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Αλέξανδρος Γ. Σφακιανάκης

Tuesday, April 20, 2021

Long-term results of a randomized partial irradiation trial compared to whole breast irradiation in the early stage and low-risk breast cancer patients after conservative surgery

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Abstract

Purpose

To report long-term results of a randomized trial comparing accelerated partial breast irradiation (APBI) to whole-breast irradiation (WBI) in terms of efficacy, toxicity, and cosmesis.

Methods and materials

WBI group was treated with 3D conformal external irradiation, 2 Gy daily/fraction, 5 fractions/week, to a total dose of 50 Gy. APBI group was treated with 3D conformal external irradiation 3.75 Gy/fraction, twice a day, 5 fractions/week, to a total dose of 37.5 Gy in the APBI group. Patients were followed up every 6 months up to 5 years and yearly thereafter. During follow-up visits, the clinician evaluated chronic toxicity and scored cosmetic results with a four-scale system.

Results

After a median follow-up of 10.3 years, 43 patients in each group (84%) are alive without disease. One patient died after disease progression in the APBI arm, and there was no death in the WBI arm. The rest of the patients died from another disease different than breast cancer, similarly between groups. There was greater fibrosis in the APBI group (9 patients grade 1 and one grade 2) compared to WBI (3 patients grade 1 and one grade 2); p = 0.18. Regarding cosmesis, in APBI group, 19 and 21 (43.2 and 47%) patients had excellent or good results, similar to the WBI group with 18 patients (40.9%) in each cosmesis outcome. The WBI group did not have any patient with poor cosmesis but the APBI had 3 (6.8%; p = 0.24).

Conclusion

After a follow-up of 10 years, there were no differences in efficacy between the 2 treatment arms. Despite slight greater toxicity in the APBI group, the cosmesis was similar and satisfactory in both groups.

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Challenges and future directions in breast cancer care in Fukushima prefecture in Japan: correspondence to “A survey on the current status of clinical resources for diagnosis and treatment of breast cancer in rural hospitals of the Tohoku region in Japan”

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Anisotropic Mechanical Properties of the Human Uterus Measured by Spherical Indentation

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Abstract

The mechanical function of the uterus is critical for a successful pregnancy. During gestation, uterine tissue grows and stretches to many times its size to accommodate the growing fetus, and it is hypothesized the magnitude of uterine tissue stretch triggers the onset of contractions. To establish rigorous mechanical testing protocols for the human uterus in hopes of predicting tissue stretch during pregnancy, this study measures the anisotropic mechanical properties of the human uterus using optical coherence tomography (OCT), instrumented spherical indentation, and video extensometry. In this work, we perform spherical indentation and digital image correlation to obtain the tissue's force and deformation response to a ramp-hold loading regimen. We translate previously reported fiber architecture, measured via optical coherence tomography, into a constitutive fiber composite material model to describe the equilibrium material behavior during indentation. We u se an inverse finite element method integrated with a genetic algorithm (GA) to fit the material model to our experimental data. We report the mechanical properties of human uterine specimens taken across different anatomical locations and layers from one non-pregnant (NP) and one pregnant (PG) patient; both patients had pathological uterine tissue. Compared to NP uterine tissue, PG tissue has a more dispersed fiber distribution and equivalent stiffness material parameters. In both PG and NP uterine tissue, the mechanical properties differ significantly between anatomical locations.

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Methodology for Evaluation of WIAMan Injury Assessment Reference Curves Using Whole Body Match-Paired Data

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Abstract

Development of the Warrior Injury Assessment Manikin (WIAMan) capability has included the creation of injury assessment reference curves (IARCs) specific to under-body blast (UBB) loading mechanisms and injuries. The WIAMan IARCs were created from high-rate vertical loading tests of component post-mortem human surrogates (PMHS) and analogous components of the WIAMan anthropomorphic test device (ATD). Validation of the WIAMan IARCs is required prior to the WIAMan ATD being utilized for injury assessment in live-fire vehicle test events. A portion of the validation process involves evaluating the ability of the IARCs to predict injury at the system level (whole body). This study evaluates a methodology to assess the performance of the WIAMan IARCs using match-paired tests of whole body PMHS and the WIAMan ATD. The methodology includes a qualitative analysis designed to identify false-positive and false-negative ATD predictions, as well as a quantitative analysis th at utilizes area under the receiver-operating characteristic curve (AROC) and Brier score indices to grade IARC performance. Three WIAMan IARCs were used to exemplify the proposed methodology and results are provided. Attributes of the false-prediction, AROC, and Brier score portions of the methodology are presented, with results indicating the new methodology is thorough and robust in evaluation of IARCs.

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Miniature Flexible Instrument with Fibre Bragg Grating-Based Triaxial Force Sensing for Intraoperative Gastric Endomicroscopy

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Abstract

Optical biopsy methods, such as probe-based endomicroscopy, can be used to identify early-stage gastric cancer in vivo. However, it is difficult to scan a large area of the gastric mucosa for mosaicking during endoscopy. In this work, we propose a miniaturised flexible instrument based on contact-aided compliant mechanisms and fibre Bragg grating (FBG) sensing for intraoperative gastric endomicroscopy. The instrument has a compact design with an outer diameter of 2.7 mm, incorporating a central channel with a diameter of 1.9 mm for the endomicroscopic probe to pass through. Experimental results show that the instrument can achieve raster trajectory scanning over a large tissue surface with a positioning accuracy of 0.5 mm. The tip force sensor provides a 4.6 mN resolution for the axial force and 2.8 mN for transverse forces. Validation with random samples shows that the force sensor can provide consistent and accurate three-axis force detection. Endomicr oscopic imaging experiments were conducted, and the flexible instrument performed no gap scanning (mosaicking area more than 3 mm2) and contact force monitoring during scanning, demonstrating the potential of the system in clinical applications.

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Real-time automotive night-vision system for drivers to inhibit headlight glare of the oncoming vehicles and enhance road visibility

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Abstract

The vision problem of drivers during the night is mainly owing to the high-intensity headlight-beam of the oncoming vehicle from the reverse direction. It causes temporary blindness to the driver. To overcome this situation, people generally use color windshield glass, sun visor, and night-vision glass. But, these are not considered as the best solution since it decreases the light intensity of the entire view including the road. Many researchers used various image enhancement techniques to overcome this situation. But, the existing approaches are unable to dim the high-beam headlights of oncoming vehicles without affecting the road view. In this paper, a novel night-vision system is proposed to resolve the problem in real-time for manual-driving vehicles and autonomous vehicles. The proposed method includes region segmentation of frames, local enhancement techniques in different regions followed by adaptive Gaussian filtering. Pixels masking, gamma correction, a nd low-light pixel enhancement are applied to three distinct regions. Both autonomous vehicles and manual drivers can get a bright and a prominent view of the road with dim headlights of oncoming vehicles in real-time. Numerous heuristic real-time test reveals the performance superiority of the projected system compared to state-of-art methods in quantitative as well as qualitative point of view.

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Biorecovery of nanogold and nanogold compounds from gold-containing ores and industrial wastes

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Abstract

In nature, microorganisms developed at various places and adapted to the various weather and geological conditions. Microorganisms participate in geological transformations leading to the dissolution of some minerals and conversion to others. While some microorganisms with their metabolic activity increase the mobility of metals, others cause precipitation of metals and the formation of new minerals. These biogeochemical interactions found practical application in the recovery of metals. In the article, the proposals for improvement of existing engineering commercial processes for recovery of metals are given which can enable the formation of nanogold and nanogold compounds.

Key points

Amino acids in pretreatment can increase the dissolution of the layer around the gold.

Amino acids in the complexing stage can increase gold leaching.

After the complexing stage, the bionanosynthesis of gold and its compounds is possible.

Graphical abstract

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Evaluation of VEGF-A in platelet and microRNA-126 in serum after coronary artery bypass grafting

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Abstract

Platelet functions are thought to contribute to clinical outcomes after heart surgery. This study was conducted to assess the pivotal roles of vascular endothelial growth factor-A (VEGF-A) and microRNA-126 (miR-126) during coronary artery bypass grafting (CABG). Whole blood was collected for platelet isolation from 67 patients who underwent CABG surgery between July 2013 and March 2014. VEGF-A and miR-126 levels in serum, plasma, and platelets were measured at various time points and compared with clinical characteristics. The platelet count was decreased at 3 days after CABG. This dynamic change in platelet count was larger after conventional coronary artery bypass (CCAB) than off-pump coronary artery bypass (OPCAB). VEGF-A in the same number of platelets (IP-VEGF-A) was increased at 3 days after CABG, followed by an increase of VEGF-A in serum (S-VEGF-A) at 7 days after surgery. The miR-126-3p level in serum (S-miR-126-3p) increased rapidly after CABG and then decreased below preoperative levels. The IP-VEGF-A level on day 7 after CABG in patients with peripheral artery disease (PAD), who suffered from endothelial dysfunction, was higher compared with patients without PAD. Conversely, S-miR-126-3p on day 7 after surgery was lower in patients with PAD than in patients without PAD. Low levels of S-miR-126-3p due to endothelial dysfunction may lead to high IP-VEGF-A, which is closely related to complications after CABG.

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DNA-derived nanostructures selectively capture gram-positive bacteria

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Abstract

We report the first demonstration of the efficient bacteria targeting properties of DNA-based polymeric micelles with high-density DNA corona. Nanoscale polymer micelles derived from DNA-b-polystyrene (DNA-b-PS) efficiently selected most tested Gram-positive strains over Gram-negative strains; single-strand DNAs were 20-fold less selective. We demonstrate that these targeting properties were derived from the interaction between densely packed DNA strands of the micelle corona and the peptidoglycan layers of Gram-positive bacteria. DNA-b-PS micelles incorporating magnetic nanoparticles (MNPs) can efficiently capture and concentrate Gram-positive bacteria suggesting the simple applications of these DNA block copolymer micelles for concentrating bacteria. Adenine (A), thymine (T), cytosine (C), and guanine (G)-rich nanostructures were fabricated, respectively, for investigating the effect of sequence on Gram-selective bacteria targeting. T -rich micelles showed the most efficient targeting properties. The targeting properties of these DNA nanostructures toward Gram-positive bacteria may have applications as a targeted therapeutic delivery system.

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Development of a miRNA Sensor by an Inducible CRISPR-Cas9 Construct in Ciona Embryogenesis

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Abstract

MicroRNAs (miRNAs) regulate multicellular processes and diverse signaling pathways in organisms. The detection of the spatiotemporal expression of miRNA in vivo is crucial for uncovering the function of miRNA. However, most of the current detecting techniques cannot reflect the dynamics of miRNA sensitively in vivo. Here, we constructed a miRNA-induced CRISPR-Cas9 platform (MICR) used in marine chordate Ciona. The key component of MICR is a pre-single guide RNA (sgRNA) flanked by miRNA-binding sites that can be released by RNA-induced silencing complex (RISC) cleavage to form functional sgRNA in the presence of complementary miRNA. By using the miRNA-inducible CRISPR-on system (MICR-ON), we successfully detected the dynamic expression of a miRNA csa-miR-4018a during development of Ciona embryo. The detected patterns were validated to be consistent with the results by in situ hybridization. It is worth noting that the expression of csa-miR-4018a was examined by MICR-ON to be present in additional tissues, where no obvious signaling was detected by in situ hybridization, suggesting that the MICR-ON might be a more sensitive approach to detect miRNA signal in living animal. Thus, MICR-ON was demonstrated to be a sensitive and highly efficient approach for monitoring the dynamics of expression of miRNA in vivo and will facilitate the exploration of miRNA functions in biological systems.

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Chitosan Versus Chitosan-Vanillin Modified: An Evaluation of the Competitive Adsorption of Five Emerging Contaminants

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Abstract

Emerging contaminants (ECs) have been studied extensively because of the various damages they can cause to the environment, especially due to the non-treated domestic effluents, which contaminate the water bodies. Therefore, it is important to evaluate alternatives to remove these compounds. The objective of this work was to evaluate the potential of a new biosorbent from chitosan modified with vanillin (CTSV) to remove isoniazid, cortisol, bisphenol A, 17α-ethinylestradiol, and triclosan by competitive adsorption studies. Structural characterization of the biosorbents was performed by Fourier transform infrared spectroscopy, thermogravimetry, Brunauer-Emmett-Teller, zeta potential, scanning electron microscopy, and 1H nuclear magnetic resonance. The adsorption for ECs were carried out in an aqueous medium, and quantitative analyzes were performed by HPLC. The effect of pH was evaluated in the pH range 5 to 10 and indicated that better results were found in pH 9 and 8 for CTS and CTSV, respectively. The salt concentrations effect was evaluated in 0.0 to 1.0 mol L−1 and revealed better adsorption conditions in 0.7 mol L−1 of NaCl. The adsorption kinetics pointed to an equilibrium condition reached quickly (with adjustment of data R2 > 0.969) with adequacy to pseudo–second-order model for both biosorbents and ECs. The linear isothermal model was suitable for the adsorption isothermal data and distribution constant (KD) showed the highest values for 17α-ethinylestradiol (0.067 L g−1) and triclosan (0.197 L g−1) in CTSV adsorption. Thus, the results indicated that CTSV performed well in removal for the tested ECs, being an interesting alternative, due to the ease of obtaining and abundance of reagents employed in its preparation.

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Impact of Pre-Chemotherapy Education with Audio Visual Methods on the Self-Efficacy of Symptom Management in Patients with Cancer

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Abstract

This study aimed to identify the effects of pre-chemotherapy education with audio visual methods on the self-efficacy of symptom management in patients with cancer who received chemotherapy. The various side effects of chemotherapy could affect the self-efficacy of symptom management. Providing pre-chemotherapy education is important to improve the self-efficacy of symptom management. Nowadays, pre-chemotherapy education is only given by using print media, which can restrict transferring information to patients with cancer. This study was based on pre- and post-test, 2 group, quasi-experimental design. A total of 80 respondents were recruited with consecutive sampling between January and March 2019. Participants in the intervention group received video pre-chemotherapy education, while participants in the control group received education with a booklet (usual care). Patients completed self-efficacy symptom management questionnaires before and 1–2 weeks aft er chemotherapy. The analysis used the Wilcoxon and Mann-Whitney tests and by counting Cohen's d effect size. The mean scores of pre- and post-test self-efficacy of symptom management increased in the intervention group to 1.77 (p = 0.000) and in the control group to 0.64 (p = 0.001). The comparative test between the two groups showed p = 0.005 (p < 0.05) with an effect size of 0.4 (66%). This result indicates that pre-chemotherapy education had medium effect on the self-efficacy of symptom management. Pre-chemotherapy education with audio visual methods can increase the self-efficacy of symptom management in patients with cancer.

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