many irrigant solutions, laser has become increasingly popular in recent years. Bacteria that penetrate deep in the dentine can be destroyed by laser up to 1150 µm. The aim of the study is to investigate and to compare the efficiency of conventional chemical disinfection using cleaning solutions - sodium hypochlorite (2%), citric acid (20%) - and the physical disinfection using a diode laser (940 nm, 1 W) in vitro using extracted teeth. Material and Methods: 23 intact, single rooted teeth were prepared and inoculated with Enterococcus Faecalis. Afterwards samples were taken from each group and placed on solid mediums. The following were applied to members of each group prior to sampling: 2% sodium hypochlorite, 20% citric acid and diode laser (940 nm, 1W). To evaluate the results, so that the bacterial strains on the medium could be counted, quenches were performed from 1/10 and 1/100 dilutions. Statistical analysis was performed using Kruskall-Wallis and unpaired T-test with a value of p&gt;0.05. Results: Statistical analysis on the 3 groups (NaOCl, citric acid, and diode laser) showed significant differences between the counted remaining colonies after disinfection. Conclusions: The diode laser used for disinfection under the used settings is not effective enough, but as an adjuvant, associated with conventional irrigation effective disinfection can be obtained. Keywords: root canal, E. Faecalis, sodium hypochlorite, citric acid, diode laser

Effect of Local Simvastatin on the Healing of Surgically Created Critical-Sized Bone Defects: An experimental Study on sheep.

Background and objective: the role of simvastatin in lowering serum cholesterol levels is well described. However, recent findings suggest they have a role in bone formation as well. The study aims to determine the effect of local simvastatin application on bone defect healing and compare the amount of new bone produced by a simvastatin-treated defect with that produced by a bone graft (biphasic calcium phosphate) and non-treated defects (left empty) histologically. Methods: Forty-five critical-size defects were created (8mm in diameter and depth) in the iliac bone of 6 sheep. For the first three sheep (5 defects/ilium), the five defects on the right ilium were left empty as a Control group, while the five defects on the left ilium were filled with biphasic calcium phosphate as Test 1 group. For the other three sheep, 5 defects were created on the right ilium, the defects were filled with 10mg crushed simvastatin tablet with gelfoam (as a carrier) as Test 2 group. The animals were sacrificed over periods of 1, 2, and 3 months. Histopathological studies were done for all the samples. SPSS version 28 was used to analyze the results. The numerical variables were checked for normality using Smirnov – Kolmogorov test, then analyzed using ANOVA and unpaired t-test (p–values ≤ 0.05 were considered statistically significant). Results: All 6 adult male sheep passed the scheduled periods uneventfully. During the wound healing period, there was no complication such as infection, excessive hematoma, or wound dehiscence. All 45 standardized iliac bone defects were included in the final analysis (n= 45). The histologic results showed that Test 2 group (defect filled with simvastatin) in the 1st, 2nd, and 3rd months had significantly higher bone formation at the surface and depth of the defects than Test 1 and Control group with P values (&lt;0.0001) at all period intervals. Conclusion: Simvastatin enhances bone formation and accelerates the healing process of the bony defect. Keywords: Bone formation, Bone graft, Bone healing, Simvastatin, Statin.

Silver diamine fluoride: A stem cell cytotoxicity and dentin growth factor release in-vitro study.

To investigate the effect of 38% SDF and its serial dilutions on the Stem cells from Human Exfoliated Deciduous teeth (SHED) and its ability to release growth factors from deciduous dentine. The viability of SHED post-exposure to 38%, 3.8%, 0.38%, 0.038%, and 0.0038% SDF were assessed at 2, 5, and 7 days using the CyQuant assay, and results were validated using the MTT assay. The osteogenic differentiation of the cells was also investigated post-exposure to 0.0038% SDF. The release of the growth factors; TGF-β1, FGF-b, BMP-2, and VEGF from deciduous dentin discs exposed to 38% SDF, 0.0038% SDF, Ca(OH)2, MTA, and 17% EDTA were examined using ELISA. Statistical analysis was performed using means and standard deviations (p < 0.05). Two-way ANOVA compared the means of more than two groups with Tukey's multiple comparison test. The unpaired t-test was also used to compare the differences between the two data sets. 38% SDF released dentinogenic growth factors from dentin discs, potentially explaining its role in reactionary dentinogenesis. Moreover, 0.0038% SDF resulted in a non-cytotoxic concentration that enhanced cellular proliferation and released bioactive molecules from dentin comparable to the 38% concentration. After further investigations, the 0.0038% dilution of SDF could present itself as a clinical concentration.

Features of HPV+ OPSCC predictive of recurrence identified by transcriptional profiling of a case-control cohort.

6055 Background: De-escalating therapy for HPV+ oropharyngeal cancers (OPSCCs) is hampered by poor ability to predict recurrence, and limited insight into the biologic traits predisposing to recurrence impedes personalizing therapy. We aimed to (1) define biologic features underlying therapy resistance by transcriptional profiling and (2) evaluate the features for prognostic utility. Methods: A single institution cohort of 851 HPV+ OPSCC patients undergoing transoral robotic surgery during 2007-2020 was used to identify 50 cases that recurred locoregionally in the adjuvant RT field (n=14) and/or at distant sites (n=43). As controls, we used 49 recurrence-free patients with long-term follow up and similar stage, smoking history, and adjuvant therapy. RNAseq of pretreatment tumors was used to compare individual gene expression and Hallmark/Kegg pathway activity between cases and controls using unpaired t-test (p&lt;.05) and Gene Set Enrichment Analysis (p-adj&lt;.05), respectively. Activity of the significant pathways was quantified in individual tumors using Gene Set Variation Analysis (GSVA), and a regression-based composite of GSVA scores was developed to distinguish cases from controls by ROC analysis. The composite score was used to test for stratification of recurrence free survival (RFS) in external cohorts using Youden Index and logrank test. Results: The21 Hallmark/Kegg pathways downregulated in cases indicated suppression of anti-tumor immunity, and the 20 upregulated ones revealed increased biosynthetic function and tumor cell proliferation. The 1472 upregulated mRNAs contained several components of the ATR-chk1 DNA repair pathway and trans-lesion synthesis polymerases, suggesting that mitigation of DNA replication stress enhanced tumor growth. The 958 downregulated mRNAs suggested reductions in the cytoplasmic dsDNA sensing and downstream NF-kB signals that lead to replication stress-driven anti-tumor immunity. Two GSVA scores were created to quantify the key tumor-intrinsic and immune suppressive features separately in each tumor. The scores correlated with each other (R=0.6, p&lt;.001), and a regression-based combination of them distinguished cases from controls (AUC=.76, p&lt;.001). This composite score also stratified RFS in three external cohorts: TCGA (n=52, p&lt;0.001) and two single institution cohorts containing both surgical and nonsurgical cases (n=46, p=.002; n=81, p&lt;0.001). Conclusions: HPV+ OPSCCs failing primary surgical therapy show evidence of reduced replication stress mediating tumor progression and low anti-tumor immunity. These features appear generalizable to heterogeneously treated external cohorts, where they predicted recurrence. Our results provide a new basis for creating transcriptomic predictors of treatment response and suggest targetable molecular mechanisms to overcome therapy resistance.

Comparison of CellRox green fluorescence upon thawing on in vitro Bos taurus and Bos indicus embryos cryopreserved by slow freezing or vitrification.

The aim of this study was to compare the levels of reactive oxygen species (ROS) in Bos taurus and Bos indicus in vitro embryos cryopreserved using either slow freezing or vitrification. Embryos were divided into four groups based on subspecies and freezing method: Bos indicus slow freezing (BiSF; n = 8), Bos indicus vitrification (BiVT; n = 10), Bos taurus slow freezing (BtSF; n = 9), and Bos taurus vitrification (BtVT; n = 6). After thawing, the embryos were incubated with CellRox Green and images were obtained using a confocal microscope. The fluorescence intensity of each cell was measured and expressed as arbitrary units of fluorescence (auf) and compared using a multiple regression and unpaired t-test with α = 0.05. Results showed that subspecies and the freezing method significantly affected auf (P < 0.001; R2 = 0.1213). Bos indicus embryos had higher auf than Bos taurus embryos, whether frozen by slow freezing (67.05 ± 23.18 vs 51.30 ± 16.84, P < 0.001) or vitrification (64.44 ± 23.32 vs 47.86 ± 17.53, P < 0.001). Slow freezing induced higher auf than vitrification in both Bos taurus (51.30 ± 16.84 vs 47.86 ± 17.53, P < 0.001) and Bos indicus (67.05 ± 23.18 vs 64.44 ± 23.32, P < 0.014). In conclusion, Bos taurus embryos had lower ROS levels when frozen using vitrification, while Bos indicus embryos had consistent ROS patterns regardless of the freezing method. However, Bos indicus embryos frozen by slow freezing tended to have a higher number of cells with elevated ROS levels.

CASTOR1 phosphorylation as a predictor of survival in male patients with KRAS-mutated lung adenocarcinoma.

e20015 Background: Lung cancer, a leading global cause of cancer-related mortality, necessitates enhanced prognostic markers for improved treatment outcomes. This study focuses on the predictive value of phosphorylated cytosolic arginine sensor for mTORC1 subunit 1 at S14 (pCASTOR1) in lung adenocarcinoma (LUAD) patients, specifically in males with KRAS mutations. Methods: This retrospective study, approved by University of Pittsburgh IRB, utilized formaline-fixed paraffin embedded primary tissues from two independent cohorts of patients who underwent thoracic surgical procedures at the University of Pittsburgh Medical Center (UPMC) from 2002 to 2011. Comprehensive clinical, demographical and pathological information was obtained from UPMC Cancer Registry, with cases lacking incomplete information excluded from analysis. Study endpoints included overall survival (OS) and relapse-free survival (RFS). An antibody targeting pCASTOR1 was employed to analyze LUAD tumor and adjacent non-tumor lung tissues from both cohorts. A pathologist, blinded to patient information and survival outcomes, conducted scoring in 5% increments. Scores were categorized as low or high pCASTOR1 based on second or third quartile. Correlations between pCASTOR1 scores and OS/RFS were examined, stratifying by clinical, pathological, demographic, or genotype data. Univariate OS and RFS analyses were conducted using the Kaplan-Meier method and log-rank test, while multivariate survival significance was assessed via Cox regression analysis. Additionally, unpaired T-tests were utilized to compare pCASTOR1 levels between non-tumor and tumor cells. A significance threshold of p &lt; 0.05 was applied for all analyses. Results: Tumor cells exhibited significantly elevated pCASTOR1 scores compared to non-tumor cells in both cohorts (P &lt; 0.05). High pCASTOR1 scores predicted poor OS (HR = 3.3, P = 0.0008) and RFS (HR = 3.0, P = 0.0035) in male patients with KRAS mutations in Cohort 1. pCASTOR1 remained an independent predictor for OS (HR = 4.1, P = 0.0047) and RFS (HR = 3.5, P = 0.0342) after controlling for other factors. Cohort 2, comprised solely of smokers with incomplete genotype information, validated these findings, with high pCASTOR1 scores correlating with worse OS (HR = 4.8, P = 0.0363). Notably, in early-stage LUAD, elevated pCASTOR1 scores were associated with significantly worse OS (HR = 3.3, P = 0.0176) and RFS (HR = 3.1, P = 0.0277) in male patients with KRAS mutations in Cohort 1, and worse OS (HR = 5.0, P = 0.0069) and RFS (HR = 5.0, P = 0.0069) in Cohort 2, akin to late-stage patients. Conclusions: Elevated pCASTOR1 score serves as a robust biomarker predicting poor OS and RFS in male LUAD patients with KRAS mutations, offering potential clinical utility in optimizing treatment strategies for this subgroup.

Comparison of Spinal Morphine and Transversus Abdominis Plane Block on Opioid Requirements After Caesarean Section: An Observational Study.

Acute postoperative pain is one of the major clinical problems that occurs in patients undergoing cesarean section with a prevalence of 89.8%. Postoperative pain causes discomfort and various complications for the mother. In addition, postoperative pain that is not handled properly can increase the risk of becoming chronic pain by 2.5 times. One of the methods recommended in the Enhanced Recovery After Caesarean Section (ERACS) protocol to prevent acute postoperative pain is the use of intrathecal long-acting opioids, with intrathecal morphine as the gold standard and Transversus Abdominis Plane (TAP) block. This study aims to assess the comparison of opioid needs as analgesic rescue between the administration of 0.1mg spinal morphine and TAP block with bupivacaine 0.2% 10mg in patients undergoing cesarean section. This study is an observational study in a single Tertiary Hospital in West Java - Indonesia. Patients were given patient-controlled anesthesia (PCA) with fentanyl as analgesic rescue. Statistical analysis of the numerical data used the unpaired t-test and Chi-Square test for categorical data. In the group that was given spinal morphine, the duration of additional opioids was longer (p < 0.05), and the total dose of additional opioids was less than the TAP block group (p < 0.05). The spinal morphine requires fewer additional opioids than the TAP block.

Comparing performance of primary care clinicians in the interpretation of SPIROmetry with or without Artificial Intelligence Decision support software (SPIRO-AID): a protocol for a randomised controlled trial

IntroductionSpirometry is a point-of-care lung function test that helps support the diagnosis and monitoring of chronic lung disease. The quality and interpretation accuracy of spirometry is variable in primary care....