The COVID-19 pandemic has caused very serious problems almost to the whole world, so every opportunity must be considered to improve the situation. One such improvement strategy is decontamination ...carried out from the air. This technique can be considered for surface clearance of larger areas; hence, there is the need to investigate its effectiveness regarding the pandemic. There are many examples of the use of drones for disinfection to improve epidemic situations, but good practices, as well as factors influencing effectiveness, have not yet been identified. In the case of using drones for disinfection during a pandemic, the adapted use of agricultural drones is clear from reports. In this paper, the authors performed calculations with different values of flight speed (10 to 50 km/h), flight altitude (1 to 5 m), and flow rate (1 to 5 L/min) to determine the possible amount of disinfectant fluid per unit area. The results show that by changing the parameters, the amount of disinfectant per unit area can be given within quite wide limits (30–0.24 g/m2). Although the results raise many new questions, they can help to identify adequate flight parameters depending on different disinfectant liquids.
Act.In.Sarc (NCT02379845) demonstrated that the first-in-class radioenhancer NBTXR3, activated by preoperative radiation therapy (RT), doubled the rate of pathologic complete response after resection ...compared with preoperative RT alone in adult patients with locally advanced soft tissue sarcoma of the extremity or trunk wall (16.1% vs 7.9%, P = .045), and more patients achieved R0 resections (77.0% vs 64.0%, P = .042). These are the toxicity and health-related quality of life (HRQoL) results.
Act.In.Sarc randomized eligible patients 1:1 to either NBTXR3 (single intratumoral injection, volume equivalent to 10% of baseline tumor volume, at 53.3 g/L) activated by external-beam RT (arm A) or external-beam RT alone (arm B) (50 Gy in 25 fractions), followed by surgery in both arms. Here, we report the safety analyses in the all-treated population with a long-term follow-up of at least 2 years, and HRQoL in the intention-to-treat full analysis set.
During the on-treatment period, serious adverse events (SAEs) of all grades related to NBTXR3 occurred in 10.1% (9/89) of patients (arm A), and SAEs related to RT occurred in 5.6% (5/89) (arm A) versus 5.6% (5/90) (arm B); postsurgery hospitalization owing to SAEs occurred in 15.7% (14/89) (arm A) versus 24.4% (22/90) (arm B). During the follow-up period, posttreatment SAEs (regardless of relationship) occurred in 13.5% (12/89) (arm A) versus 24.4% (22/90) (arm B). NBTXR3 did not negatively affect HRQoL; during the follow-up period, there was an improvement in most mean Toronto extremity salvage, EuroQoL 5-dimension (EQ-5D), EQ5D02-EQ visual analog scale, reintegration to normal living index, and musculoskeletal tumor rating scale scores.
NBTXR3 did not negatively affect safety or HRQoL. Long-term safety results reinforce the favorable benefit–risk ratio of NBTXR3 plus RT.
The authors report the case of a six-year-old child with MRI abnormalities symptomatic of ischiopubic synchondrosis. The concept of "osteochondrose ischiopubic" of Van neck-Odelberg is revised in the ...light of modern imaging, and the importance of its differentiation from different pathological entities such as osteomyelitis, tumor, fracture or other pathological entities is recalled.
It is still not clear how chronotype influences caffeine consumption (CC) and caffeine use disorder (CUD). The aim of the study was to investigate the relationship between chronotype, CC, CUD, and ...wellbeing. Participants of an online survey in Hungary (N = 2259) answered the CUD Questionnaire, Morningness-Eveningness Questionnaire and the WHO-5 Well-Being Index. Morningness positively associated with tea consumption, and negatively with cola and energy drink consumption. Severe CUD was more common among evening-type participants. Two significant mediations were found in the path model: Morningness→Tea consumption→Wellbeing and Eveningness→Energy drink consumption→CUD. It is concluded that CUD like other substance use disorders is associated with eveningness. The results indicate that the carrier beverages of the chemical compound of caffeine should be examined separately. Energy drink use can be accompanied by more unfavorable consequences, especially for evening-types, while tea consumption, which was associated with morningness, had more favorable consequences, like higher wellbeing.
(1) Background: Considering the increasing workload of pathologists, computer-assisted methods have the potential to come to their aid. Considering the prognostic role of myocardial fibrosis, its ...precise quantification is essential. Currently, the evaluation is performed semi-quantitatively by the pathologist, a method exposed to the issues of subjectivity. The present research proposes validating a semi-automatic algorithm that aims to quantify myocardial fibrosis on microscopic images. (2) Methods: Forty digital images were selected from the slide collection of The Iowa Virtual Slidebox, from which the collagen volume fraction (CVF) was calculated using two semi-automatic methods: CIELAB-MATLAB® and CIELAB-Python. These involve the use of color difference analysis, using Delta E, in a rectangular region for CIELAB-Python and a region with a random geometric shape, determined by the user’s cursor movement, for CIELAB-MATLAB®. The comparison was made between the stereological evaluation and ImageJ. (3) Results: A total of 36 images were included in the study (n = 36), demonstrating a high, statistically significant correlation between stereology and ImageJ on the one hand, and the proposed methods on the other (p < 0.001). The mean CVF determined by the two methods shows a mean bias of 1.5% compared with stereology and 0.9% compared with ImageJ. Conclusions: The combined algorithm has a superior performance compared to the proposed methods, considered individually. Despite the relatively small mean bias, the limits of agreement are quite wide, reflecting the variability of the images included in the study.
Molecular weight regulated release profile and polyester enhanced aqueous stability of poorly water-soluble Nimodipine drug.
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•Biocompatible and biodegradable polyester was synthesized ...by direct polycondensation.•Nanoprecipitation encapsulation of Nimodipine within poly (ethylene succinate) PES.•The encapsulated form showed a decrease of crystallinity and particle size of the drug.•Encapsulation within the polyester improved the drug's water solubility and stability.•Adjusting the drug-releasing via the variation of the molecular weight of the polyester.
In the present study, we demonstrate that well-known molecular weight-dependent solubility properties of a polymer can also be used in the field of controlled drug delivery. To prove this, poly(ethylene succinate) (PES) polyesters with polycondensation time regulated molecular weights were synthesized via catalyst-free direct polymerization in an equimolar ratio of ethylene glycol and succinic acid monomers at 185 °C. DSC and contact angle measurements revealed that increasing the molecular weight (Mw, 4.3–5.05 kDa) through the polymerization time (40–80 min) increased the thermal stability (Tm= ∼61–80 °C) and slightly the hydrophobicity (Θw= ∼27–41°) of the obtained aliphatic polyester. Next, this biodegradable polymer was used for the encapsulation of Ca2+ channel blocker Nimodipine (NIMO) to overcome the poor water solubility and enhance the bioavailability of the drug. The drug/ polymer compatibility was proved by the means of solubility (δ) and Flory-Huggins interaction (miscibility) parameters (χ). The nanoprecipitation encapsulation of NIMO into PES with increasing Mw resulted in the formation of spherical 270 ± 103 nm NIMO-loaded PES nanoparticles (NPs). Furthermore, based on the XRD measurements, the encapsulated form of NIMO-loaded PES NPs showed lower drug crystallinity, which enhanced not only the water solubility but even the water stability of the NIMO in an aqueous medium. The in-vitro drug release experiments demonstrated that the release of NIMO drug could be accelerated or even prolonged by the molecular weights of PES as well. Due to the low crystallinity of PES polyester and low particle size of the encapsulated NIMO drug led to enhance solubility and releasing process of NIMO from PES with lower Mw (4.3 kDa and 4.5 kDa) compared to pure crystalline NIMO. However, further increasing the molecular weight (5.05 kDa) was already reduced the amount of drug release that provides the prolonged therapeutic effect and enhances the bioavailability of the NIMO drug.
Abstract
Background
An enlarged left atrial volume index (LAVI) at rest mirrors increased LA pressure and/or impairment of LA function. A cardiovascular stress may acutely modify LAVI within minutes.
...Purpose
To assess the feasibility and functional correlates of LAVI-stress echocardiography (SE)
Methods
Out of 514 subjects referred to 10 quality-controlled labs, LAVI-SE was completed in 490 (359 male, age 67±12 yrs, ejection fraction 60±10%) with suspected or known chronic coronary syndromes (n=462) or asymptomatic controls (n=28). The utilized stress was exercise in 177, vasodilator in 167, dobutamine in 146. LAVI was measured with the biplane disk summation method. SE was performed with the ABCDE protocol. In a single center sub-study in 50 subjects, including 28 controls and 22 patients, also peak longitudinal atrial strain (PALS, %) was measured as an index of LA reservoir function.
Results
The intra-observer and inter-observer LAVI variability were 5% and 8%, respectively. Δ-LAVI changes (stress-rest) were negatively correlated with resting LAVI (r=−0.271, p<0.001), heart rate reserve (r=−0.239, p<0.001), and Δ-PALS (n=50, r=−0.374, p=0.007).LAVI-dilators were defined as those with stress-rest increase ≥6.8 ml/m2, a cutoff derived from a calculated reference change value above the biological, analytical and observer variability of LAVI. LAVI dilation (see figure) occurred in 56 patients (11%). At multivariable logistic regression analysis, B-lines ≥2 (OR: 2.586, 95% CI =1.1293–5.169, p=0.007) and abnormal left ventricular contractile reserve (OR: 2.207, 95% CI=1.111–4.386, p=0.024) were associated with LAVI dilation.
Conclusion
LAVI-SE is feasible, with high success rate and low variability, in patients with chronic coronary syndromes. A wet (increased B-lines) and weak (reduced LV contractile reserve and LA reservoir function) heart frequently portends LAVI dilation during stress.
Figure 1
Funding Acknowledgement
Type of funding source: None
Abstract
Background
A reduction in coronary flow velocity reserve (CFVR) related to coronary microvascular dysfunction is a major mechanism for ischemia in hypertrophic cardiomyopathy (HCM).
...Hypothesis
To assess the functional correlates and prognostic value of CFVR during stress echocardiography (SE) in HCM.
Methods
We enrolled 201 HCM patients (age 51±14 years, 105 male, 52%; maximal wall thickness: 18±3 mm) studied with CFVR during exercise (n=33, 16.4%), dipyridamole (n=89, 44.3%) or adenosine (n=79, 39.3%) SE in 6 certified centers. CFVR was assessed using pulsed wave Doppler sampling in left anterior descending coronary artery. All patients completed the clinical follow-up.
Results
During SE mean value of CFVR was 2.11±0.46. No patients showed regional wall motion abnormalities during stress. LV outflow tract obstruction (LVOTO) was present in 34 (16.9%) patients at rest and in 47 (23.4%) at peak stress. CFVR was inversely related to age (r=−0.229, p=0.001) and maximal wall thickness (r=−0.197, p=0.031). During a median follow-up of 26 months (IQ range: 12–48 months), 75 events in 63 patients occurred: 10 deaths, 33 new hospital admission for acute heart failure, 8 sustained ventricular tachycardias and 24 atrial fibrillations. Patients in the lowest tertile (≤1.88) showed the worse prognosis with higher incidence of follow-up events compared to median tertile (1.89–2.29) and highest tertile (≥2.30) (see figure). At multivariable analysis, NYHA functional class (HR: 2.234, 95% CI: 1.398–3.517, p=0.001), presence of LVOTO at rest (HR: 2.958, 95% CI: 1.074–3.570, p=0.028) and lowest tertile of CFVR (HR: 2.144, 95% CI: 1.126–4.081, p=0.011) were the independent predictors of follow-up events.
Conclusions
In HCM patients, reduction in CFVR is associated to a clearly worse outcome. The spectrum of prognostic stratification is expanded if the response is titrated according to a continuous scale.
Figure 1
Funding Acknowledgement
Type of funding source: None
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