Category: Nevin Manimala

Wei Sheng Yan Jiu. 2023 Mar;52(2):188-192. doi: 10.19813/j.cnki.weishengyanjiu.2023.02.003.

ABSTRACT

OBJECTIVE: To explore the relationship between red meat intake and the prevalence of diabetes.

METHODS: Using the data of the China Health and Nutrition Survey in 1997, 2000, 2004, 2006, 2009, 2011, 2015 and 2018, 1154 people aged 18-75 years were included, and age, gender, urban and rural, education, marital status, income, occupational physical activity, total energy intake, fat energy ratio, smoking, drinking, body mass index and hypertension were adjusted. The Cox proportional hazard regression analysis was used to calculate diabetes hazard ratio(HR) and corresponding 95%CI.

RESULTS: In the study population, the per capita intake of red meat increased from 40.59 g/d in 1997 to 73.91 g/d in 2018, and the prevalence of diabetes rose from 6.14% in 2009 to 7.00% in 2018. In the early adjustment model, compared with the control group, the red meat intake HR of 1-39 g/d group was 0.92(95% CI 0.51-1.68), and the HR of 40-74 g/d group was 0.86(95% CI 0.47-1.58), and the HR of the group ≥75 g/d was 1.02(95% CI 0.62-1.68). In model 2, compared with the control group, the red meat intake HR of 1-39 g/d group was 0.71(95% CI 0.37-1.35), and the HR of 40-74 g/d group was 0.71(95% CI 0.38-1.35), the HR of ≥75 g/d group was 1.06(95% CI 0.69-1.87). In the fully adjusted model, compared with the control group, the red meat intake HR of 1-39 g/d group was 0.75(95% CI 0.61-1.55), the HR of 40-74 g/d group was 0.66(95% CI 0.57-1.43), and the HR of ≥75 g/d group was 1.27(95% CI 0.87-2.04).

CONCLUSION: With the increase of red meat intake, the prevalence of diabetes was also increasing, but there was no statistically significant association.

PMID:37062680 | DOI:10.19813/j.cnki.weishengyanjiu.2023.02.003

Wei Sheng Yan Jiu. 2023 Mar;52(2):173-178. doi: 10.19813/j.cnki.weishengyanjiu.2023.02.001.

ABSTRACT

OBJECTIVE: To investigate the dietary consumption of branched-chain amino acids(BCAAs)intake status of middle-aged and elderly people 50 years and older in China, and to analyze the distribution differences between different ages, genders and regions.

METHODS: The research sample was derived from the 2015 Chinese adult chronic disease and nutrition monitoring data. The survey adopts the stratified multi-stage cluster random sampling method, and selects 298 monitoring points from 31 provinces(autonomous regions and municipalities), a total of 44 218 people aged 50 years and over were sampled. Condiment weighing method, 24-hour dietary review method, and weighing method were used to obtain individual dietary data, and the dietary BCAAs intake of middle-aged and elderly people was calculated based on the Chinese Food Composition Table.

RESULTS: In 2015, the dietary BCAAs of middle-aged and elderly people in China accounted for 45.1% of leucine, 29.8% of valine and 25.1% of isoleucine. The top six dietary sources were cereals, red meat, vegetables, fish and seafood, beans and eggs. There were differences in the intake of three branched-chain amino acids(F=1926.67, P<0.01), the intake of leucine was greater than that of valine, and the intake of valine was greater than isoleucine. There were statistically significant differences in dietary BCAAs intake between different age groups, genders, urban and rural areas and regions(P<0.01), among which men were greater than women(t=12.89, P<0.01), and the south was greater than the north(t=-6.36, P<0.01), the eastern part was larger than the central part, and the central part was larger than the western part(F=82.42, P<0.01). The intake of BCAAs decreased with the increase of age groups(F=22.69, P<0.01), and there was no significant difference in age groups over 70 years old. The dietary intake of BCAAs was higher in the eastern coastal areas and Inner Mongolia, Xinjiang and Tibet.

CONCLUSION: There were gender, age and geographical differences in dietary BCAAs intake among middle-aged and elderly people in China, and the contribution of various foods to dietary BCAAs was also different.

PMID:37062678 | DOI:10.19813/j.cnki.weishengyanjiu.2023.02.001

J Cardiothorac Vasc Anesth. 2023 Mar 17:S1053-0770(23)00181-7. doi: 10.1053/j.jvca.2023.03.012. Online ahead of print.

ABSTRACT

OBJECTIVE: Despite inherent comorbidities, obese cardiac surgical patients paradoxically had shown lower morbidity and mortality, although the nature of this association is still unclear. Thus, the authors intended in this large registry-based study to investigate the impact of obesity on short- and long-term postoperative outcomes, focusing on bleeding and transfusion requirements.

DESIGN: Retrospective registry study.

SETTING: Three university hospitals.

PARTICIPANTS: A cohort of 12,330 prospectively compiled data from coronary bypass grafting patients undergoing surgery between 2007 to 2020 were retrieved from the Western Denmark Heart Registry.

INTERVENTIONS: The parameters were analyzed to assess the association between body mass index (BMI) and the selected outcome parameters.

MEASUREMENTS AND MAIN RESULTS: The crude data showed a clear statistically significant association in postoperative drainage from 637 (418-1108) mL in underweight patients with BMI <18.5 kg/m² to 427 (295-620) mL in severely obese patients with BMI ≥40 kg/m² (p < 0.0001, Kruskal-Wallis). Further, 50.0% of patients with BMI <18.5 received an average of 451 mL/m² in red blood cell transfusions, compared to 16.7% of patients with BMI >40 receiving 84 mL/m². The obese groups were less often submitted to reexploration due to bleeding, and fewer received perioperative hemostatics, inotropes, and vasoconstrictors. The crude data showed increasing 30-day and 6-month mortality with lower BMI, whereas the one-year mortality showed a V-shaped pattern, but BMI had no independent impact on mortality in logistic regression analysis.

CONCLUSION: Patients with high BMI may carry protection against postoperative bleeding after cardiac surgery, probably secondary to an inherent hypercoagulable state, whereas underweight patients carry a higher risk of bleeding and worse outcomes.

PMID:37062665 | DOI:10.1053/j.jvca.2023.03.012

Acad Radiol. 2023 Apr 14:S1076-6332(23)00129-0. doi: 10.1016/j.acra.2023.03.018. Online ahead of print.

ABSTRACT

OBJECTIVES: The objective of this prospective study was to evaluate the virtual monoenergetic images (VMI) and virtual noncontrast (VNC) phase in the detection of endoleaks after endovascular abdominal aortic repair (EVAR). The potential dose reduction of abbreviated examination protocols was calculated.

MATERIALS AND METHODS: Ninety-seven patients after the EVAR procedure were enrolled in this study. An initial single-source noncontrast acquisition was followed by two dual-energy acquisitions (arterial and 60 s delayed). Fast-kVp switching scanner was used. VNC images were reconstructed from the delayed phase. First examination session (reference) included a full triphasic study protocol consisting of true noncontrast (TNC) images and two postcontrast phases, the latter ones presented as classical polyenergetic reconstructions. Reading sessions II and III were performed by two independent and blinded readers evaluating VMIs in abbreviated protocols-biphasic (VNC + arterial, delayed phase), monophasic (VNC + delayed phase). The diagnostic accuracy of sessions II and III was calculated.

RESULTS: The calculated sensitivity of the biphasic protocol with the use of VMIs in endoleak detection was 100%, with a statistically significant increase in the number of endoleaks detected in comparison with the reference study. The monophasic protocol showed 83.33% sensitivity. The use of abbreviated examination protocols led to a decrease in the mean effective dose (ED) of 23.28% (biphasic protocol) and 61.37% (monophasic protocol).

CONCLUSION: The use of VMIs increases the number of endoleaks diagnosed with a possible radiation reduction by up to ¼ (biphasic protocol). Further reduction to a monophasic protocol leads to over 60% dose reduction but with a decrease in diagnostic accuracy.

PMID:37062628 | DOI:10.1016/j.acra.2023.03.018

Eur J Cancer. 2023 Mar 17:S0959-8049(23)00144-2. doi: 10.1016/j.ejca.2023.03.010. Online ahead of print.

ABSTRACT

BACKGROUND: An increasing number of clinical trials are being conducted exploring the efficacy of neoadjuvant immune checkpoint inhibitors. Surrogate end-points for overall survival (OS) are urgently needed.

METHODS: Phase II or III trials of neoadjuvant immunotherapy that reported data on OS and surrogate end-points were identified from January 1, 2000, to November 25, 2022. Individual patient data, and trial-level data were requested from corresponding authors or extracted from eligible trials. At the individual level, correlations between radiological and pathological response and OS were measured by the Cox model and quantified by hazard ratio (HR). C-statistic was used to quantify the predictive performance of radiological and pathological response for OS. The coefficient of determination (R²) between RFS and OS was evaluated by a bivariate survival model.

RESULTS: A total of 29 trials reporting 2901 patients were included. ORR correlated with improved OS (3-year OS: 87.0% versus 70.4% for ORR versus non-ORR, respectively; HR, 0.34, 95% confidence interval [CI], 0.17-0.68). The HRs for OS in patients achieving MPR and pCR were 0.24 (95% CI, 0.12-0.46) and 0.13 (95% CI, 0.05-0.36). The survival benefit maintained after adjusting tumour type. C-statistics of ORR, MPR and pCR were 0.63, 0.63 and 0.65, respectively. The strength of association between RFS and OS was strong (R² = 0.88, 95% CI, 0.79-0.94).

CONCLUSIONS: These findings suggest that ORR, MPR, pCR and RFS are valid predictors for OS when using neoadjuvant immune checkpoint inhibitors. Moreover, MPR, pCR and RFS may be the most optimal surrogates for OS.

PMID:37062625 | DOI:10.1016/j.ejca.2023.03.010

Phys Med. 2023 Apr 14;109:102586. doi: 10.1016/j.ejmp.2023.102586. Online ahead of print.

ABSTRACT

PURPOSE: To develop an automated planning approach in Raystation and evaluate its feasibility in multiple clinical application scenarios.

METHODS: An automated planning approach (Ruiplan) was developed by using the scripting platform of Raystation. Radiotherapy plans were re-generated both automatically by using Ruiplan and manually. 60 patients, including 20 patients with nasopharyngeal carcinoma (NPC), 20 patients with esophageal carcinoma (ESCA), and 20 patients with rectal cancer (RECA) were retrospectively enrolled in this study. Dosimetric and planning efficiency parameters of the automated plans (APs) and manual plans (MPs) were statistically compared.

RESULTS: For target coverage, APs yielded superior dose homogeneity in NPC and RECA, while maintaining similar dose conformity for all studied anatomical sites. For OARs sparing, APs led to significant improvement in most OARs sparing. The average planning time required for APs was reduced by more than 43% compared with MPs. Despite the increased monitor units (MUs) for NPC and RECA in APs, the beam-on time of APs and MPs had no statistical difference. Both the MUs and beam-on time of APs were significantly lower than that of MPs in ESCA.

CONCLUSIONS: This study developed a new automated planning approach, Ruiplan, it is feasible for multi-treatment techniques and multi-anatomical sites cancer treatment planning. The dose distributions of targets and OARs in the APs were similar or better than those in the MPs, and the planning time of APs showed a sharp reduction compared with the MPs. Thus, Ruiplan provides a promising approach for realizing automated treatment planning in the future.

PMID:37062102 | DOI:10.1016/j.ejmp.2023.102586

J Mech Behav Biomed Mater. 2023 Apr 5;142:105804. doi: 10.1016/j.jmbbm.2023.105804. Online ahead of print.

ABSTRACT

PURPOSE: This in vitro study aims to evaluate the bonding strengths of Polyether ether ketone (PEEK), Polyether ketone (PEKK), Fiber, and Zirconia (ZrO₂) post-core restorations with posts in different diameter and length following chewing simulator.

MATERIALS AND METHODS: Endodontic treatment was performed on 256 intact maxillary central teeth. The test specimens were prepared in four groups according to the types of materials: Glass fiber post-composite core (FB-n:64), Zirconia post-core (Zr-n:64), PEEK post-core (PE-n:64), and PEKK post-core (PK-n:64). The groups were divided into four subgroups according to diameter and length (n:16): Group 1: 10 mm length 1.75 mm diameter, Group 2: 10 mm length 1.5 mm diameter, Group 3: 7 mm length 1.75 mm diameter, Group 4: 7 mm length 1.5 mm diameter. Custom PEKK, PEEK, Zirconia post-cores, and Zirconia crowns were milled on the CAD/CAM. The post-cores and crowns were cemented to the teeth with dual-cure resin cement. After that, all subgroups were divided into control and cyclic loading groups. During the cycling, the control test group was kept in distilled water at 37±1^oC before the push-out test. Half of the specimens were loaded with 250,000 cycles and 50 N with a chewing simulator. All test specimens had 1.5 mm sections taken from their roots. Then, the push-out test was applied to these sections for bond strength. Data were analyzed by Mann-Whitney U test, Shapiro-Wilk, Kruskal-Wallis’s test, and Chi-Square. The statistical significance level was determined as 0.05.

RESULTS: The bond strength of all test groups decreased after the cycling loading. The bond strength values of zirconia posts showed a statistically significant difference (p < 0.05). The 10 mm length 1.75 mm diameter posts made of Zirconium had the highest bond strength observed in all control and cyclic loading groups of test specimens (9.74 MPa-6.25 MPa). The PEEK test specimens with a 7 mm length and 1.75 mm diameter showed the weakest bond strength in all control and cyclic loading groups (5.44 MPa-3.37 MPa). The average of the cervical region’s bond strength values was statistically significantly higher than the apical region (p < 0.05).

CONCLUSION: Within the limitations of this study, one-piece custom-milled Zirconia post-cores appear promising, as they perform well under functional forces, especially in the anterior region. In addition, custom-milled PEKK post-cores might be considered a suitable alternative to prefabricated fiber-reinforced posts.

PMID:37062099 | DOI:10.1016/j.jmbbm.2023.105804

J Mech Behav Biomed Mater. 2023 Apr 5;142:105819. doi: 10.1016/j.jmbbm.2023.105819. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the influence of intaglio ceramic surface treatments, resin cement viscosities, and storage regimens on the microshear bond strength of lithium disilicate ceramic. In addition, to investigate the dynamic viscosity of the resin-based luting agents.

MATERIALS AND METHODS: Ceramic slices were randomly allocated into eight groups (n = 19) considering three factors: ceramic surface treatment (hydrofluoric acid followed by silane, HF; or self-etching ceramic primer, E&P), resin cement viscosity (high, HIGH; or low, LOW) and storage regimen (baseline or aging). Surface treatments were performed, resin cement cylinders were built and microshear bond strength tests (μSBS, wire-loop method, speed: 1.0 mm/min) were run according to the storage factor. Failure mode, topographic and dynamic viscosity (37 °C; shear rate of 1.0-100 s^-1) of resin cement components (base, high and low catalyst) were also performed.

RESULTS: Resin cement viscosity and the association among ceramic surface treatment, resin cement viscosity, and storage regimen were statistically significant factors (p < 0.05). Worse behavior was identified for the E&P_HIGH group compared to the E&P_LOW and HF_LOW in the baseline condition. After aging, the HF_HIGH group (16.78 MPa) presented the worst result among the aged groups (21.44-25.25 MPa). Most of the failures were adhesive. Surface micrographs revealed a distinct pattern after etching, more aggressive by HF and milder by E&P. High viscosity catalyst is 5.3 and 8.5-fold more viscous than the base and low viscosity catalyst, respectively (high > base > low).

CONCLUSION: Differences in filler content can impact the resin viscosity of the material (more fillers increase the viscosity), which in turn can influence the bond strength of a lithium disilicate ceramic, depending on the surface treatment and storage regimen.

PMID:37062098 | DOI:10.1016/j.jmbbm.2023.105819

Cancer Med. 2023 Apr 16. doi: 10.1002/cam4.5918. Online ahead of print.

ABSTRACT

BACKGROUND: An ever-increasing number of efforts are focused on identifying effective biomarkers for immune checkpoint inhibitors (ICIs). Cytokines and chemokines are critical to tumor growth, metastasis, tumor angiogenesis, and the immune response against tumor cells. In the study here, we determined the correlation between circulating cytokines/chemokines and the clinical benefit of ICIs for non-small cell lung cancer (NSCLC) patients.

METHODS: Peripheral blood samples were collected before and during treatment (at 12th week). Plasma levels of cytokines/chemokines and specific stress response markers were measured using the Bio-Plex Pro Human Cytokines Grp I Panel (27-plex), an APEX1 detection kit, and a human LAP(TGF-β1) immunoassay kit. A Mann-Whitney U-test or Wilcoxon signed-rank test and a Cox proportional hazards model were employed for statistical analysis.

RESULTS: In the ICI monotherapy cohort, a high level of IL-6 at pretreatment or an elevation of IL-6, IL-8, FGF2, CXCL10, CCR1, PDFGB, TNF, and APEX1 posttreatment was associated with poor progress-free survival (PFS). A posttreatment elevation (defined herein as change rate) of CXCL10 was also associated with poor overall survival (OS). In the combinational therapy group, a high level of IL-12, IL-17A, FGF2, VEGF, and APEX1 at pretreatment and an elevation of CCL2 posttreatment were associated with poor PFS. A high level of IL-9, FGF2, PDFGB, CCL4, TFGB, and APEX1 at pretreatment and an elevation of IL-13, CSF2, and CCL2 at posttreatment were associated with poor OS of patients receiving combination therapy.

CONCLUSIONS: The study here suggests that circulating cytokines/chemokines are feasible, noninvasive biomarkers for predicting clinical benefit of ICI treatment for NSCLC. Distinct circulating factor profiles were observed in individuals receiving ICI monotherapy or combination therapy.

PMID:37062076 | DOI:10.1002/cam4.5918

Cancer Med. 2023 Apr 16. doi: 10.1002/cam4.5895. Online ahead of print.

ABSTRACT

PURPOSE: To clarify the necessity and effect of a single intraoperative instillation of chemotherapy during radical cystectomy.

METHODS: Patients who underwent radical cystectomy for bladder cancer between January 2013 and April 2019 were retrospectively evaluated and divided into a non-instillation group and an instillation group according to the intraoperative instillation of chemotherapy. Univariate and multivariate Cox regression was used to determine the clinical predictors of overall survival and disease-free survival. Kaplan-Meier analysis and log-rank tests were performed to analyze overall survival and disease-free survival.

RESULTS: Of the 320 patients who were enrolled in the study, 113 underwent radical cystectomy with intraoperative instillation of chemotherapy. Univariate Cox analysis showed that intraoperative instillation was not a risk factor for overall survival or disease-free survival (HR: 1.04, 95% CI: 0.66-1.63, p = 0.864; HR: 1.11, 95% CI: 0.76-1.62, p = 0.602, respectively). As shown in the Kaplan-Meier analysis, no significant differences were noted in overall survival (p = 0.857) and disease-free survival (p = 0.600) between the two groups. A subgroup analysis demonstrated that intraoperative instillation was not associated with a statistically better overall survival and disease-free survival in the nonmuscle invasive (p = 0.852 and 0.836) and muscle-invasive (p = 0.929 and 0.805) patients.

CONCLUSION: A single intraoperative instillation of chemotherapy during radical cystectomy was not related to better disease-free survival or overall survival. It is unnecessary to consider single instillation of chemotherapy as a regular procedure during radical cystectomy.

PMID:37062074 | DOI:10.1002/cam4.5895