The Explosive Reactive Armors(ERA)are really efficient at reducing Shaped Charge Jet(SCJ)performance.The main destabilizing mechanism is the transverse movement of the front and rear moving plates(MP)on the SCJ.Theref...The Explosive Reactive Armors(ERA)are really efficient at reducing Shaped Charge Jet(SCJ)performance.The main destabilizing mechanism is the transverse movement of the front and rear moving plates(MP)on the SCJ.Therefore,a good understanding of the interaction SCJ/MP is essential for improving both weapon and armor systems.In a previous article,we have shown that interaction regimes are mainly influenced by the local collision geometry.Thus,in the collision point frame,the angle of collision be-tween the continuous SCJ and the MP is a key parameter.This flow angle is acute for the Backward Moving plate(BMP)moving against the SCJ and obtuse for the Forward Moving Plate(FMP)moving alongside it.In the former,the jet is simply deflected,which is the regime 1 of deflection.In the latter,the interaction turns on an alternative creation of fragment and ligament,which is the regime 2.Fragments are parts of the jet that are only slightly deflected while ligaments are the curved material bridges that connect two consecutive fragments.When stretching,the jet is systematically subject to instabilities that disturb its surface,creating necks along it.Their growth finally leads to the jet fragmentation.In this article,we focus on this jet distur-bance and its consequences on the SCJ/MP interaction.An experimental set-up was built to implement the interaction between a SCJ and a moving plate for different collision points,at different stand-off distances.The plate can interact with a smooth SCJ or a disturbed SCJ at a close and a far stand-off distance,respectively.One of the main results is the visualization of a regime change in SCJ/BMP interaction.A regime 1(deflection)interaction changes into a ligament regime interaction(similar to a FMP regime 2)when the collision point stand-off is increased.It is proposed that this change can be attributed as the increase of the amplitude of the jet surface disturbances.This phenomenon is well captured by the gSPH simula-tions.Finally,using both experimental and numerical approaches,we propose a new detailed analysis of the different phenomena occurring during the interaction between a disturbed-surface jet and a moving plate.Interaction regime changes are linked to jet local geometry changes.The interactions of a BMP with a smooth SCJ or with a disturbed surface SCJ are geometrically not the same and,thus,generate different local flows and interaction mechanisms.However,some other simulations have been carried out with constant velocity jet whose surface has been previously disturbed.These simulations underline the influence of both disturbance wavelength l and amplitude A on the interaction regimes.Surface disturbances of the SCJ,linked to its stretching,have a major influence on its interaction with a moving plate.展开更多
Dear Editor,Local recurrence and cervical lymph node metastases are major causes of mortality in patients with head and neck squamous cell carcinoma(HNSCC).To date,none of the proposed strategies for predicting outcom...Dear Editor,Local recurrence and cervical lymph node metastases are major causes of mortality in patients with head and neck squamous cell carcinoma(HNSCC).To date,none of the proposed strategies for predicting outcomes in this disease have proven fully effective,and a comprehensive physical examination remains the primary method for early detection and monitoring of HNSCC.展开更多
Numerous studies have demonstrated that the high expression of CXC motif chemokine ligand 16(CXCL16)in cancer correlates with poor prognosis,as well as tumor cell proliferation,migration,and invasion.While CXCL16 can ...Numerous studies have demonstrated that the high expression of CXC motif chemokine ligand 16(CXCL16)in cancer correlates with poor prognosis,as well as tumor cell proliferation,migration,and invasion.While CXCL16 can serve as a tumor biomarker,the underlying mechanism in modulating head and neck squamous cell carcinoma(HNSCC)remains unclear.In this study,the aimed was to investigate the CXCL16 expression in HNSCC and to uncover the potential underlying mechanism.Hereby,we determined the high expression of CXCL16 in The Cancer Genome Atlas(TCGA)database,as well as in tissue samples from patients with HNSCC at our central hospital and from HNSCC cell lines.The results showed that CXCL16 knockdown inhibited the proliferation,migration,and invasion of HNSCC cells.Mechanistically,transcriptome sequencing revealed that CXCL16 may affect HNSCC cell growth by regulating the antioxidant pathway of glutathione peroxidase 1(GPX1).The reactive oxygen species(ROS)levels were elevated in small interfering CXCL16(si-CXCL16)cells,which may contribute to the inhibition of cell proliferation,migration,and invasion.Moreover,treatment of cells with the GPX1 inhibitor eldecalcitol(ED-71)revealed that HNSCC cell growth was significantly inhibited in the synergistic group of si-CXCL16 and GPX1 inhibitor compared to the si-CXCL16 group.In conclusion,CXCL16 contributed to the development of HNSCC cells by modulating the GPX1-mediated antioxidant pathway.Thus,targeting cellular CXCL16 expression seems to be a promising strategy for treating HNSCC.展开更多
针对红外图像背景复杂、信噪比低、检测目标尺寸小和亮度弱等检测难点,提出一种基于YOLOv7s的轻量级红外小目标检测算法ISTD-YOLO(Infrared Small Target Detection-You Only Look Once)。首先,对YOLOv7s网络结构进行轻量化重构,分别将...针对红外图像背景复杂、信噪比低、检测目标尺寸小和亮度弱等检测难点,提出一种基于YOLOv7s的轻量级红外小目标检测算法ISTD-YOLO(Infrared Small Target Detection-You Only Look Once)。首先,对YOLOv7s网络结构进行轻量化重构,分别将特征提取网络和特征融合网络重新调整,设计出一种三尺度轻量级网络架构,提高对小目标的检测性能;然后,采用VoV-GSCSP来取代模型颈部网络的ELAN-W模块,以降低计算成本和网络结构的复杂性,提高推理速度;其次,在颈部网络中引入一种无参注意力机制,增强局部上下文信息的关联性,更准确地提取目标的定位;最后,选用归一化高斯Wasserstein距离(Normalized Gaussian Wasserstein Distance,NWD)优化常用的IoU指标,来计算预测框与真实框之间的重叠关系,增强对小目标的定位和检测精度。实验结果表明,ISTD-YOLO可以有效改善检测效果,对比基线模型,在HIT-UAV与IDSAT数据集上的检测精度分别提高8.52%与4.77%;模型体积仅有21.8 MB,参数量减少69.8%,计算量下降17.6%;相较于当下主流算法,ISTD-YOLO在各方面指标均得到有效改善,能够实现对红外小目标的高质量检测。展开更多
Objectives To elucidate the potential mechanisms of electroacupuncture(EA)in restoring detrusor-bladder neck dyssynergia(DBND)following suprasacral spinal cord injury(SSCI).Methods A total of 52 specific pathogen-free...Objectives To elucidate the potential mechanisms of electroacupuncture(EA)in restoring detrusor-bladder neck dyssynergia(DBND)following suprasacral spinal cord injury(SSCI).Methods A total of 52 specific pathogen-free(SPF)grade famale Sprague-Dawley(SD)rats(10-12 weeks,250-280 g)were randomly assigned to either a sham group(n=12)or a spinal cord injury model group(n=40).In the model group,DBND was induced through Hassan Shaker spinal cord transection at T10 level,with 24 rats meeting inclusion criteria and subse-quently randomized into DBND group(n=12)and EA intervention group(DBND+EA group,n=12).After spinal shock recovery(day 19 after modeling),DBND+EA group received EA treatment at Ciliao(BL32),Zhongji(RN3),and Sanyinjiao(SP6)acupoints for 20 min per ses-sion at 10/50 Hz frequencies,once daily for 10 d.Sham and DBND groups received anesthe-sia only without EA intervention.On day 29 post-modeling,all rats underwent urodynamic assessments,followed by hematoxylin and eosin(HE)staining,tandem mass tag(TMT)pro-teomics,and Western blot(WB)analysis of detrusor and bladder neck tissues.Differentially expressed proteins(DEPs)were defined as proteins with P<0.05,unique peptides≥2,and fold change>1.2 or<0.83.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway anal-ysis was performed using KOBAS 3.0(P<0.01),and protein-protein interaction(PPI)net-works were analyzed using Search Tool for the Retrieval of Interacting Genes/Proteins(STRING)11.5 and Cytoscape 3.9.1.Results Compared with sham group,DBND group showed significantly elevated leak point pressure(LPP)and maximum cystometric capacity(MCC)(both P<0.01).EA treatment sig-nificantly reduced both LPP and MCC compared with DBND group(P<0.01 and P<0.05,re-spectively).HE staining revealed that EA reduced detrusor fibrosis and improved bladder neck inflammation.TMT proteomics identified 30 overlapping DEPs in detrusor and 59 over-lapping DEPs in bladder neck when comparing DBND+EA/DBND groups with sham group.In detrusor tissue,KEGG analysis revealed 10 significantly enriched pathways(P<0.01),in-cluding mitogen-activated protein kinase(MAPK)signaling pathway.PPI analysis showed 22 of 30 DEPs were interconnected.In bladder neck tissue,14 pathways were significantly en-riched(P<0.01),including relaxin signaling pathway,with 51 of 59 DEPs showing intercon-nections.Both TMT and WB validations demonstrated that compared with sham controls,DBND rats exhibited upregulated collagen type IV alpha 2 chain(Col4a2)and downregulated guanine nucleotide-binding protein G(z)subunit alpha(Gnaz)in detrusor tissue,while EA treatment normalized both proteins(both P<0.05).In bladder neck tissue,DBND rats showed decreased expression of smoothelin(Smtn)and calcium-activated potassium chan-nel subunit beta-1(Kcnmb1)compared with sham controls(both P<0.01),which were both upregulated following EA treatment(P<0.01 and P<0.05,respectively).Conclusion EA restores detrusor-bladder neck coordination in DBND through dual-target mechanisms.In detrusor tissue,EA modulates contraction via extracellular matrix remodel-ing,cyclic adenosine monophosphate(cAMP)signaling pathway regulation,and enhanced adenosine triphosphate(ATP)biosynthesis mediated by neurotransmitters.In bladder neck tissue,EA promotes relaxation by maintaining contractile phenotypes,reducing fibrosis,sup-pressing smooth muscle excitation,and regulating presynaptic neurotransmitter release.These findings provide mechanistic insights into EA's therapeutic role in managing DBND.展开更多
Dear Editor,Primary bladder neck obstruction(PBNO)affects approximately 28%–54%of men[1].Its etiology remains unclear.Symptoms of PBNO present as voiding(e.g.,decreased force of stream,hesitancy,intermittent stream,a...Dear Editor,Primary bladder neck obstruction(PBNO)affects approximately 28%–54%of men[1].Its etiology remains unclear.Symptoms of PBNO present as voiding(e.g.,decreased force of stream,hesitancy,intermittent stream,and incomplete emptying),storage(e.g.,frequency,urgency,urge incontinence,and nocturia),or a combination of both[2].Untreated PBNO can lead to bladder dysfunction,bladder diverticula,hydronephrosis,and impaired renal function[3].展开更多
Objective:This paper conducts a bibliometric analysis of the literature on neck pain research from 2000 to 2025,aiming to comprehensively and systematically understand the research landscape,hotspots,and frontier tren...Objective:This paper conducts a bibliometric analysis of the literature on neck pain research from 2000 to 2025,aiming to comprehensively and systematically understand the research landscape,hotspots,and frontier trends in this field,providing a reference for future research directions.Methods:Data were sourced from the Web of Science Core Collection,with the search term TI=“neck pain,”covering the time span from 2000 to 2025,resulting in 2746 articles.Software such as CiteSpace V6.3.R1 and VOSviewer 1.6.20 was used to analyze publication volume,countries,authors,institutions,keywords,and co-citation networks.Results:The number of publications in neck pain research has been increasing year by year,indicating a rising level of research activity.Authors like Falla,D,Jull,G,and institutions such as Univ Queensland and Univ Toronto have significant influence in this field.Co-occurrence analysis of keywords shows that“neck pain,”“low back pain,”and“disability index”are high-frequency keywords,reflecting research hotspots such as the characteristics and treatment of neck pain and its interrelation with pain in other regions.Timeline analysis and keyword emergence analysis reveal the frontiers and development trends in this field,such as the growing attention on emerging therapeutic methods like“exercise therapy”and“dry needling,”while keywords like“intensity,”“individuals,”and“quality”indicate an increasing emphasis on personalization,precision,and quality control in the treatment process.Conclusion:The field of neck pain research is continuously expanding and deepening.Future research should further investigate the pathogenesis of neck pain,its associations with other conditions,the refinement of assessment methods,and the development of innovative rehabilitation strategies.Emphasis should also be placed on interdisciplinary collaboration to provide more robust theoretical foundations and practical guidance for the clinical treatment and rehabilitation management of neck pain.展开更多
The online version of the original article can be found at:https://www.sciopen.com/article/10.26599/JOTO.2025.9540018 Erratum to Journal of Otology,2025,20(2):123-126.https://doi.org/10.26599/JOTO.2025.9540018 The sur...The online version of the original article can be found at:https://www.sciopen.com/article/10.26599/JOTO.2025.9540018 Erratum to Journal of Otology,2025,20(2):123-126.https://doi.org/10.26599/JOTO.2025.9540018 The surnames and given names of these authors are reversed:Saro-Buendía Miguel,Andresen-Lorca Belén,Pérez-García Alberto,Llópez Carratala Nacho,Carreres Polo Joan,Armengot Carceller Miguel,Perolada Valmaña Jose María.It should be Miguel Saro-Buendía,Belén Andresen-Lorca,Alberto Pérez-García,Nacho Llópez Carratala,Joan Carreres Polo,Miguel Armengot Carceller,Jose María Perolada Valmaña.展开更多
Osteoradionecrosis of the temporal bone(ORN-TB)is usually controlled with conservative measures.However,a temporal bone resection may be required in unresponsive cases.The reconstruction of the resulting defects may b...Osteoradionecrosis of the temporal bone(ORN-TB)is usually controlled with conservative measures.However,a temporal bone resection may be required in unresponsive cases.The reconstruction of the resulting defects may be challenging because of the radiation damage to regional tissues.As a result,distant free flaps may be an optimal choice.For instance,the gracilis muscular free flap(GMFF)has consistent vascular anatomy and can be used to reconstruct small defects.We report three cases of uncontrolled ORN-TB requiring an extensive temporal bone resection followed by vascularized obliteration with a GMFF.The patients reported complete control of the main otologic symptoms(otorrhea,otalgia,and aural fullness)and optimal functional and aesthetic outcomes.Finally,the patients reported significant improvement in quality of life despite early postoperative complications.To our knowledge,the GMFF had not been used to obliterate temporal bone defects in patients with ORN-TB.展开更多
Flexible piezoresistive pressure sensors have attracted much attention for applications in health monitoring and human-machine interfaces due to their simple device structures and easy-to-read signals.For practical ap...Flexible piezoresistive pressure sensors have attracted much attention for applications in health monitoring and human-machine interfaces due to their simple device structures and easy-to-read signals.For practical applications,the deployment of flexible pressure sensors characterized by high sensitivity and fast response time is imperative for the rapid and accurate detection and monitoring of tiny signals.Such capabilities are essential for facilitating immediate feedback and informed decision-making across a spectrum of contexts.Drawing lessons from the hypersensitive and fast-responding pressure sensing structures in the dragonfly’s neck(for stable imaging during its highly maneuverable flight),a Biomimetic Piezoresistive Pressure Sensor(BPPS)with exquisite mechanically interlocking sensing microstructures is developed.Each interlocking perceptual structure pair consists of an ox-horn-shaped and a mushroom-shaped structural unit.Through the characteristic configuration of the perceptual structure pair,the BPPS realizes a fast gradient accumulation of the contact area,thus synergistically enhancing the sensitivity and fast response capability.Remarkably,the sensitivity of the BPPS reaches 0.35 kPa^(−1),which increased by 75%compared to the 0.2 kPa^(−1) of the pressure sensors without biomimetic structures.Moreover,the BPPS also achieves rapid response/recovery times(<90/15 ms).Our BPPS finds utility in tasks such as identifying objects of different weights,monitoring human respiratory status,and tracking motion,demonstrating its potential in wearable healthcare devices,assistive technology,and intelligent soft robotics.Moreover,it possesses the advantages of high sensitivity and fast response time in practical applications.展开更多
BACKGROUND Intracranial blister-like microaneurysms are an extremely rare disease.Rupture of intracranial aneurysms can lead to subarachnoid hemorrhage(SAH).Patients with SAH may experience severe neurological symptom...BACKGROUND Intracranial blister-like microaneurysms are an extremely rare disease.Rupture of intracranial aneurysms can lead to subarachnoid hemorrhage(SAH).Patients with SAH may experience severe neurological symptoms,including severe headache,nausea,vomiting,transient or persistent loss of consciousness,limb weakness,and blurred vision.Ruptured aneurysms should be surgically treated as soon as possible.Intravascular electrocoagulation is becoming a promising treatment method for intracranial blister-like microaneurysms.The short-term follow-up results demonstrated that this method is safe and effective.This article presents a case of endovascular electrocoagulation for the treatment of a blisterlike microaneurysm.CASE SUMMARY This article reports the case of 71-year-old female patient with an intracranial aneurysm.The patient experienced a sudden headache with vomiting for 3 hours.Brain computed tomography(CT)scan showed a subarachnoid hemorrhage.She was diagnosed with rupture of an aneurysm and subarachnoid hemorrhage.The aneurysm was located in the choroidal segment of the right internal carotid artery.The size of the aneurysm was 2.00 mm×1.80 mm×1.97 mm,and the neck of the aneurysm was less than 0.5 mm wide.We successfully treated this aneurysm with endovascular electrocoagulation,and the patient was safely returned to the ward and discharged after subsequent supportive treatment.CT angiography reexamination 3 months after surgery revealed no contrast agent extravasation in the original lesion,with a good prognosis.CONCLUSION Endovascular electrocoagulation is an effective and safe method for the treatment of intracranial blister-like microaneurysms.展开更多
Musculoskeletal Symptoms(MSS)often arise from prolonged maintenance of bent postures in the neck and trunk during surgical procedures.To prevent MSS,a passive exoskeleton utilizing carbon fiber beams to offer support ...Musculoskeletal Symptoms(MSS)often arise from prolonged maintenance of bent postures in the neck and trunk during surgical procedures.To prevent MSS,a passive exoskeleton utilizing carbon fiber beams to offer support to the neck and trunk was proposed.The application of support force is intended to reduce muscle forces and joint compression forces.A nonlinear mathematical model for the neck and trunk support beam is presented to estimate the support force.A validation test is subsequently conducted to assess the accuracy of the mathematical model.Finally,a preliminary functional evaluation test is performed to evaluate movement capabilities and support provided by the exoskeleton.The mathematical model demonstrates an accuracy for beam support force within a range of 0.8–1.2 N Root Mean Square Error(RMSE).The exoskeleton was shown to allow sufficient Range of Motion(ROM)for neck and trunk during open surgery training.While the exoskeleton showed potential in reducing musculoskeletal load and task difficulty during simulated surgery tasks,the observed reduction in perceived task difficulty was deemed non-significant.This prompts the recommendation for further optimization in personalized adjustments of beams to facilitate improvements in task difficulty and enhance comfort.展开更多
Intracranial aneurysm(IA)is a prevalent cerebrovascular disease associated with high mortality and disability rates upon rupture.The hemodynamics of IA,which are significantly influenced by geometric parameters,direct...Intracranial aneurysm(IA)is a prevalent cerebrovascular disease associated with high mortality and disability rates upon rupture.The hemodynamics of IA,which are significantly influenced by geometric parameters,directly impact its rupture.This study focuses on investigating the transient flow characteristics in saccular IA models fabricated using a water droplet-based method,specifically examining the influence of neck widths.Particle image velocimetry technique and numerical simulation were employed to investigate the dynamic evolution of flow structures within three IA models.The results reveal that neck width(W)has a substantial effect on flow characteristics in the neck region,subsequently impacting the deep flow inside the sac.Three distinct patterns were observed during flow evolution inside the sac:for W=2 mm,two vortices occur and then disappear with relatively low average flow velocity;for W=4 mm,enhanced effects of a high-speed jet result in periodic pulsatile flow velocity distribution while maintaining stable vortex core position;for W=6 mm,significant changes in flow velocity occur due to size expansion and intensity increase of vortices.These findings demonstrate that neck widths play a complex role in influencing transient flow characteristics within IAs.Overall,this research contributes to further understanding transient flow behaviors in IAs.展开更多
BACKGROUND Clinical pathways(CPs)are structured guidelines introduced to improve healthcare quality and efficiency.In South Korea,CPs for Korean medicine have been developed since 2016 under the 3rd Comprehensive Plan...BACKGROUND Clinical pathways(CPs)are structured guidelines introduced to improve healthcare quality and efficiency.In South Korea,CPs for Korean medicine have been developed since 2016 under the 3rd Comprehensive Plan for Korean Medicine Promotion,with limited studies on their clinical application.Neck and shoulder pain are common conditions frequently treated at Korean medicine clinics,often by patients dissatisfied with conventional treatments.The demand for Korean medicine treatments for neck and shoulder pain is on the rise.AIM To evaluate the clinical applicability and effectiveness of Korean medicine CPs for neck pain and shoulder pain in public healthcare institutions in South Korea.METHODS We collected and analyzed data from patients aged 19 years and older who visited the outpatient clinic of the Department of Korean Medicine at the National Medical Center in Korea from March 1,2023 to August 31,2023.CP completion rates,along with patient satisfaction,clinical outcomes,and economic outcomes between the CP-implemented and non-CP groups were assessed.RESULTS The CP completion rates were 93.3%for neck pain and 96.8%for shoulder pain.Patient satisfaction scores showed an improvement of 17.7%for neck pain and 18.0%for shoulder pain in the CP-implemented group compared to the non-CP group.For neck pain,significant improvements were observed in the numerical rating scale(NRS)and the neck disability index,while for shoulder pain,only the University of California-Los Angeles shoulder rating scale showed notable progress,with no substantial change in NRS scores.CONCLUSION This study partially confirms the clinical applicability and effectiveness of the Korean medicine CPs for neck pain and shoulder pain.Further research is required to enhance and validate these findings.展开更多
BACKGROUND Clinical studies using Trabecular Titanium™acetabular cups have shown promising short and medium-term results.This material,due to its macro and micro surface roughness,provides a substrate for osseointegra...BACKGROUND Clinical studies using Trabecular Titanium™acetabular cups have shown promising short and medium-term results.This material,due to its macro and micro surface roughness,provides a substrate for osseointegration and enhances implant stability.However,there is a lack of evidence in the literature on the use of this material in patients with femoral neck fracture.AIM To evaluate the short-term clinical-functional and radiographic outcomes in patients with femoral neck fractures undergoing total hip arthroplasty(THA)with Trabecular Titanium™acetabular cup implants.METHODS The study included 104 patients with medial femoral neck fractures who underwent THA between January 2020 and December 2020 with the Delta TT acetabular cup(Lima Corporate,Villanova di San Daniele del Friuli,Italy).The mean age of the patients was 69.57±10.16 years(range:36-85 years).The followup period ranged from a minimum of 3 to a maximum of 4 years.Three questionnaires(Harris Hip Score,Oxford Hip Score,and EQ5D)were administered along with radiographic evaluations.Statistical methods included the Student's t-test and one-way analysis of variance for comparisons(with significance set at 0.05),and the Kaplan-Meier curve for prosthetic implant survival.RESULTS The mean follow-up was 41.5 months.The Harris Hip Score(HHS)showed a mean increase of 2.74 points(mean HHS 88.52 at 6 months postoperatively and mean HHS 91.26 at the last follow-up)with statistical significance.Similarly,the Oxford Hip Score demonstrated a statistically significant difference between follow-up groups.However,the EQ5D did not show statistically significant differences among the three groups(preoperative,6-month follow-up,and last follow-up).Revision surgery was required in 6 patients.According to Moore's criteria,96%of the acetabular components were radiographically stable and well-integrated at the last follow-up.The Kaplan-Meier curve showed a 96%survival rate.CONCLUSION The clinical and radiographic results obtained in the short to medium term confirm the excellent performance of the Delta TT acetabular cup in terms of osseointegration,providing an optimal solution both for young patients with high functional recovery demands and for fragile patients requiring optimal stability of the acetabular component to reduce the risk of implant failure.展开更多
Treatment delays during radiotherapy for head and neck cancer(HNC)are a well-established factor negatively affecting clinical outcomes,with similar trends observed in other cancers.In this first part of a two-part rev...Treatment delays during radiotherapy for head and neck cancer(HNC)are a well-established factor negatively affecting clinical outcomes,with similar trends observed in other cancers.In this first part of a two-part review,we assessed the impact of overall treatment time(OTT)prolongation on locoregional control(LRC)and survival(SV)in cervical cancer(CC),prostate cancer(PC),and anal cancer(AC),while updating evidence for HNC.A comprehensive literature search was performed in evidence-based databases,including MEDLINE,identifying studies evaluating the relationship between OTT prolongation and outcomes.Particular attention was paid to the strength of evidence,distinguishing univariate analysis from multivariate analysis(MV-An).For CC,37 articles were identified,with 88.8%reporting a detrimental impact on LRC and/or SV,mostly supported by MV-An.In AC,15 studies were found,with 33.3%showing negative impacts,although with weaker evidence.For PC,12 articles were reviewed,with 66.6%demonstrating detrimental effects mainly on LRC or biochemical control,and occasional associations with cancer-specific SV.Recent studies in HNC reinforced prior findings.When available,radiobiological parameters and practical recommendations are provided.In conclusion,strong evidence confirms that prolonged OTT worsens outcomes in HNC and CC,with less consistent but relevant effects in PC and AC.展开更多
Objective:The aim of the study is to evaluate the effect of neck massage on increased breast milk secretion among postnatal mothers.Materials and Methods:The current study adopted a quasi-experimental design conducted...Objective:The aim of the study is to evaluate the effect of neck massage on increased breast milk secretion among postnatal mothers.Materials and Methods:The current study adopted a quasi-experimental design conducted among 60 primi postnatal mothers(30 in each group).Study was conducted at the Postnatal ward of IMS and SUM Hospital,Bhubaneswar,Odisha.Tools used were structured sociodemographic pro forma,structured breast milk adequacy questionnaire,and structured rating scale to assess the adequacy of breast milk production.The duration of the study is 1 year.All the postnatal mothers who were primigravida and undergone cesarean section were chosen as the sample through a convenience sampling technique.Then,the samples were assigned to the intervention group(receiving neck massage)and control group(receiving standard postnatal care).The data were collected and analyzed using both descriptive and inferential statistics by SPSS version 20.Results:The study resulted a significant difference between the pretest and posttest score of breast milk production after neck massage(P=0.000).The mean score of the posttest(2.90±0.36)is more than the mean score of the pretest(2.89±0.36)of the baby’s weight(P<0.001).Further,the number of urination and stool passed in 24 h was more in the intervention group than the control group(P<0.001).The Chi-square analysis showed statistical significance between breast milk production after neck massage with religion of the postnatal mothers(P<0.05).Conclusion:The neck massage is found effective in improving the breast milk production among primi c-section mothers with improve newborn parameters.展开更多
BACKGROUND Merkel cell carcinoma(MCC)is a rare and aggressive skin cancer with high incidence in older and immunocompromised patients.Its occurrence in the nasal dorsum is extremely rare and poses significant diagnost...BACKGROUND Merkel cell carcinoma(MCC)is a rare and aggressive skin cancer with high incidence in older and immunocompromised patients.Its occurrence in the nasal dorsum is extremely rare and poses significant diagnostic and therapeutic challenges.CASE SUMMARY We report the case of a 65-year-old woman with diabetes mellitus and hypertension who presented with a dorsal nasal mass.The initial differential diagnosis favored hemangioma-based clinical examination on imaging.Histopathological examination after excision revealed MCC,necessitating a complex management strategy.A 3 cm×2 cm nasal mass,initially suspected to be a hemangioma,was excised but revealed MCC with positive margins.Positron emission tomography–computed tomography confirmed metastatic cervical lymphadenopathy.The patient underwent bilateral neck dissection,revealing metastases in seven nodes.Residual activity was treated with radiation therapy,leading to a favorable response after 6 months.CONCLUSION This case highlights the importance of considering MCC in the differential diagnosis of nasal masses,and integrated management.展开更多
基金supported by the Ministère des Arméesthe Agence de l'Innovation de Défense (AID)
文摘The Explosive Reactive Armors(ERA)are really efficient at reducing Shaped Charge Jet(SCJ)performance.The main destabilizing mechanism is the transverse movement of the front and rear moving plates(MP)on the SCJ.Therefore,a good understanding of the interaction SCJ/MP is essential for improving both weapon and armor systems.In a previous article,we have shown that interaction regimes are mainly influenced by the local collision geometry.Thus,in the collision point frame,the angle of collision be-tween the continuous SCJ and the MP is a key parameter.This flow angle is acute for the Backward Moving plate(BMP)moving against the SCJ and obtuse for the Forward Moving Plate(FMP)moving alongside it.In the former,the jet is simply deflected,which is the regime 1 of deflection.In the latter,the interaction turns on an alternative creation of fragment and ligament,which is the regime 2.Fragments are parts of the jet that are only slightly deflected while ligaments are the curved material bridges that connect two consecutive fragments.When stretching,the jet is systematically subject to instabilities that disturb its surface,creating necks along it.Their growth finally leads to the jet fragmentation.In this article,we focus on this jet distur-bance and its consequences on the SCJ/MP interaction.An experimental set-up was built to implement the interaction between a SCJ and a moving plate for different collision points,at different stand-off distances.The plate can interact with a smooth SCJ or a disturbed SCJ at a close and a far stand-off distance,respectively.One of the main results is the visualization of a regime change in SCJ/BMP interaction.A regime 1(deflection)interaction changes into a ligament regime interaction(similar to a FMP regime 2)when the collision point stand-off is increased.It is proposed that this change can be attributed as the increase of the amplitude of the jet surface disturbances.This phenomenon is well captured by the gSPH simula-tions.Finally,using both experimental and numerical approaches,we propose a new detailed analysis of the different phenomena occurring during the interaction between a disturbed-surface jet and a moving plate.Interaction regime changes are linked to jet local geometry changes.The interactions of a BMP with a smooth SCJ or with a disturbed surface SCJ are geometrically not the same and,thus,generate different local flows and interaction mechanisms.However,some other simulations have been carried out with constant velocity jet whose surface has been previously disturbed.These simulations underline the influence of both disturbance wavelength l and amplitude A on the interaction regimes.Surface disturbances of the SCJ,linked to its stretching,have a major influence on its interaction with a moving plate.
文摘Dear Editor,Local recurrence and cervical lymph node metastases are major causes of mortality in patients with head and neck squamous cell carcinoma(HNSCC).To date,none of the proposed strategies for predicting outcomes in this disease have proven fully effective,and a comprehensive physical examination remains the primary method for early detection and monitoring of HNSCC.
基金supported by the Scientific Research Fund of the National Health Commission-Zhejiang Provincial Health Major Science and Technology Plan Project(No.WKJ-ZJ-2415)the Key Research and Development Program of Zhejiang Province(No.2024C03166)+1 种基金the Traditional Chinese Medicine Science and Technology Project of Zhejiang Province(No.2022ZB020)the Zhejiang Provincial Natural Science Foundation of China(No.LY21H160049).
文摘Numerous studies have demonstrated that the high expression of CXC motif chemokine ligand 16(CXCL16)in cancer correlates with poor prognosis,as well as tumor cell proliferation,migration,and invasion.While CXCL16 can serve as a tumor biomarker,the underlying mechanism in modulating head and neck squamous cell carcinoma(HNSCC)remains unclear.In this study,the aimed was to investigate the CXCL16 expression in HNSCC and to uncover the potential underlying mechanism.Hereby,we determined the high expression of CXCL16 in The Cancer Genome Atlas(TCGA)database,as well as in tissue samples from patients with HNSCC at our central hospital and from HNSCC cell lines.The results showed that CXCL16 knockdown inhibited the proliferation,migration,and invasion of HNSCC cells.Mechanistically,transcriptome sequencing revealed that CXCL16 may affect HNSCC cell growth by regulating the antioxidant pathway of glutathione peroxidase 1(GPX1).The reactive oxygen species(ROS)levels were elevated in small interfering CXCL16(si-CXCL16)cells,which may contribute to the inhibition of cell proliferation,migration,and invasion.Moreover,treatment of cells with the GPX1 inhibitor eldecalcitol(ED-71)revealed that HNSCC cell growth was significantly inhibited in the synergistic group of si-CXCL16 and GPX1 inhibitor compared to the si-CXCL16 group.In conclusion,CXCL16 contributed to the development of HNSCC cells by modulating the GPX1-mediated antioxidant pathway.Thus,targeting cellular CXCL16 expression seems to be a promising strategy for treating HNSCC.
基金National Natural Science Foundation of China (General Program, 81874510)Natural Science Foundation of Hunan Province (2022JJ40301)Scientific Research Project of the Hunan Provincial Department of Education (21B0369)。
文摘Objectives To elucidate the potential mechanisms of electroacupuncture(EA)in restoring detrusor-bladder neck dyssynergia(DBND)following suprasacral spinal cord injury(SSCI).Methods A total of 52 specific pathogen-free(SPF)grade famale Sprague-Dawley(SD)rats(10-12 weeks,250-280 g)were randomly assigned to either a sham group(n=12)or a spinal cord injury model group(n=40).In the model group,DBND was induced through Hassan Shaker spinal cord transection at T10 level,with 24 rats meeting inclusion criteria and subse-quently randomized into DBND group(n=12)and EA intervention group(DBND+EA group,n=12).After spinal shock recovery(day 19 after modeling),DBND+EA group received EA treatment at Ciliao(BL32),Zhongji(RN3),and Sanyinjiao(SP6)acupoints for 20 min per ses-sion at 10/50 Hz frequencies,once daily for 10 d.Sham and DBND groups received anesthe-sia only without EA intervention.On day 29 post-modeling,all rats underwent urodynamic assessments,followed by hematoxylin and eosin(HE)staining,tandem mass tag(TMT)pro-teomics,and Western blot(WB)analysis of detrusor and bladder neck tissues.Differentially expressed proteins(DEPs)were defined as proteins with P<0.05,unique peptides≥2,and fold change>1.2 or<0.83.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway anal-ysis was performed using KOBAS 3.0(P<0.01),and protein-protein interaction(PPI)net-works were analyzed using Search Tool for the Retrieval of Interacting Genes/Proteins(STRING)11.5 and Cytoscape 3.9.1.Results Compared with sham group,DBND group showed significantly elevated leak point pressure(LPP)and maximum cystometric capacity(MCC)(both P<0.01).EA treatment sig-nificantly reduced both LPP and MCC compared with DBND group(P<0.01 and P<0.05,re-spectively).HE staining revealed that EA reduced detrusor fibrosis and improved bladder neck inflammation.TMT proteomics identified 30 overlapping DEPs in detrusor and 59 over-lapping DEPs in bladder neck when comparing DBND+EA/DBND groups with sham group.In detrusor tissue,KEGG analysis revealed 10 significantly enriched pathways(P<0.01),in-cluding mitogen-activated protein kinase(MAPK)signaling pathway.PPI analysis showed 22 of 30 DEPs were interconnected.In bladder neck tissue,14 pathways were significantly en-riched(P<0.01),including relaxin signaling pathway,with 51 of 59 DEPs showing intercon-nections.Both TMT and WB validations demonstrated that compared with sham controls,DBND rats exhibited upregulated collagen type IV alpha 2 chain(Col4a2)and downregulated guanine nucleotide-binding protein G(z)subunit alpha(Gnaz)in detrusor tissue,while EA treatment normalized both proteins(both P<0.05).In bladder neck tissue,DBND rats showed decreased expression of smoothelin(Smtn)and calcium-activated potassium chan-nel subunit beta-1(Kcnmb1)compared with sham controls(both P<0.01),which were both upregulated following EA treatment(P<0.01 and P<0.05,respectively).Conclusion EA restores detrusor-bladder neck coordination in DBND through dual-target mechanisms.In detrusor tissue,EA modulates contraction via extracellular matrix remodel-ing,cyclic adenosine monophosphate(cAMP)signaling pathway regulation,and enhanced adenosine triphosphate(ATP)biosynthesis mediated by neurotransmitters.In bladder neck tissue,EA promotes relaxation by maintaining contractile phenotypes,reducing fibrosis,sup-pressing smooth muscle excitation,and regulating presynaptic neurotransmitter release.These findings provide mechanistic insights into EA's therapeutic role in managing DBND.
文摘Dear Editor,Primary bladder neck obstruction(PBNO)affects approximately 28%–54%of men[1].Its etiology remains unclear.Symptoms of PBNO present as voiding(e.g.,decreased force of stream,hesitancy,intermittent stream,and incomplete emptying),storage(e.g.,frequency,urgency,urge incontinence,and nocturia),or a combination of both[2].Untreated PBNO can lead to bladder dysfunction,bladder diverticula,hydronephrosis,and impaired renal function[3].
基金Hubei Provincial Natural Science Foundation Innovation and Development Joint Fund Project(Project No.:2025AFD278)Three Gorges University Scientific Fund Project(Project No.:2022kj008)Three Gorges University Special Scientific Fund Project(Project No.:2023kjzx001)。
文摘Objective:This paper conducts a bibliometric analysis of the literature on neck pain research from 2000 to 2025,aiming to comprehensively and systematically understand the research landscape,hotspots,and frontier trends in this field,providing a reference for future research directions.Methods:Data were sourced from the Web of Science Core Collection,with the search term TI=“neck pain,”covering the time span from 2000 to 2025,resulting in 2746 articles.Software such as CiteSpace V6.3.R1 and VOSviewer 1.6.20 was used to analyze publication volume,countries,authors,institutions,keywords,and co-citation networks.Results:The number of publications in neck pain research has been increasing year by year,indicating a rising level of research activity.Authors like Falla,D,Jull,G,and institutions such as Univ Queensland and Univ Toronto have significant influence in this field.Co-occurrence analysis of keywords shows that“neck pain,”“low back pain,”and“disability index”are high-frequency keywords,reflecting research hotspots such as the characteristics and treatment of neck pain and its interrelation with pain in other regions.Timeline analysis and keyword emergence analysis reveal the frontiers and development trends in this field,such as the growing attention on emerging therapeutic methods like“exercise therapy”and“dry needling,”while keywords like“intensity,”“individuals,”and“quality”indicate an increasing emphasis on personalization,precision,and quality control in the treatment process.Conclusion:The field of neck pain research is continuously expanding and deepening.Future research should further investigate the pathogenesis of neck pain,its associations with other conditions,the refinement of assessment methods,and the development of innovative rehabilitation strategies.Emphasis should also be placed on interdisciplinary collaboration to provide more robust theoretical foundations and practical guidance for the clinical treatment and rehabilitation management of neck pain.
文摘The online version of the original article can be found at:https://www.sciopen.com/article/10.26599/JOTO.2025.9540018 Erratum to Journal of Otology,2025,20(2):123-126.https://doi.org/10.26599/JOTO.2025.9540018 The surnames and given names of these authors are reversed:Saro-Buendía Miguel,Andresen-Lorca Belén,Pérez-García Alberto,Llópez Carratala Nacho,Carreres Polo Joan,Armengot Carceller Miguel,Perolada Valmaña Jose María.It should be Miguel Saro-Buendía,Belén Andresen-Lorca,Alberto Pérez-García,Nacho Llópez Carratala,Joan Carreres Polo,Miguel Armengot Carceller,Jose María Perolada Valmaña.
文摘Osteoradionecrosis of the temporal bone(ORN-TB)is usually controlled with conservative measures.However,a temporal bone resection may be required in unresponsive cases.The reconstruction of the resulting defects may be challenging because of the radiation damage to regional tissues.As a result,distant free flaps may be an optimal choice.For instance,the gracilis muscular free flap(GMFF)has consistent vascular anatomy and can be used to reconstruct small defects.We report three cases of uncontrolled ORN-TB requiring an extensive temporal bone resection followed by vascularized obliteration with a GMFF.The patients reported complete control of the main otologic symptoms(otorrhea,otalgia,and aural fullness)and optimal functional and aesthetic outcomes.Finally,the patients reported significant improvement in quality of life despite early postoperative complications.To our knowledge,the GMFF had not been used to obliterate temporal bone defects in patients with ORN-TB.
基金supported by the Foundation for Innovative Research Groups of the National Natural Science Foundation of China(No.52021003)National Natural Science Foundation of China(Nos.52222509,52105301)+1 种基金the Natural Science Foundation of Jilin Province(Grant No.20220101220JC)supported by“Fundamental Research Funds for the Central Universities”.
文摘Flexible piezoresistive pressure sensors have attracted much attention for applications in health monitoring and human-machine interfaces due to their simple device structures and easy-to-read signals.For practical applications,the deployment of flexible pressure sensors characterized by high sensitivity and fast response time is imperative for the rapid and accurate detection and monitoring of tiny signals.Such capabilities are essential for facilitating immediate feedback and informed decision-making across a spectrum of contexts.Drawing lessons from the hypersensitive and fast-responding pressure sensing structures in the dragonfly’s neck(for stable imaging during its highly maneuverable flight),a Biomimetic Piezoresistive Pressure Sensor(BPPS)with exquisite mechanically interlocking sensing microstructures is developed.Each interlocking perceptual structure pair consists of an ox-horn-shaped and a mushroom-shaped structural unit.Through the characteristic configuration of the perceptual structure pair,the BPPS realizes a fast gradient accumulation of the contact area,thus synergistically enhancing the sensitivity and fast response capability.Remarkably,the sensitivity of the BPPS reaches 0.35 kPa^(−1),which increased by 75%compared to the 0.2 kPa^(−1) of the pressure sensors without biomimetic structures.Moreover,the BPPS also achieves rapid response/recovery times(<90/15 ms).Our BPPS finds utility in tasks such as identifying objects of different weights,monitoring human respiratory status,and tracking motion,demonstrating its potential in wearable healthcare devices,assistive technology,and intelligent soft robotics.Moreover,it possesses the advantages of high sensitivity and fast response time in practical applications.
文摘BACKGROUND Intracranial blister-like microaneurysms are an extremely rare disease.Rupture of intracranial aneurysms can lead to subarachnoid hemorrhage(SAH).Patients with SAH may experience severe neurological symptoms,including severe headache,nausea,vomiting,transient or persistent loss of consciousness,limb weakness,and blurred vision.Ruptured aneurysms should be surgically treated as soon as possible.Intravascular electrocoagulation is becoming a promising treatment method for intracranial blister-like microaneurysms.The short-term follow-up results demonstrated that this method is safe and effective.This article presents a case of endovascular electrocoagulation for the treatment of a blisterlike microaneurysm.CASE SUMMARY This article reports the case of 71-year-old female patient with an intracranial aneurysm.The patient experienced a sudden headache with vomiting for 3 hours.Brain computed tomography(CT)scan showed a subarachnoid hemorrhage.She was diagnosed with rupture of an aneurysm and subarachnoid hemorrhage.The aneurysm was located in the choroidal segment of the right internal carotid artery.The size of the aneurysm was 2.00 mm×1.80 mm×1.97 mm,and the neck of the aneurysm was less than 0.5 mm wide.We successfully treated this aneurysm with endovascular electrocoagulation,and the patient was safely returned to the ward and discharged after subsequent supportive treatment.CT angiography reexamination 3 months after surgery revealed no contrast agent extravasation in the original lesion,with a good prognosis.CONCLUSION Endovascular electrocoagulation is an effective and safe method for the treatment of intracranial blister-like microaneurysms.
基金funded by China Scholarship Council,Grant Number 201906840121department of rehabilitation medicine,University Medical Center Groningen,University of Groningen,grant number:O/085350.
文摘Musculoskeletal Symptoms(MSS)often arise from prolonged maintenance of bent postures in the neck and trunk during surgical procedures.To prevent MSS,a passive exoskeleton utilizing carbon fiber beams to offer support to the neck and trunk was proposed.The application of support force is intended to reduce muscle forces and joint compression forces.A nonlinear mathematical model for the neck and trunk support beam is presented to estimate the support force.A validation test is subsequently conducted to assess the accuracy of the mathematical model.Finally,a preliminary functional evaluation test is performed to evaluate movement capabilities and support provided by the exoskeleton.The mathematical model demonstrates an accuracy for beam support force within a range of 0.8–1.2 N Root Mean Square Error(RMSE).The exoskeleton was shown to allow sufficient Range of Motion(ROM)for neck and trunk during open surgery training.While the exoskeleton showed potential in reducing musculoskeletal load and task difficulty during simulated surgery tasks,the observed reduction in perceived task difficulty was deemed non-significant.This prompts the recommendation for further optimization in personalized adjustments of beams to facilitate improvements in task difficulty and enhance comfort.
基金supported by the National Natural Science Foundation of China(Grant Nos.12172017 and 11872083)Project of Beijing Municipal Education Commission(Grant Nos.KZ202210005006 and KZ202110005007).
文摘Intracranial aneurysm(IA)is a prevalent cerebrovascular disease associated with high mortality and disability rates upon rupture.The hemodynamics of IA,which are significantly influenced by geometric parameters,directly impact its rupture.This study focuses on investigating the transient flow characteristics in saccular IA models fabricated using a water droplet-based method,specifically examining the influence of neck widths.Particle image velocimetry technique and numerical simulation were employed to investigate the dynamic evolution of flow structures within three IA models.The results reveal that neck width(W)has a substantial effect on flow characteristics in the neck region,subsequently impacting the deep flow inside the sac.Three distinct patterns were observed during flow evolution inside the sac:for W=2 mm,two vortices occur and then disappear with relatively low average flow velocity;for W=4 mm,enhanced effects of a high-speed jet result in periodic pulsatile flow velocity distribution while maintaining stable vortex core position;for W=6 mm,significant changes in flow velocity occur due to size expansion and intensity increase of vortices.These findings demonstrate that neck widths play a complex role in influencing transient flow characteristics within IAs.Overall,this research contributes to further understanding transient flow behaviors in IAs.
基金approved by the National Medical Center Institutional Review Board(approval No.NRC-2023-10-109).
文摘BACKGROUND Clinical pathways(CPs)are structured guidelines introduced to improve healthcare quality and efficiency.In South Korea,CPs for Korean medicine have been developed since 2016 under the 3rd Comprehensive Plan for Korean Medicine Promotion,with limited studies on their clinical application.Neck and shoulder pain are common conditions frequently treated at Korean medicine clinics,often by patients dissatisfied with conventional treatments.The demand for Korean medicine treatments for neck and shoulder pain is on the rise.AIM To evaluate the clinical applicability and effectiveness of Korean medicine CPs for neck pain and shoulder pain in public healthcare institutions in South Korea.METHODS We collected and analyzed data from patients aged 19 years and older who visited the outpatient clinic of the Department of Korean Medicine at the National Medical Center in Korea from March 1,2023 to August 31,2023.CP completion rates,along with patient satisfaction,clinical outcomes,and economic outcomes between the CP-implemented and non-CP groups were assessed.RESULTS The CP completion rates were 93.3%for neck pain and 96.8%for shoulder pain.Patient satisfaction scores showed an improvement of 17.7%for neck pain and 18.0%for shoulder pain in the CP-implemented group compared to the non-CP group.For neck pain,significant improvements were observed in the numerical rating scale(NRS)and the neck disability index,while for shoulder pain,only the University of California-Los Angeles shoulder rating scale showed notable progress,with no substantial change in NRS scores.CONCLUSION This study partially confirms the clinical applicability and effectiveness of the Korean medicine CPs for neck pain and shoulder pain.Further research is required to enhance and validate these findings.
文摘BACKGROUND Clinical studies using Trabecular Titanium™acetabular cups have shown promising short and medium-term results.This material,due to its macro and micro surface roughness,provides a substrate for osseointegration and enhances implant stability.However,there is a lack of evidence in the literature on the use of this material in patients with femoral neck fracture.AIM To evaluate the short-term clinical-functional and radiographic outcomes in patients with femoral neck fractures undergoing total hip arthroplasty(THA)with Trabecular Titanium™acetabular cup implants.METHODS The study included 104 patients with medial femoral neck fractures who underwent THA between January 2020 and December 2020 with the Delta TT acetabular cup(Lima Corporate,Villanova di San Daniele del Friuli,Italy).The mean age of the patients was 69.57±10.16 years(range:36-85 years).The followup period ranged from a minimum of 3 to a maximum of 4 years.Three questionnaires(Harris Hip Score,Oxford Hip Score,and EQ5D)were administered along with radiographic evaluations.Statistical methods included the Student's t-test and one-way analysis of variance for comparisons(with significance set at 0.05),and the Kaplan-Meier curve for prosthetic implant survival.RESULTS The mean follow-up was 41.5 months.The Harris Hip Score(HHS)showed a mean increase of 2.74 points(mean HHS 88.52 at 6 months postoperatively and mean HHS 91.26 at the last follow-up)with statistical significance.Similarly,the Oxford Hip Score demonstrated a statistically significant difference between follow-up groups.However,the EQ5D did not show statistically significant differences among the three groups(preoperative,6-month follow-up,and last follow-up).Revision surgery was required in 6 patients.According to Moore's criteria,96%of the acetabular components were radiographically stable and well-integrated at the last follow-up.The Kaplan-Meier curve showed a 96%survival rate.CONCLUSION The clinical and radiographic results obtained in the short to medium term confirm the excellent performance of the Delta TT acetabular cup in terms of osseointegration,providing an optimal solution both for young patients with high functional recovery demands and for fragile patients requiring optimal stability of the acetabular component to reduce the risk of implant failure.
文摘Treatment delays during radiotherapy for head and neck cancer(HNC)are a well-established factor negatively affecting clinical outcomes,with similar trends observed in other cancers.In this first part of a two-part review,we assessed the impact of overall treatment time(OTT)prolongation on locoregional control(LRC)and survival(SV)in cervical cancer(CC),prostate cancer(PC),and anal cancer(AC),while updating evidence for HNC.A comprehensive literature search was performed in evidence-based databases,including MEDLINE,identifying studies evaluating the relationship between OTT prolongation and outcomes.Particular attention was paid to the strength of evidence,distinguishing univariate analysis from multivariate analysis(MV-An).For CC,37 articles were identified,with 88.8%reporting a detrimental impact on LRC and/or SV,mostly supported by MV-An.In AC,15 studies were found,with 33.3%showing negative impacts,although with weaker evidence.For PC,12 articles were reviewed,with 66.6%demonstrating detrimental effects mainly on LRC or biochemical control,and occasional associations with cancer-specific SV.Recent studies in HNC reinforced prior findings.When available,radiobiological parameters and practical recommendations are provided.In conclusion,strong evidence confirms that prolonged OTT worsens outcomes in HNC and CC,with less consistent but relevant effects in PC and AC.
文摘Objective:The aim of the study is to evaluate the effect of neck massage on increased breast milk secretion among postnatal mothers.Materials and Methods:The current study adopted a quasi-experimental design conducted among 60 primi postnatal mothers(30 in each group).Study was conducted at the Postnatal ward of IMS and SUM Hospital,Bhubaneswar,Odisha.Tools used were structured sociodemographic pro forma,structured breast milk adequacy questionnaire,and structured rating scale to assess the adequacy of breast milk production.The duration of the study is 1 year.All the postnatal mothers who were primigravida and undergone cesarean section were chosen as the sample through a convenience sampling technique.Then,the samples were assigned to the intervention group(receiving neck massage)and control group(receiving standard postnatal care).The data were collected and analyzed using both descriptive and inferential statistics by SPSS version 20.Results:The study resulted a significant difference between the pretest and posttest score of breast milk production after neck massage(P=0.000).The mean score of the posttest(2.90±0.36)is more than the mean score of the pretest(2.89±0.36)of the baby’s weight(P<0.001).Further,the number of urination and stool passed in 24 h was more in the intervention group than the control group(P<0.001).The Chi-square analysis showed statistical significance between breast milk production after neck massage with religion of the postnatal mothers(P<0.05).Conclusion:The neck massage is found effective in improving the breast milk production among primi c-section mothers with improve newborn parameters.
文摘BACKGROUND Merkel cell carcinoma(MCC)is a rare and aggressive skin cancer with high incidence in older and immunocompromised patients.Its occurrence in the nasal dorsum is extremely rare and poses significant diagnostic and therapeutic challenges.CASE SUMMARY We report the case of a 65-year-old woman with diabetes mellitus and hypertension who presented with a dorsal nasal mass.The initial differential diagnosis favored hemangioma-based clinical examination on imaging.Histopathological examination after excision revealed MCC,necessitating a complex management strategy.A 3 cm×2 cm nasal mass,initially suspected to be a hemangioma,was excised but revealed MCC with positive margins.Positron emission tomography–computed tomography confirmed metastatic cervical lymphadenopathy.The patient underwent bilateral neck dissection,revealing metastases in seven nodes.Residual activity was treated with radiation therapy,leading to a favorable response after 6 months.CONCLUSION This case highlights the importance of considering MCC in the differential diagnosis of nasal masses,and integrated management.
