This study compared the acute effects of electrical energy transfer(TECAR) and transcutaneous electrical stimulation(TENS) on pain and flexibility after a hamstring injury. Young athletes received either a 20 min TECA...This study compared the acute effects of electrical energy transfer(TECAR) and transcutaneous electrical stimulation(TENS) on pain and flexibility after a hamstring injury. Young athletes received either a 20 min TECAR(n = 24) or TENS(n = 26) session within 5 days following a hamstring injury, while the control(CON, n = 25)group was instructed to rest. Visual analogue scale(VAS), functional Assessment Scale for Acute Hamstring Injuries(FASH), straight leg raise test(SLR), and sit-and-reach scores(STR) were obtained prior to, immediately,24, and 48 h after therapy. Group differences were detected after therapy in VAS and FASH scores(p < 0.05).Compared to pre-therapy measurements, VAS scores showed a greater decrease in the TECAR group(-38.75% to-63.33%) than in the TENS group(-16.67% to-25.00%) and both were greater than in the CON group(-2.81%to-9.81%)(p < 0.05). The TECAR group improved FASH scores(28.57%–48.21%) more than the TENS group(15.89%–27.79%) and both groups more than the CON group(0%–8.33%)(p < 0.05). The increase in SLR and STR was greater in the TECAR group(6.26%–13.96%) than in the TENS(1.72%–9.53%) and CON groups(0%–3.03%). These results suggest that in the acute phase of hamstring injury, the use of TECAR and, to a lesser extent, TENS may relieve pain symptoms and bring some improvements in flexibility more than instructing patients to rest.展开更多
Achillea species are known for their healing properties since ancient times.There is extensive literature on their pharmacological action due to their bioactive compounds.The present study aimed to investigate the ant...Achillea species are known for their healing properties since ancient times.There is extensive literature on their pharmacological action due to their bioactive compounds.The present study aimed to investigate the antioxidant and antimicrobial effects of hydroalcoholic extracts from the inflorescences and leaves of the species Achillea crithmifolia Waldst.and Kit.,A.grandifolia Friv.and A.millefolium L.The phytochemical profiles of all extracts were evaluated both by NMR spectroscopy and LC-MS analysis,and the results were consistent with the spectrophotometrically determined total phenolic(TP:125.42-191.98 mg/g)and total flavonoid(TF:47.34-180.02 mg/g)contents.All the extracts were tested for their antioxidant activity using DPPH and ABTS•+radical scavenging assay,as well as ferrous ion chelating ability and reducing power tests.All the extracts showed moderate antioxidant activity,compared to the reference substance BHT.Additionally,the antibacterial activity of the extracts was evaluated against major food-borne pathogens,showing moderate antimicrobial effects.展开更多
Pancreatic ductal adenocarcinoma(PDAC)is characterized by high aggressiveness,poor prognosis,and unsatisfactory survival rates.The incidence of PDAC is increasing annually,and thus,the number of deaths due to PDAC is ...Pancreatic ductal adenocarcinoma(PDAC)is characterized by high aggressiveness,poor prognosis,and unsatisfactory survival rates.The incidence of PDAC is increasing annually,and thus,the number of deaths due to PDAC is increasing worldwide.Modern imaging modalities,including multidetector computed tomography,magnetic resonance imaging-cholangiopancreatography,endoscopic retrograde cholangiopancreatography,positron emission tomography-computed tomography,endoscopic ultrasound and tumor markers,have made significant contributions to the diagnosis of pancreatic cancer.However,early diagnosis remains challenging despite progress in liquid biopsy(tumor DNA,tumor parts or cells),miRNAs,genomic analysis,MTA(metastasis-associated)proteins or circulating cancer-derived exosomes.Early diagnosis and radical surgical excision offer a unique chance of long-term survival in patients with an otherwise poor prognosis.However,surgery alone is insufficient,and multimodal treatment is needed.Novel treatment modalities,i.e.,immunotherapy,vaccines,targeted gene therapy,extracellular vesicles(particularly exosomes),new chemotherapy,novel radiotherapy and angiogenesis-restricting biological agents,were applied with promising outcomes.It seems that the biological mechanisms underlying the disease determine the effectiveness of any therapeutic effort.Thus,further research at the molecular level must focus on novel treatments to prevent the growth,invasion,and spread of cancer cells.展开更多
BACKGROUND Kidney and liver transplantation are two sub-specialized medical disciplines,with transplant professionals spending decades in training.While artificial intelligencebased(AI-based)tools could potentially as...BACKGROUND Kidney and liver transplantation are two sub-specialized medical disciplines,with transplant professionals spending decades in training.While artificial intelligencebased(AI-based)tools could potentially assist in everyday clinical practice,comparative assessment of their effectiveness in clinical decision-making remains limited.AIM To compare the use of ChatGPT and GPT-4 as potential tools in AI-assisted clinical practice in these challenging disciplines.METHODS In total,400 different questions tested ChatGPT’s/GPT-4 knowledge and decision-making capacity in various renal and liver transplantation concepts.Specifically,294 multiple-choice questions were derived from open-access sources,63 questions were derived from published open-access case reports,and 43 from unpublished cases of patients treated at our department.The evaluation covered a plethora of topics,including clinical predictors,treatment options,and diagnostic criteria,among others.RESULTS ChatGPT correctly answered 50.3%of the 294 multiple-choice questions,while GPT-4 demonstrated a higher performance,answering 70.7%of questions(P<0.001).Regarding the 63 questions from published cases,ChatGPT achieved an agreement rate of 50.79%and partial agreement of 17.46%,while GPT-4 demonstrated an agreement rate of 80.95%and partial agreement of 9.52%(P=0.01).Regarding the 43 questions from unpublished cases,ChatGPT demonstrated an agreement rate of 53.49%and partial agreement of 23.26%,while GPT-4 demonstrated an agreement rate of 72.09%and partial agreement of 6.98%(P=0.004).When factoring by the nature of the task for all cases,notably,GPT-4 demonstrated outstanding performance,providing a differential diagnosis that included the final diagnosis in 90%of the cases(P=0.008),and successfully predicting the prognosis of the patient in 100%of related questions(P<0.001).CONCLUSION GPT-4 consistently provided more accurate and reliable clinical recommendations with higher percentages of full agreements both in renal and liver transplantation compared with ChatGPT.Our findings support the potential utility of AI models like ChatGPT and GPT-4 in AI-assisted clinical practice as sources of accurate,individualized medical information and facilitating decision-making.The progression and refinement of such AI-based tools could reshape the future of clinical practice,making their early adoption and adaptation by physicians a necessity.展开更多
BACKGROUND Despite the developments in the field of kidney transplantation,the already existing diagnostic techniques for patient monitoring are considered insufficient.Protein biomarkers that can be derived from mode...BACKGROUND Despite the developments in the field of kidney transplantation,the already existing diagnostic techniques for patient monitoring are considered insufficient.Protein biomarkers that can be derived from modern approaches of proteomic analysis of liquid biopsies(serum,urine)represent a promising innovation in the monitoring of kidney transplant recipients.AIM To investigate the diagnostic utility of protein biomarkers derived from proteomics approaches in renal allograft assessment.METHODS A systematic review was conducted in accordance with PRISMA guidelines,based on research results from the PubMed and Scopus databases.The primary focus was on evaluating the role of biomarkers in the non-invasive diagnosis of transplant-related com-plications.Eligibility criteria included protein biomarkers and urine and blood samples,while exclusion criteria were language other than English and the use of low resolution and sensitivity methods.The selected research articles,were categorized based on the biological sample,condition and methodology and the significantly and reproducibly differentiated proteins were manually selected and extracted.Functional and network analysis of the selected proteins was performed.RESULTS In 17 included studies,58 proteins were studied,with the cytokine CXCL10 being the most investigated.Biological pathways related to immune response and fibrosis have shown to be enriched.Applications of biomarkers for the assessment of renal damage as well as the prediction of short-term and long-term function of the graft were reported.Overall,all studies have shown satisfactory diagnostic accuracy of proteins alone or in combination with conventional methods,as far as renal graft assessment is concerned.CONCLUSION Our review suggests that protein biomarkers,evaluated in specific biological fluids,can make a significant contribution to the timely,valid and non-invasive assessment of kidney graft.展开更多
Patients with inflammatory bowel disease(IBD)have an increased risk of deve-loping colorectal cancer,which may ultimately result in peritoneal metastases(PM).PM in patients with IBD is by nature difficult to treat due...Patients with inflammatory bowel disease(IBD)have an increased risk of deve-loping colorectal cancer,which may ultimately result in peritoneal metastases(PM).PM in patients with IBD is by nature difficult to treat due to the chronic inflammation and immunosuppression inherent in IBD.This minireview com-piled existing evidence on management approaches to PM in patients with IBD,including surgical procedures,systemic treatment,and novel therapies.A li-terature review was conducted by searching PubMed and Scopus through June 2025 for studies addressing PM in IBD-associated colorectal or small bowel cancer.Literature specific to PM in IBD is sparse,comprising primarily two small retrospective cohort series comparing outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy(CRS/HIPEC)in patients with and without IBD.These studies indicated that in high-volume centers with careful preoperative optimization perioperative morbidity and mortality rates for patients with IBD undergoing CRS/HIPEC were similar to those without IBD.However,median overall survival(approximately 19.6-24.0 months)and disease-free survival were consistently shorter and rates of early peritoneal recurrence were higher in patients with IBD.Although CRS/HIPEC can be performed safely in selected patients with IBD and PM,long-term oncologic outcomes appear inferior compared to populations without IBD,likely reflecting later-stage pre-sentation,distinct tumor biology,and IBD-related factors.展开更多
BACKGROUND Silver-Russell syndrome(SRS)is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction,relative macrocephaly at birth,distinct facial features,and body asymmetry com...BACKGROUND Silver-Russell syndrome(SRS)is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction,relative macrocephaly at birth,distinct facial features,and body asymmetry combined with other malformations.CASE SUMMARY Herein,we describe four individuals with SRS,focusing on their prenatal phenotype,postnatal presentation,diagnosis,and management.All cases had a typical phenotype,including postnatal growth failure,short stature(chronic malnutrition),and protruding forehead.Individually,they presented with feeding difficulties,leg length discrepancy,triangular face,or relative macrocephaly at birth,and each one exhibited distinct SRS features,including motor and/or speech delay,experiencing frequent hypoglycemic episodes.The fact that each patient exhibited a different combination of clinical findings underlines the heterogeneity of the syndrome.CONCLUSION SRS is diagnosed clinically.However,only 60%of cases are genetically confirmed,while most are sporadic.Although SRS is a well-described syndrome,a delayed diagnosis can have grave consequences on a child’s growth.Recombinant human growth hormone treatment is often initiated shortly after the diagnosis.The follow-up requires a multidisciplinary approach.展开更多
BACKGROUND Hepatic ischemia-reperfusion injury(HIRI)remains one of the major causes of postoperative liver dysfunction following extensive hepatectomy and liver transplantation.Owing to its progressive and dynamic nat...BACKGROUND Hepatic ischemia-reperfusion injury(HIRI)remains one of the major causes of postoperative liver dysfunction following extensive hepatectomy and liver transplantation.Owing to its progressive and dynamic nature,HIRI may lead to multiple organ failure and a worsened outcome.Treprostinil is a relatively new synthetic prostacyclin analog with a potential beneficial effect against HIRI.Ischemic preconditioning(IP)is a promising method to protect against HIRI.AIM To investigate HIRI biomarkers,their effects on liver and heart,and the effects of treprostinil and IP on these processes.METHODS Forty male Wistar albino rats aged 3-4 months were randomly assigned to four groups of ten,subjected to a 3-hour surgical intervention,and then sacrificed.Hepatic ischemia was induced by clamping the hepatoduodenal ligament for 30 minutes,followed by reperfusion for 120 minutes.Treprostinil(100 ng/kg/minute for 24 hours)or IP before HIRI,no protection,and a sham operation were applied accordingly in each group.Liver and heart histopathology and specific serum and hepatic tissue biomarkers were assessed.RESULTS HIRI deteriorated hepatocellular function and exacerbated liver and myocardial damage in the control group.Furthermore,HIRI triggered cytokine overexpression and protein carbonyl content(P<0.001).Compared with those in the HIRI group,lower troponin I,tumor necrosis factor-α,endothelin-1,and interleukin-1βin serum and liver tissue were significantly correlated with reduced cellular necrosis and improved hepatocellular function in the treprostinil group(P<0.001).Similar but less pronounced effects were observed in the IP group.Both treprostinil and IP had protective effects in hepatic and cardiac tissues.However,treprostinil showed slightly superior cardioprotective efficacy,as evidenced by a statistically significant difference in troponin I levels(P<0.05)and histopathological scoring of myocardium samples,but there were no differences in the other parameters.CONCLUSION HIRI results in oxidative stress and cytokine overexpression,which deteriorate hepatic function and accelerates myocardial damage.Treprostinil and IP are promising strategies for preventing reperfusion-induced cellular and systemic damage.展开更多
Inappropriate use of antibiotics leads to microbial resistance.Single-dose antibio-tic prophylaxis prior to laparoscopic cholecystectomy is well known for reducing the risk of postoperative infection in high-risk pati...Inappropriate use of antibiotics leads to microbial resistance.Single-dose antibio-tic prophylaxis prior to laparoscopic cholecystectomy is well known for reducing the risk of postoperative infection in high-risk patients despite some conflicting aspects.High-risk patients are those who are older than 70 years,have diabetes mellitus,whose operation time exceeded 120 minutes,have acute cholecystitis,experienced iatrogenic intraoperative gallbladder perforation resulting in bile or gallstone spillage,suffered from obstructive jaundice,or were deemed immuno-compromised.For gallbladder perforation,one dose of antibiotic prophylaxis is sufficient.Therefore,guidelines are needed and must be strictly followed.Prophy-lactic treatment is not needed for patients at low risk of developing sepsis fo-llowing elective laparoscopic cholecystectomy,although the opposite is suppor-ted.Similarly,superficial surgical infections are related to low morbidity.Patients without risk factors have a very low risk of infection.Thus,the routine use of anti-biotic prophylaxis in elective laparoscopic cholecystectomy is not recommended.展开更多
BACKGROUND Autoimmune autonomic ganglionopathy(AAG),formerly known as acute pandysautonomia,is a rare,acquired,antibody-mediated,potentially curable autonomic disorder that presents with diffuse autonomic failure.High...BACKGROUND Autoimmune autonomic ganglionopathy(AAG),formerly known as acute pandysautonomia,is a rare,acquired,antibody-mediated,potentially curable autonomic disorder that presents with diffuse autonomic failure.High levels of anti-ganglionic nicotinic acetylcholine receptor(gAChR)serum antibodies are detected in approximately 50%of AAG cases,confirming the diagnosis.CASE SUMMARY We present the case of a 68-year-old man who developed autonomic failure gradually over a 2-year period.Recently,the patient was unable to stand upright for more than a few seconds before fainting.Additionally,he presented with decreased sweating,dry mouth,urinary retention,early satiety,weight loss,bloating,constipation,and erectile dysfunction.Neurological examination revealed dilated pupils that were unresponsive to light.Deep tendon reflexes were absent or diminished.Serologic evaluation revealed the presence of gAChR autoantibodies.An orthostatic hypotension test yielded a positive result.The patient did not respond to symptomatic therapy,including midodrine,fludrocortisone and atomoxetine.Second-line therapy with immunoadsorption produced a noticeable clinical improvement;however,orthostatic hypotension persisted.Sequential rituximab infusion therapy successfully led to a significant improvement in symptoms.CONCLUSION Our case report supports the benefit of combined immunomodulatory therapy for refractory AAG cases that are unresponsive to single-agent treatment.展开更多
Echinococcosis or hydatid disease is induced mainly by Echinococcus granulosus and occasionally by Echinococcus multilocularis(alveolaris)and affects the liver predominantly.Hepatic alveolar echinococcosis is similar ...Echinococcosis or hydatid disease is induced mainly by Echinococcus granulosus and occasionally by Echinococcus multilocularis(alveolaris)and affects the liver predominantly.Hepatic alveolar echinococcosis is similar to carcinoma in appearance,and without treatment,it can lead to death.Diagnosis is based on current imaging modalities.Surgical management is the cornerstone of treatment.Complete removal of the cyst(total pericystectomy or hepatectomy)ensures a permanent cure and should be the first-choice treatment for cystic disease.Cyst evacuation,partial cystectomy,and drainage or omentoplasty,may be alternative choices in difficult cases.Albendazole,mebendazole and praziquantel are options for treating small cysts and preventing recurrence after surgery.Despite the efforts,alveolar echinococcus is not usually amenable to surgical management,except in the early stage,which is less common,and management by albendazole is indicated.However,there are few recent reports of major operations(ex-vivo hepatectomy,autotransplantation and vascular reconstruction)in advanced stages.展开更多
Hepatic ischemia-reperfusion injury is an important mechanism of liver failure that occurs in many clinical conditions,including massive hemorrhage,major hepatectomy and liver transplantation,and leads to poor outcome...Hepatic ischemia-reperfusion injury is an important mechanism of liver failure that occurs in many clinical conditions,including massive hemorrhage,major hepatectomy and liver transplantation,and leads to poor outcomes.The underlying cellular and molecular reactions are extremely complex and not completely understood.Anaerobic metabolism,ATP depletion,intracellular acidosis,calcium overload,mitochondrial dysfunction,oxidative stress,activation of Kupffer cells and neutrophils,platelet aggregation,nitric oxide production,activation of the complement system and overexpression of cytokines and chemokines constitute the main pathophysiological actions and pathways for possible therapeutic strategies.Prostaglandins(PGs)are a group of biologically active lipid compounds called eicosanoids with many physiological activities.Prostacyclin(PGI_(2))is a member of the PGs family with an unstable chemical structure and a very short half-life.PGI_(2)has potent vasodilating activity,inhibits platelet activation and exerts anti-inflammatory effects.PGI_(2)has been evaluated in chronic liver disease as a mediator of hepatic stellate cell function,an antiproliferative and antifibrotic agent and a regulator of the hepatic microcirculation.In recent decades,the cytoprotective effects of PGI_(2)analogs on hepatic ischemiareperfusion injury have been experimentally and clinically studied.Moreover,the administration of synthetic PGI_(2)analogs to patients who underwent liver transplantation produced very encouraging results.The downregulation of PGE_(2) production,reduction of neutrophil aggregation in liver lobules,regulation of local microcirculatory homeostasis,improvement in mitochondrial function,alleviation of hepatic oxidative stress,suppression of the c-Jun N-terminal kinase and p38 cascades and downregulation of tumor necrosis factor-alpha and interleukin-1βproduction constitute some of the underlying physiological mechanisms of the beneficial effects of PGI_(2)on hepatic ischemia-reperfusion injury.Thus,PGI_(2)analogs appear to hold great promise for the management of hepatic ischemia-reperfusion injury,but further research is needed.展开更多
BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increas...BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increase re-tear rates.AIM To investigate the potential inhibitory effects of alpha-tocopherol(vitamin E)and OTR-4131 on muscle atrophy,fatty infiltration,and fibrosis in rotator cuff muscles following a massive RCT using a Wistar rat model,and establish a standardized methodology for evaluating potential therapeutic agents.METHODS This protocol outlines a controlled animal study using 40 male Wistar rats,randomized into five groups.The experimental groups will receive either systemic administration of alpha-tocopherol or local administration of OTR-4131 via intramuscular injection into the supraspinatus and infraspinatus muscles.Two sham groups will receive systemic and local saline injections respectively,while a control group will undergo no intervention.The interventions will be administered after surgical transection of the supraspinatus and infraspinatus tendons.Outcomes will be assessed via wet muscle weight measurements,muscle fiber diameter,fatty infiltration percentage,and fibrosis evaluation using histological methods.RESULTS The study anticipates that alpha-tocopherol and OTR-4131 will reduce muscle atrophy,fatty infiltration,and fibrosis compared to control and sham groups,supporting their potential protective role in rotator cuff muscle degeneration.CONCLUSION The results are expected to improve the understanding on the role of alpha-tocopherol and OTR-4131 in rotator cuff muscle protection after massive RCT and may serve as a foundation for further preclinical and clinical research aimed at improving rotator cuff repair outcomes.展开更多
Treprostinil is a relatively new tricyclic prostacyclin analog with a stable str-ucture,extended half-life and improved potency.Currently,treprostinil is indicated by the Food and Drug Administration in the United Sta...Treprostinil is a relatively new tricyclic prostacyclin analog with a stable str-ucture,extended half-life and improved potency.Currently,treprostinil is indicated by the Food and Drug Administration in the United States for the treatment of pulmonary arterial hypertension(group 1 in the pulmonary hy-pertension classification of the World Health Organization).It has a potent vasodilating effect along with the inhibition of platelet aggregation and the attenuation of the inflammatory response in pulmonary and systemic circulation.It is available in the following formulations:Subcutaneous,intravenous,inhaled and oral.Although unknown to many clinicians,several encouraging reports of off-label treprostinil use in the adult population suggest its potential effectiveness in other clinical conditions.Currently under investigation are digital ischemia secondary to systemic sclerosis,chronic limb ischemia,hepatic ischemia-reper-fusion injury and group 3 and 4 pulmonary hypertension.Based on review and analysis of the available literature,this article provides a thorough update on the off-label use of treprostinil in adult patients.展开更多
BACKGROUND Safety and efficacy of intravascular ultrasound(IVUS)guidance in percutaneous coronary intervention(PCI)has been consistently shown in recent trials.However,prospective data on the clinical effects of IVUS ...BACKGROUND Safety and efficacy of intravascular ultrasound(IVUS)guidance in percutaneous coronary intervention(PCI)has been consistently shown in recent trials.However,prospective data on the clinical effects of IVUS usage in primary PCI are still warranted.The ULTRA-STEMI trial is a prospective investigator-initiated observational single-center cohort trial aiming to enroll 80 patients with STEMI.AIM To investigate the outcomes of patients with STEMI undergoing IVUS-guided PCI and correlate derived IVUS measurements with clinical,procedural,imaging and follow-up outcomes of interest.METHODS Study participants will undergo primary PCI as per standardized procedures.IVUS pullbacks will be performed pre-intervention,post-lesion preparation,postintervention and post-optimization using a 20 MHz digital IVUS(Eagle Eye Platinum,Philips).Manual thrombus aspiration will be performed in cases of high thrombus burden.The aspirated thrombi will be scanned with micro-computed tomography to extract volumetric measurements of the aspirated thrombotic burden.Moreover,angiographic,peri-procedural and 3-year follow-up data will be gathered.Co-primary endpoints will be cardiovascular mortality and target vessel failure,defined as the composite of:Cardiovascular mortality,target vessel myocardial infarction and/or clinically driven target vessel revascularization.RESULTS The results of the study are expected by the third quarter of 2029.CONCLUSION The ULTRA-STEMI trial will add to the existing literature the clinical,angiographic,micro-computed tomography and follow-up outcomes of IVUS-guided PCI in 80 patients presenting with STEMI.展开更多
BACKGROUND A diagnosis of a chronic disease has been shown to predispose patients to the development of feeding and eating disorders(FEDs).AIM To screen children and adolescents with type 1 diabetes mellitus(T1DM)for ...BACKGROUND A diagnosis of a chronic disease has been shown to predispose patients to the development of feeding and eating disorders(FEDs).AIM To screen children and adolescents with type 1 diabetes mellitus(T1DM)for FEDs and compare them to their counterparts with short stature.METHODS A total of 110 children and adolescents(55 with T1DM and 55 with short stature)were enrolled in the study.The SCOFF questionnaire was used to screen for possible FEDs,while anthropometric and dietary data were also collected.RESULTS Approximately 60%of the children with T1DM screened positive for FEDs compared to 30.9%of the children with short stature.Having a T1DM tripled the chances of screening positive for FEDs and halved the annual growth rate of children with T1DM.No differences were noted in the dietary intake between groups.CONCLUSION The results necessitate the education of pediatric endocrinologists and diabetologists on proper screening and identification of children at risk for developing FEDs.A prompt diagnosis might help children catch up growth and attain their genetically predisposed height.展开更多
Recently,significant progress has been made in conceptually describing the dynamic aspects of coarse particle entrainment,which has been explored experimentally for open channel flows.The aim of this study is to exten...Recently,significant progress has been made in conceptually describing the dynamic aspects of coarse particle entrainment,which has been explored experimentally for open channel flows.The aim of this study is to extend the application of energy criterion to the low mobility aeolian transport of solids(including both natural sediment and anthropogenic debris such as plastics),ranging from incomplete(rocking)to full(rolling)entrainments.This is achieved by linking particle movements to energetic flow events,which are defined as flow structures with the ability to work on particles,setting them into motion.It is hypothesized that such events should impart sufficient energy to the particles,above a certain threshold value.The concept’s validity is demonstrated experimentally,using a wind tunnel and laser distance sensor to capture the dynamics of an individual target particle,exposed on a rough bed surface.Measurements are acquired at a high spatiotemporal resolution,and synchronously with the instantaneous air velocity at an appropriate distance upwind of the target particle,using a hot film anemometer.This enables the association of flow events with rocking and rolling entrainments.Furthermore,it is shown that rocking and rolling may have distinct energy thresholds.Estimates of the energy transfer efficiency,normalized by the drag coefficient,range over an order of magnitude(from about 0.001 to 0.0048 for rocking,up to about 0.01,for incipient rolling).The proposed event-based theoretical framework is a novel approach to characterizing the energy imparted from the wind to the soil surface and could have potential implications for modelling intermittent creep transport of coarse particles and related aeolian bedforms.展开更多
We have examined an isotropic and homogeneous cosmological model in f(R,T^(φ))gravity,where R represents the Ricci scalar and T^(φ)exhibits the energy momentum tensor's trace.We examine the stability criteria by...We have examined an isotropic and homogeneous cosmological model in f(R,T^(φ))gravity,where R represents the Ricci scalar and T^(φ)exhibits the energy momentum tensor's trace.We examine the stability criteria by performing the dynamical system analysis for our model f(R,T^(φ))=R+2(a T^(φ)+b),where a and b are the constants.We derive a set of autonomous equations and find their solutions by assuming a flat potential V0.We assess the equilibrium points from these equations and find the eigenvalues.We analyze the physical interpretation of the phase space for this system.We obtain three stable equilibrium points.We also examine the interaction between the scalar field and dark energy,represented by Q=ψH_(ρde)and determine the equilibrium points for this interaction.We identify four stable equilibrium points for this interaction.We calculate the values of the physical parameters for both scenarios at each equilibrium point,indicating the Universe's accelerated expansion.展开更多
This study focused on the production of polypropylene(PP)/silver(Ag)composites via additive manufacturing.This study aimed to enhance the quality of medical-grade PP in material extrusion(MEX)three-dimensional printin...This study focused on the production of polypropylene(PP)/silver(Ag)composites via additive manufacturing.This study aimed to enhance the quality of medical-grade PP in material extrusion(MEX)three-dimensional printing(3DP)by improving its mechanical properties while simultaneously adding antibacterial properties.The latter can find extremely important and versatile properties that are applicable in defense and security domains.PP/Ag nanocomposites were prepared using a novel method based on a reaction occurring while mixing appropriate quantities of the starting polymers and additives,namely polyvinylpyrrolidone(PVP)as the matrix material and silver nitrate(AgNO_(3))as the filler.This process produced three-dimensional(3D)printed filaments,which were then used to create specimens for a series of standardized tests.It was found that the mechanical properties of the nanocomposites were enhanced in relation to pristine PP,especially for the PP matrix with various loadings of AgNO_(3)and PVP,such as 5.0 wt%and 2.5 wt%,respectively.The voids,inclusions,and actual-to-nominal dimensions also showed improved results.The 3DP specimens exhibited a more effective biocidal performance against Staphylococcus aureus than Escherichia coli,which developed an inhibition zone only in the case of PP with filler loading percentages of AgNO_(3)and PVP at 10.0 wt%and 5.0 wt%,respectively Compounds possessing such properties can be beneficial for various applications requiring increased mechanical properties and biocidal capabilities,such as in the Defence or medical industries.展开更多
BACKGROUND Tofacitinib is an oral,selective Janus kinase inhibitor that is approved for the treatment of ulcerative colitis(UC).The 8-week induction protocol involves the administration of 10 mg twice daily(bid)with t...BACKGROUND Tofacitinib is an oral,selective Janus kinase inhibitor that is approved for the treatment of ulcerative colitis(UC).The 8-week induction protocol involves the administration of 10 mg twice daily(bid)with the possibility of extending the induction period to 16 weeks.The maintenance dose of tofacitinib is either 5 mg or 10 mg bid.AIM To assess predictors for clinical remission and drug persistence in patients with UC receiving the extended induction tofacitinib protocol.METHODS This was a real-world multicenter retrospective study in patients with moderateto-severe UC.Patients received physician-directed extended induction tofacitinib treatment.We collected clinical and demographic data at baseline and data regarding clinical,laboratory,and endoscopic evaluations,therapeutic modifications,and adverse events at the 52-week follow-up.Possible predictors for clinical remission at week 52 was the primary endpoint.Differences between patients receiving 5 mg bid vs 10 mg bid at week 52 and identification of predictors for treatment persistence were secondary endpoints.RESULTS Thirty-seven consecutive patients from 11 medical centers were included[51.4%males with median age 39(17-64)years].Twenty-eight patients continued treatment until week 52(75.7%)with 67.9%receiving 10 mg tofacitinib;all had prior history of biologic use.We observed that 57.1%of patients achieved clinical remission(66.7%in the 5 mg tofacitinib group and 52.6%in the 10 mg tofacitinib group,P=0.483).De-escalation to 5 mg tofacitinib was attempted in 17 patients with a success rate of 52.9%.Prior biologic use was significantly more frequent in patients treated with 10 mg tofacitinib.Active smoking was significantly associated with treatment discontinuation at week 52.We identified eight adverse events,and only one led to treatment discontinuation.CONCLUSION Our results supported the extended induction strategy with tofacitinib in selected patients with UC.Patients with prior failure of advanced therapies particularly benefitted,highlighting the importance of personalized maintenance regimens.展开更多
文摘This study compared the acute effects of electrical energy transfer(TECAR) and transcutaneous electrical stimulation(TENS) on pain and flexibility after a hamstring injury. Young athletes received either a 20 min TECAR(n = 24) or TENS(n = 26) session within 5 days following a hamstring injury, while the control(CON, n = 25)group was instructed to rest. Visual analogue scale(VAS), functional Assessment Scale for Acute Hamstring Injuries(FASH), straight leg raise test(SLR), and sit-and-reach scores(STR) were obtained prior to, immediately,24, and 48 h after therapy. Group differences were detected after therapy in VAS and FASH scores(p < 0.05).Compared to pre-therapy measurements, VAS scores showed a greater decrease in the TECAR group(-38.75% to-63.33%) than in the TENS group(-16.67% to-25.00%) and both were greater than in the CON group(-2.81%to-9.81%)(p < 0.05). The TECAR group improved FASH scores(28.57%–48.21%) more than the TENS group(15.89%–27.79%) and both groups more than the CON group(0%–8.33%)(p < 0.05). The increase in SLR and STR was greater in the TECAR group(6.26%–13.96%) than in the TENS(1.72%–9.53%) and CON groups(0%–3.03%). These results suggest that in the acute phase of hamstring injury, the use of TECAR and, to a lesser extent, TENS may relieve pain symptoms and bring some improvements in flexibility more than instructing patients to rest.
基金supported by the Serbian Ministry of Education,Science and Technological Development(Agreements No.451-03-136/2025-03/200122 and 451-03-136/2025-03/200378).
文摘Achillea species are known for their healing properties since ancient times.There is extensive literature on their pharmacological action due to their bioactive compounds.The present study aimed to investigate the antioxidant and antimicrobial effects of hydroalcoholic extracts from the inflorescences and leaves of the species Achillea crithmifolia Waldst.and Kit.,A.grandifolia Friv.and A.millefolium L.The phytochemical profiles of all extracts were evaluated both by NMR spectroscopy and LC-MS analysis,and the results were consistent with the spectrophotometrically determined total phenolic(TP:125.42-191.98 mg/g)and total flavonoid(TF:47.34-180.02 mg/g)contents.All the extracts were tested for their antioxidant activity using DPPH and ABTS•+radical scavenging assay,as well as ferrous ion chelating ability and reducing power tests.All the extracts showed moderate antioxidant activity,compared to the reference substance BHT.Additionally,the antibacterial activity of the extracts was evaluated against major food-borne pathogens,showing moderate antimicrobial effects.
文摘Pancreatic ductal adenocarcinoma(PDAC)is characterized by high aggressiveness,poor prognosis,and unsatisfactory survival rates.The incidence of PDAC is increasing annually,and thus,the number of deaths due to PDAC is increasing worldwide.Modern imaging modalities,including multidetector computed tomography,magnetic resonance imaging-cholangiopancreatography,endoscopic retrograde cholangiopancreatography,positron emission tomography-computed tomography,endoscopic ultrasound and tumor markers,have made significant contributions to the diagnosis of pancreatic cancer.However,early diagnosis remains challenging despite progress in liquid biopsy(tumor DNA,tumor parts or cells),miRNAs,genomic analysis,MTA(metastasis-associated)proteins or circulating cancer-derived exosomes.Early diagnosis and radical surgical excision offer a unique chance of long-term survival in patients with an otherwise poor prognosis.However,surgery alone is insufficient,and multimodal treatment is needed.Novel treatment modalities,i.e.,immunotherapy,vaccines,targeted gene therapy,extracellular vesicles(particularly exosomes),new chemotherapy,novel radiotherapy and angiogenesis-restricting biological agents,were applied with promising outcomes.It seems that the biological mechanisms underlying the disease determine the effectiveness of any therapeutic effort.Thus,further research at the molecular level must focus on novel treatments to prevent the growth,invasion,and spread of cancer cells.
文摘BACKGROUND Kidney and liver transplantation are two sub-specialized medical disciplines,with transplant professionals spending decades in training.While artificial intelligencebased(AI-based)tools could potentially assist in everyday clinical practice,comparative assessment of their effectiveness in clinical decision-making remains limited.AIM To compare the use of ChatGPT and GPT-4 as potential tools in AI-assisted clinical practice in these challenging disciplines.METHODS In total,400 different questions tested ChatGPT’s/GPT-4 knowledge and decision-making capacity in various renal and liver transplantation concepts.Specifically,294 multiple-choice questions were derived from open-access sources,63 questions were derived from published open-access case reports,and 43 from unpublished cases of patients treated at our department.The evaluation covered a plethora of topics,including clinical predictors,treatment options,and diagnostic criteria,among others.RESULTS ChatGPT correctly answered 50.3%of the 294 multiple-choice questions,while GPT-4 demonstrated a higher performance,answering 70.7%of questions(P<0.001).Regarding the 63 questions from published cases,ChatGPT achieved an agreement rate of 50.79%and partial agreement of 17.46%,while GPT-4 demonstrated an agreement rate of 80.95%and partial agreement of 9.52%(P=0.01).Regarding the 43 questions from unpublished cases,ChatGPT demonstrated an agreement rate of 53.49%and partial agreement of 23.26%,while GPT-4 demonstrated an agreement rate of 72.09%and partial agreement of 6.98%(P=0.004).When factoring by the nature of the task for all cases,notably,GPT-4 demonstrated outstanding performance,providing a differential diagnosis that included the final diagnosis in 90%of the cases(P=0.008),and successfully predicting the prognosis of the patient in 100%of related questions(P<0.001).CONCLUSION GPT-4 consistently provided more accurate and reliable clinical recommendations with higher percentages of full agreements both in renal and liver transplantation compared with ChatGPT.Our findings support the potential utility of AI models like ChatGPT and GPT-4 in AI-assisted clinical practice as sources of accurate,individualized medical information and facilitating decision-making.The progression and refinement of such AI-based tools could reshape the future of clinical practice,making their early adoption and adaptation by physicians a necessity.
文摘BACKGROUND Despite the developments in the field of kidney transplantation,the already existing diagnostic techniques for patient monitoring are considered insufficient.Protein biomarkers that can be derived from modern approaches of proteomic analysis of liquid biopsies(serum,urine)represent a promising innovation in the monitoring of kidney transplant recipients.AIM To investigate the diagnostic utility of protein biomarkers derived from proteomics approaches in renal allograft assessment.METHODS A systematic review was conducted in accordance with PRISMA guidelines,based on research results from the PubMed and Scopus databases.The primary focus was on evaluating the role of biomarkers in the non-invasive diagnosis of transplant-related com-plications.Eligibility criteria included protein biomarkers and urine and blood samples,while exclusion criteria were language other than English and the use of low resolution and sensitivity methods.The selected research articles,were categorized based on the biological sample,condition and methodology and the significantly and reproducibly differentiated proteins were manually selected and extracted.Functional and network analysis of the selected proteins was performed.RESULTS In 17 included studies,58 proteins were studied,with the cytokine CXCL10 being the most investigated.Biological pathways related to immune response and fibrosis have shown to be enriched.Applications of biomarkers for the assessment of renal damage as well as the prediction of short-term and long-term function of the graft were reported.Overall,all studies have shown satisfactory diagnostic accuracy of proteins alone or in combination with conventional methods,as far as renal graft assessment is concerned.CONCLUSION Our review suggests that protein biomarkers,evaluated in specific biological fluids,can make a significant contribution to the timely,valid and non-invasive assessment of kidney graft.
文摘Patients with inflammatory bowel disease(IBD)have an increased risk of deve-loping colorectal cancer,which may ultimately result in peritoneal metastases(PM).PM in patients with IBD is by nature difficult to treat due to the chronic inflammation and immunosuppression inherent in IBD.This minireview com-piled existing evidence on management approaches to PM in patients with IBD,including surgical procedures,systemic treatment,and novel therapies.A li-terature review was conducted by searching PubMed and Scopus through June 2025 for studies addressing PM in IBD-associated colorectal or small bowel cancer.Literature specific to PM in IBD is sparse,comprising primarily two small retrospective cohort series comparing outcomes of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy(CRS/HIPEC)in patients with and without IBD.These studies indicated that in high-volume centers with careful preoperative optimization perioperative morbidity and mortality rates for patients with IBD undergoing CRS/HIPEC were similar to those without IBD.However,median overall survival(approximately 19.6-24.0 months)and disease-free survival were consistently shorter and rates of early peritoneal recurrence were higher in patients with IBD.Although CRS/HIPEC can be performed safely in selected patients with IBD and PM,long-term oncologic outcomes appear inferior compared to populations without IBD,likely reflecting later-stage pre-sentation,distinct tumor biology,and IBD-related factors.
文摘BACKGROUND Silver-Russell syndrome(SRS)is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction,relative macrocephaly at birth,distinct facial features,and body asymmetry combined with other malformations.CASE SUMMARY Herein,we describe four individuals with SRS,focusing on their prenatal phenotype,postnatal presentation,diagnosis,and management.All cases had a typical phenotype,including postnatal growth failure,short stature(chronic malnutrition),and protruding forehead.Individually,they presented with feeding difficulties,leg length discrepancy,triangular face,or relative macrocephaly at birth,and each one exhibited distinct SRS features,including motor and/or speech delay,experiencing frequent hypoglycemic episodes.The fact that each patient exhibited a different combination of clinical findings underlines the heterogeneity of the syndrome.CONCLUSION SRS is diagnosed clinically.However,only 60%of cases are genetically confirmed,while most are sporadic.Although SRS is a well-described syndrome,a delayed diagnosis can have grave consequences on a child’s growth.Recombinant human growth hormone treatment is often initiated shortly after the diagnosis.The follow-up requires a multidisciplinary approach.
文摘BACKGROUND Hepatic ischemia-reperfusion injury(HIRI)remains one of the major causes of postoperative liver dysfunction following extensive hepatectomy and liver transplantation.Owing to its progressive and dynamic nature,HIRI may lead to multiple organ failure and a worsened outcome.Treprostinil is a relatively new synthetic prostacyclin analog with a potential beneficial effect against HIRI.Ischemic preconditioning(IP)is a promising method to protect against HIRI.AIM To investigate HIRI biomarkers,their effects on liver and heart,and the effects of treprostinil and IP on these processes.METHODS Forty male Wistar albino rats aged 3-4 months were randomly assigned to four groups of ten,subjected to a 3-hour surgical intervention,and then sacrificed.Hepatic ischemia was induced by clamping the hepatoduodenal ligament for 30 minutes,followed by reperfusion for 120 minutes.Treprostinil(100 ng/kg/minute for 24 hours)or IP before HIRI,no protection,and a sham operation were applied accordingly in each group.Liver and heart histopathology and specific serum and hepatic tissue biomarkers were assessed.RESULTS HIRI deteriorated hepatocellular function and exacerbated liver and myocardial damage in the control group.Furthermore,HIRI triggered cytokine overexpression and protein carbonyl content(P<0.001).Compared with those in the HIRI group,lower troponin I,tumor necrosis factor-α,endothelin-1,and interleukin-1βin serum and liver tissue were significantly correlated with reduced cellular necrosis and improved hepatocellular function in the treprostinil group(P<0.001).Similar but less pronounced effects were observed in the IP group.Both treprostinil and IP had protective effects in hepatic and cardiac tissues.However,treprostinil showed slightly superior cardioprotective efficacy,as evidenced by a statistically significant difference in troponin I levels(P<0.05)and histopathological scoring of myocardium samples,but there were no differences in the other parameters.CONCLUSION HIRI results in oxidative stress and cytokine overexpression,which deteriorate hepatic function and accelerates myocardial damage.Treprostinil and IP are promising strategies for preventing reperfusion-induced cellular and systemic damage.
文摘Inappropriate use of antibiotics leads to microbial resistance.Single-dose antibio-tic prophylaxis prior to laparoscopic cholecystectomy is well known for reducing the risk of postoperative infection in high-risk patients despite some conflicting aspects.High-risk patients are those who are older than 70 years,have diabetes mellitus,whose operation time exceeded 120 minutes,have acute cholecystitis,experienced iatrogenic intraoperative gallbladder perforation resulting in bile or gallstone spillage,suffered from obstructive jaundice,or were deemed immuno-compromised.For gallbladder perforation,one dose of antibiotic prophylaxis is sufficient.Therefore,guidelines are needed and must be strictly followed.Prophy-lactic treatment is not needed for patients at low risk of developing sepsis fo-llowing elective laparoscopic cholecystectomy,although the opposite is suppor-ted.Similarly,superficial surgical infections are related to low morbidity.Patients without risk factors have a very low risk of infection.Thus,the routine use of anti-biotic prophylaxis in elective laparoscopic cholecystectomy is not recommended.
文摘BACKGROUND Autoimmune autonomic ganglionopathy(AAG),formerly known as acute pandysautonomia,is a rare,acquired,antibody-mediated,potentially curable autonomic disorder that presents with diffuse autonomic failure.High levels of anti-ganglionic nicotinic acetylcholine receptor(gAChR)serum antibodies are detected in approximately 50%of AAG cases,confirming the diagnosis.CASE SUMMARY We present the case of a 68-year-old man who developed autonomic failure gradually over a 2-year period.Recently,the patient was unable to stand upright for more than a few seconds before fainting.Additionally,he presented with decreased sweating,dry mouth,urinary retention,early satiety,weight loss,bloating,constipation,and erectile dysfunction.Neurological examination revealed dilated pupils that were unresponsive to light.Deep tendon reflexes were absent or diminished.Serologic evaluation revealed the presence of gAChR autoantibodies.An orthostatic hypotension test yielded a positive result.The patient did not respond to symptomatic therapy,including midodrine,fludrocortisone and atomoxetine.Second-line therapy with immunoadsorption produced a noticeable clinical improvement;however,orthostatic hypotension persisted.Sequential rituximab infusion therapy successfully led to a significant improvement in symptoms.CONCLUSION Our case report supports the benefit of combined immunomodulatory therapy for refractory AAG cases that are unresponsive to single-agent treatment.
文摘Echinococcosis or hydatid disease is induced mainly by Echinococcus granulosus and occasionally by Echinococcus multilocularis(alveolaris)and affects the liver predominantly.Hepatic alveolar echinococcosis is similar to carcinoma in appearance,and without treatment,it can lead to death.Diagnosis is based on current imaging modalities.Surgical management is the cornerstone of treatment.Complete removal of the cyst(total pericystectomy or hepatectomy)ensures a permanent cure and should be the first-choice treatment for cystic disease.Cyst evacuation,partial cystectomy,and drainage or omentoplasty,may be alternative choices in difficult cases.Albendazole,mebendazole and praziquantel are options for treating small cysts and preventing recurrence after surgery.Despite the efforts,alveolar echinococcus is not usually amenable to surgical management,except in the early stage,which is less common,and management by albendazole is indicated.However,there are few recent reports of major operations(ex-vivo hepatectomy,autotransplantation and vascular reconstruction)in advanced stages.
文摘Hepatic ischemia-reperfusion injury is an important mechanism of liver failure that occurs in many clinical conditions,including massive hemorrhage,major hepatectomy and liver transplantation,and leads to poor outcomes.The underlying cellular and molecular reactions are extremely complex and not completely understood.Anaerobic metabolism,ATP depletion,intracellular acidosis,calcium overload,mitochondrial dysfunction,oxidative stress,activation of Kupffer cells and neutrophils,platelet aggregation,nitric oxide production,activation of the complement system and overexpression of cytokines and chemokines constitute the main pathophysiological actions and pathways for possible therapeutic strategies.Prostaglandins(PGs)are a group of biologically active lipid compounds called eicosanoids with many physiological activities.Prostacyclin(PGI_(2))is a member of the PGs family with an unstable chemical structure and a very short half-life.PGI_(2)has potent vasodilating activity,inhibits platelet activation and exerts anti-inflammatory effects.PGI_(2)has been evaluated in chronic liver disease as a mediator of hepatic stellate cell function,an antiproliferative and antifibrotic agent and a regulator of the hepatic microcirculation.In recent decades,the cytoprotective effects of PGI_(2)analogs on hepatic ischemiareperfusion injury have been experimentally and clinically studied.Moreover,the administration of synthetic PGI_(2)analogs to patients who underwent liver transplantation produced very encouraging results.The downregulation of PGE_(2) production,reduction of neutrophil aggregation in liver lobules,regulation of local microcirculatory homeostasis,improvement in mitochondrial function,alleviation of hepatic oxidative stress,suppression of the c-Jun N-terminal kinase and p38 cascades and downregulation of tumor necrosis factor-alpha and interleukin-1βproduction constitute some of the underlying physiological mechanisms of the beneficial effects of PGI_(2)on hepatic ischemia-reperfusion injury.Thus,PGI_(2)analogs appear to hold great promise for the management of hepatic ischemia-reperfusion injury,but further research is needed.
基金thank the staff of the accredited animal facility of the laboratory of anatomy,Histology and Embryology of Aristotle University of Thessaloniki’s veterinary school for their assistance in animal handling and care.
文摘BACKGROUND Massive rotator cuff tears(RCTs)result in impaired shoulder function and quality of life.These tears lead to structural changes in the rotator cuff muscles,which compromise recovery after repair and increase re-tear rates.AIM To investigate the potential inhibitory effects of alpha-tocopherol(vitamin E)and OTR-4131 on muscle atrophy,fatty infiltration,and fibrosis in rotator cuff muscles following a massive RCT using a Wistar rat model,and establish a standardized methodology for evaluating potential therapeutic agents.METHODS This protocol outlines a controlled animal study using 40 male Wistar rats,randomized into five groups.The experimental groups will receive either systemic administration of alpha-tocopherol or local administration of OTR-4131 via intramuscular injection into the supraspinatus and infraspinatus muscles.Two sham groups will receive systemic and local saline injections respectively,while a control group will undergo no intervention.The interventions will be administered after surgical transection of the supraspinatus and infraspinatus tendons.Outcomes will be assessed via wet muscle weight measurements,muscle fiber diameter,fatty infiltration percentage,and fibrosis evaluation using histological methods.RESULTS The study anticipates that alpha-tocopherol and OTR-4131 will reduce muscle atrophy,fatty infiltration,and fibrosis compared to control and sham groups,supporting their potential protective role in rotator cuff muscle degeneration.CONCLUSION The results are expected to improve the understanding on the role of alpha-tocopherol and OTR-4131 in rotator cuff muscle protection after massive RCT and may serve as a foundation for further preclinical and clinical research aimed at improving rotator cuff repair outcomes.
文摘Treprostinil is a relatively new tricyclic prostacyclin analog with a stable str-ucture,extended half-life and improved potency.Currently,treprostinil is indicated by the Food and Drug Administration in the United States for the treatment of pulmonary arterial hypertension(group 1 in the pulmonary hy-pertension classification of the World Health Organization).It has a potent vasodilating effect along with the inhibition of platelet aggregation and the attenuation of the inflammatory response in pulmonary and systemic circulation.It is available in the following formulations:Subcutaneous,intravenous,inhaled and oral.Although unknown to many clinicians,several encouraging reports of off-label treprostinil use in the adult population suggest its potential effectiveness in other clinical conditions.Currently under investigation are digital ischemia secondary to systemic sclerosis,chronic limb ischemia,hepatic ischemia-reper-fusion injury and group 3 and 4 pulmonary hypertension.Based on review and analysis of the available literature,this article provides a thorough update on the off-label use of treprostinil in adult patients.
文摘BACKGROUND Safety and efficacy of intravascular ultrasound(IVUS)guidance in percutaneous coronary intervention(PCI)has been consistently shown in recent trials.However,prospective data on the clinical effects of IVUS usage in primary PCI are still warranted.The ULTRA-STEMI trial is a prospective investigator-initiated observational single-center cohort trial aiming to enroll 80 patients with STEMI.AIM To investigate the outcomes of patients with STEMI undergoing IVUS-guided PCI and correlate derived IVUS measurements with clinical,procedural,imaging and follow-up outcomes of interest.METHODS Study participants will undergo primary PCI as per standardized procedures.IVUS pullbacks will be performed pre-intervention,post-lesion preparation,postintervention and post-optimization using a 20 MHz digital IVUS(Eagle Eye Platinum,Philips).Manual thrombus aspiration will be performed in cases of high thrombus burden.The aspirated thrombi will be scanned with micro-computed tomography to extract volumetric measurements of the aspirated thrombotic burden.Moreover,angiographic,peri-procedural and 3-year follow-up data will be gathered.Co-primary endpoints will be cardiovascular mortality and target vessel failure,defined as the composite of:Cardiovascular mortality,target vessel myocardial infarction and/or clinically driven target vessel revascularization.RESULTS The results of the study are expected by the third quarter of 2029.CONCLUSION The ULTRA-STEMI trial will add to the existing literature the clinical,angiographic,micro-computed tomography and follow-up outcomes of IVUS-guided PCI in 80 patients presenting with STEMI.
文摘BACKGROUND A diagnosis of a chronic disease has been shown to predispose patients to the development of feeding and eating disorders(FEDs).AIM To screen children and adolescents with type 1 diabetes mellitus(T1DM)for FEDs and compare them to their counterparts with short stature.METHODS A total of 110 children and adolescents(55 with T1DM and 55 with short stature)were enrolled in the study.The SCOFF questionnaire was used to screen for possible FEDs,while anthropometric and dietary data were also collected.RESULTS Approximately 60%of the children with T1DM screened positive for FEDs compared to 30.9%of the children with short stature.Having a T1DM tripled the chances of screening positive for FEDs and halved the annual growth rate of children with T1DM.No differences were noted in the dietary intake between groups.CONCLUSION The results necessitate the education of pediatric endocrinologists and diabetologists on proper screening and identification of children at risk for developing FEDs.A prompt diagnosis might help children catch up growth and attain their genetically predisposed height.
基金supported by the National Natural Science Foundation of China (Grants Nos.41171005,41071005,12272344,and 12350710176)the Ministry of Science and Technology of the People’s Republic of China (Grant No.2013CB956000).
文摘Recently,significant progress has been made in conceptually describing the dynamic aspects of coarse particle entrainment,which has been explored experimentally for open channel flows.The aim of this study is to extend the application of energy criterion to the low mobility aeolian transport of solids(including both natural sediment and anthropogenic debris such as plastics),ranging from incomplete(rocking)to full(rolling)entrainments.This is achieved by linking particle movements to energetic flow events,which are defined as flow structures with the ability to work on particles,setting them into motion.It is hypothesized that such events should impart sufficient energy to the particles,above a certain threshold value.The concept’s validity is demonstrated experimentally,using a wind tunnel and laser distance sensor to capture the dynamics of an individual target particle,exposed on a rough bed surface.Measurements are acquired at a high spatiotemporal resolution,and synchronously with the instantaneous air velocity at an appropriate distance upwind of the target particle,using a hot film anemometer.This enables the association of flow events with rocking and rolling entrainments.Furthermore,it is shown that rocking and rolling may have distinct energy thresholds.Estimates of the energy transfer efficiency,normalized by the drag coefficient,range over an order of magnitude(from about 0.001 to 0.0048 for rocking,up to about 0.01,for incipient rolling).The proposed event-based theoretical framework is a novel approach to characterizing the energy imparted from the wind to the soil surface and could have potential implications for modelling intermittent creep transport of coarse particles and related aeolian bedforms.
基金funded by Researchers Supporting Project No.RSPD2025R733,King Saud University,Riyadh,Saudi Arabia。
文摘We have examined an isotropic and homogeneous cosmological model in f(R,T^(φ))gravity,where R represents the Ricci scalar and T^(φ)exhibits the energy momentum tensor's trace.We examine the stability criteria by performing the dynamical system analysis for our model f(R,T^(φ))=R+2(a T^(φ)+b),where a and b are the constants.We derive a set of autonomous equations and find their solutions by assuming a flat potential V0.We assess the equilibrium points from these equations and find the eigenvalues.We analyze the physical interpretation of the phase space for this system.We obtain three stable equilibrium points.We also examine the interaction between the scalar field and dark energy,represented by Q=ψH_(ρde)and determine the equilibrium points for this interaction.We identify four stable equilibrium points for this interaction.We calculate the values of the physical parameters for both scenarios at each equilibrium point,indicating the Universe's accelerated expansion.
文摘This study focused on the production of polypropylene(PP)/silver(Ag)composites via additive manufacturing.This study aimed to enhance the quality of medical-grade PP in material extrusion(MEX)three-dimensional printing(3DP)by improving its mechanical properties while simultaneously adding antibacterial properties.The latter can find extremely important and versatile properties that are applicable in defense and security domains.PP/Ag nanocomposites were prepared using a novel method based on a reaction occurring while mixing appropriate quantities of the starting polymers and additives,namely polyvinylpyrrolidone(PVP)as the matrix material and silver nitrate(AgNO_(3))as the filler.This process produced three-dimensional(3D)printed filaments,which were then used to create specimens for a series of standardized tests.It was found that the mechanical properties of the nanocomposites were enhanced in relation to pristine PP,especially for the PP matrix with various loadings of AgNO_(3)and PVP,such as 5.0 wt%and 2.5 wt%,respectively.The voids,inclusions,and actual-to-nominal dimensions also showed improved results.The 3DP specimens exhibited a more effective biocidal performance against Staphylococcus aureus than Escherichia coli,which developed an inhibition zone only in the case of PP with filler loading percentages of AgNO_(3)and PVP at 10.0 wt%and 5.0 wt%,respectively Compounds possessing such properties can be beneficial for various applications requiring increased mechanical properties and biocidal capabilities,such as in the Defence or medical industries.
文摘BACKGROUND Tofacitinib is an oral,selective Janus kinase inhibitor that is approved for the treatment of ulcerative colitis(UC).The 8-week induction protocol involves the administration of 10 mg twice daily(bid)with the possibility of extending the induction period to 16 weeks.The maintenance dose of tofacitinib is either 5 mg or 10 mg bid.AIM To assess predictors for clinical remission and drug persistence in patients with UC receiving the extended induction tofacitinib protocol.METHODS This was a real-world multicenter retrospective study in patients with moderateto-severe UC.Patients received physician-directed extended induction tofacitinib treatment.We collected clinical and demographic data at baseline and data regarding clinical,laboratory,and endoscopic evaluations,therapeutic modifications,and adverse events at the 52-week follow-up.Possible predictors for clinical remission at week 52 was the primary endpoint.Differences between patients receiving 5 mg bid vs 10 mg bid at week 52 and identification of predictors for treatment persistence were secondary endpoints.RESULTS Thirty-seven consecutive patients from 11 medical centers were included[51.4%males with median age 39(17-64)years].Twenty-eight patients continued treatment until week 52(75.7%)with 67.9%receiving 10 mg tofacitinib;all had prior history of biologic use.We observed that 57.1%of patients achieved clinical remission(66.7%in the 5 mg tofacitinib group and 52.6%in the 10 mg tofacitinib group,P=0.483).De-escalation to 5 mg tofacitinib was attempted in 17 patients with a success rate of 52.9%.Prior biologic use was significantly more frequent in patients treated with 10 mg tofacitinib.Active smoking was significantly associated with treatment discontinuation at week 52.We identified eight adverse events,and only one led to treatment discontinuation.CONCLUSION Our results supported the extended induction strategy with tofacitinib in selected patients with UC.Patients with prior failure of advanced therapies particularly benefitted,highlighting the importance of personalized maintenance regimens.
