Atrial fibrillation (AF) is uncommon in the youngest population. Epicardial adipose tissue (EAT) volume has been proposed as an independent AF risk factor.
The aim of this retrospective study was to ...evaluate the impact of the EAT, the anatomy of the pulmonary veins (PVs), and electrocardiogram (ECG) features in these young patients with AF.
Sixty-two patients divided in 2 groups, one with history of paroxysmal AF treated with ablation and the other a control group, all younger than 30 years of age, were included. Computed tomography scans were performed in both groups to estimate the PV anatomy and EAT volume. Twelve-lead ECGs were performed in all patients. Patients underwent follow-up in our outpatient clinic (35.9 ± 18.3 months).
In the AF group, the EAT volume around the left atrium was 22.25 ± 9.3 cm3 compared with 12.61 ± 3.37 cm3, showing a statistically significance difference (P = .003). Family history resulted to be another significant risk factor (P = .009). During follow-up, 67.7% of the patients treated were still free of events. The anatomy and morphology of the right-sided PVs seemed to play a more consistent role in the patients with AF recurrences (P = .04). The P/PR ratio, a new ECG index, seemed predict AF recurrences after ablation (P = .03).
The abundance of EAT seems related to the risk of developing AF in young patients. The recurrence of AF is about 33% and does not seem related to the EAT volume, but rather to the anatomy of the PVs. A higher P/PR ratio might suggest recurrences.
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Flow–duration curves (FDCs) provide a compact view of the historical variability of river flows, reflecting climate conditions and the main hydrologic features of river basins. The Surface Water and ...Ocean Topography (SWOT) satellite mission will enable the estimation of river flows globally, by sensing rivers wider than 100 m with a sampling recurrence from 3 to 21 days. This study investigated the lifetime mission potential for FDC estimation through the comparison between remotely-sensed and empirical FDCs. We employed the Global Runoff Data Center dataset and derived SWOT-like river flows by selecting gauging stations of rivers wider than 100 m with more than 10-year long daily river flow time series. Overall, 1200 gauged river cross-sections were examined. For each site, we created a set of 24 SWOT-simulated FDCs (i.e., based on different sampling recurrences, mean biases, and random errors) to be compared against their empirical counterparts through the Nash–Sutcliffe efficiency and the mean relative error. Our results show that climate and the sampling recurrence play a key role on the performance of SWOT-based FDCs. Tropical and temperate climates performed the best, whereas arid climates mostly revealed higher uncertainties, especially for high- and low-flows.
For decades, regenerative medicine and dentistry have been improved with new therapies and innovative clinical protocols. The aim of the present investigation was to evaluate through a critical ...review the recent innovations in the field of bone regeneration with a focus on the healing potentials and clinical protocols of bone substitutes combined with engineered constructs, growth factors and photobiomodulation applications.
A Boolean systematic search was conducted by PubMed/Medline, PubMed/Central, Web of Science and Google scholar databases according to the PRISMA guidelines.
After the initial screening, a total of 304 papers were considered eligible for the qualitative synthesis. The articles included were categorized according to the main topics: alloplastic bone substitutes, autologous teeth derived substitutes, xenografts, platelet-derived concentrates, laser therapy, microbiota and bone metabolism and mesenchymal cells construct.
The effectiveness of the present investigation showed that the use of biocompatible and bio-resorbable bone substitutes are related to the high-predictability of the bone regeneration protocols, while the oral microbiota and systemic health of the patient produce a clinical advantage for the long-term success of the regeneration procedures and implant-supported restorations. The use of growth factors is able to reduce the co-morbidity of the regenerative procedure ameliorating the post-operative healing phase. The LLLT is an adjuvant protocol to improve the soft and hard tissues response for bone regeneration treatment protocols.
The article describes the orthodontically treated case of a 25-year-old patient with skeletal and dental class III malocclusion, anterior crossbite, which caused functional and aesthetic problems, ...occlusal trauma, and incisor wear. Treatment with transparent aligners was proposed to meet the patient's needs, using the sequential distalization protocol. While sequential distalization is well documented for class II malocclusion treatment in maxillary arch teeth, further investigations are necessary for class III malocclusions. In fact, lower teeth movements are more complex due to mandibular bone density and the presence of the third molars, which are often extracted to perform distalization. In addition, the use of intermaxillary elastics helps control the proclination of the anterior teeth as a reaction to distalizing forces. At the end of the treatment, the patient reached molar and canine class I and positive overjet and overbite. The inclination of lower incisors and the interincisal angle have improved, resulting in aesthetic and functional enhancement.
The research for alternative administration methods for anticancer drugs, towards enhanced effectiveness and selectivity, represents a major challenge for the scientific community. In the last ...decade, polymeric nanostructured delivery systems represented a promising alternative to conventional drug administration since they ensure secure transport to the selected target, providing active compounds protection against elimination, while minimizing drug toxicity to non-target cells. In the present research, poly(glycerol sebacate), a biocompatible polymer, was synthesized and then nanostructured to allow curcumin encapsulation, a naturally occurring polyphenolic phytochemical isolated from the powdered rhizome of Curcuma longa L. Curcumin was selected as an anticancer agent in virtue of its strong chemotherapeutic activity against different cancer types combined with good cytocompatibility within healthy cells. Despite its strong and fascinating biological activity, its possible exploitation as a novel chemotherapeutic has been hampered by its low water solubility, which results in poor absorption and low bioavailability upon oral administration. Hence, its encapsulation within nanoparticles may overcome such issues. Nanoparticles obtained through nanoprecipitation, an easy and scalable technique, were characterized in terms of size and stability over time using dynamic light scattering and transmission electron microscopy, confirming their nanosized dimensions and spherical shape. Finally, biological investigation demonstrated an enhanced cytotoxic effect of curcumin-loaded PGS-NPs on human cervical cancer cells compared to free curcumin.
Many different osteotomy procedures has been proposed in the literature for dental implant site preparation. The osseodensification is a drilling technique that has been proposed to improve the local ...bone quality and implant stability in poor density alveolar ridges. This technique determines an expansion of the implant site by increasing the density of the adjacent bone. The aim of the present investigation was to evaluate the effectiveness of the osseodensification technique for implant site preparation through a literature review and meta-analysis. The database electronic research was performed on PubMed (Medline) database for the screening of the scientific papers. A total of 16 articles have been identified suitable for the review and qualitative analysis-11 clinical studies (eight on animals, three on human subjects), four literature reviews, and one case report. The meta-analysis was performed to compare the bone-to-implant contact % (BIC), bone area fraction occupied % (BAFO), and insertion torque of clockwise and counter-clockwise osseodensification procedure in animal studies. The included articles reported a significant increase in the insertion torque of the implants positioned through the osseodensification protocol compared to the conventional drilling technique. Advantages of this new technique are important above all when the patient has a strong missing and/or low quantity of bone tissue. The data collected until the drafting of this paper detect an improvement when the osseodensification has been adopted if compared to the conventional technique. A significant difference in BIC and insertion torque between the clockwise and counter-clockwise osseodensification procedure was reported, with no difference in BAFO measurements between the two approaches. The effectiveness of the present study demonstrated that the osseodensification drilling protocol is a useful technique to obtain increased implant insertion torque and bone to implant contact (BIC) in vivo. Further randomized clinical studies are required to confirm these pieces of evidence in human studies.
The criteria for selecting insulating materials in the energy retrofitting of industrial buildings can often be conflicting, leading to a multicriteria decision-making problem. This is the first ...study to take an indirect elicitation approach to solving this selection problem, which is particularly applicable in the preliminary phases of negotiation with all of the decision-makers involved. We introduce a nonlinear indirect elicitation approach for PROMETHEE II that uses Bézier curves as nonlinear preference curves to fit the decision-maker's preferences, i.e., indifference and/or strict preferences for insulating materials that are taken as references. In our approach, no parameters need to be initially set, and thus, it has the advantage of setting both the preference curves on the criteria and the criteria weights when the decision-maker is not confident. The set of Bézier curves and criteria weights that best fits the preferences given by the decision-maker may thus be achieved and visualized, which provides managerial insights as it makes explicit the preference structure of the decision-maker. We use a case study to validate our proposal in a real setting and confirm that linear preference curves would have achieved less clear relations between the insulating materials used as references respect to Bèzier curves.
The KEYNOTE-048 trial showed that pembrolizumab-based first-line treatment for R/M HNSCC led to improved OS in the PD-L1 CPS ≥ 1 population when compared to the EXTREME regimen. However, the R/M ...HNSCC real-world population is generally frailer, often presenting with multiple comorbidities, worse performance status and older age than the population included in phase III clinical trials.
This is a retrospective, single-centre analysis of patients with R/M HNSCC treated with pembrolizumab-based first-line treatment.
From February 2021 to March 2023, 92 patients were treated with pembrolizumab-based first-line treatment. Patients treated with pembrolizumab-based chemoimmunotherapy had better ECOG PS and younger age than those treated with pembrolizumab monotherapy. Median PFS and OS were 4 months and 8 months, respectively. PFS was similar among patients treated with pembrolizumab-based chemoimmunotherapy and pembrolizumab monotherapy, while patients treated with pembrolizumab monotherapy had worse OS (log-rank p =.001, HR 2.7). PFS and OS were improved in patients with PD-L1 CPS > = 20 (PFS: log-rank p =.005, HR 0.50; OS: log-rank p =.04, HR 0.57). Patients with higher ECOG PS scores had worse PFS and OS (PFS, log-rank p =.004; OS, log-rank p = 6e-04). In multivariable analysis, ECOG PS2 was associated with worse PFS and OS.
PFS in our real-world cohort was similar to the KEYNOTE-048 reference while OS was numerically inferior. A deeper understanding of clinical variables that might affect survival outcomes of patients with R/M HNSCC beyond ECOG PS and PD-L1 CPS is urgently needed.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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