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BACKGROUND AND STUDY AIMS: Capsule endoscopy is increasingly reported as an important diagnostic procedure in patients with known or suspected Crohn's disease, but its clinical utility in patients with ulcerative colitis or unclassified type inflammatory bowel disease (IBDU) is unclear. The aim of our study was to determine the diagnostic yield of capsule endoscopy for small-bowel disease in patients with ulcerative colitis and IBDU. PATIENTS AND METHODS: All data from patients with a history of ulcerative colitis or IBDU who underwent capsule endoscopy between October 2001 and August 2005 were analyzed for procedure indications and findings. Images were reviewed by an experienced capsule endoscopist. The finding of multiple ulcerations (three or more) on capsule endoscopy was classified as diagnostic of small-bowel Crohn's disease. RESULTS: 120 patients had undergone 122 capsule endoscopy procedures. Overall, 19 of 120 patients (15.8 %) had capsule endoscopy findings consistent with the diagnosis of Crohn's disease. The proportion of patients with small-bowel disease was significantly higher among patients with a history of colectomy (7 of 21 patients, 33 %) compared with those without colectomy (12/99, 12 %) ( P = 0.04). Among patients with positive findings on capsule endoscopy, 18 had also previously undergone a small-bowel follow-through study and only one showed findings consistent with Crohn's disease. CONCLUSIONS: Many patients with a diagnosis of ulcerative colitis and atypical features or IBDU may have small-bowel findings on capsule endoscopy that are consistent with Crohn's disease. Capsule endoscopy should be considered in ulcerative colitis patients with atypical clinical features particularly after colectomy. [ABSTRACT FROM AUTHOR]

In this research, the use of tungsten (W) and barium (Ba) in composition with lead (Pb) was investigated to decrease weight and to increase the efficiency of the protective aprons in attenuating of the diagnostic X-rays. First, the X-ray tube of the Radiation Research Center (RCC) of the Shiraz University was simulated by MCNP4C code to obtain the bremsstrahlung and characteristic X-ray spectrum. In order to confirm the simulation, the obtained output of this code was compared with the resultant output of the spectrum simulator software, viz., the spectrum processor (SP). The simulated protective apron samples with the dimension of 10cm×10cm and weight of 86.5, 81.5 and 70 g, containing various percentages of Pb, W and Ba, were placed in the path of the simulated spectra, and the attenuation coefficient of radiation was calculated using MCNP4C. The results showed that the composition of Pb, Ba and vinyl, with the percentages of 23, 42 and 35 and also 17, 48 and 35, respectively, improved the attenuation about %46 in comparison with the use of pure Pb.

Background: One of the coping strategies in stressful situations effectively is resilience skills. Due to the coronavirus disease 2019 (COVID-19) pandemic and its resulting stresses, this study was conducted to determine the relationship between resilience and social and organizational support among nurses working with COVID-19 patients., Materials and Methods: A cross-sectional study was undertaken on 224 nurses working with COVID-19 patients in Iran in 2021. A demographic questionnaire, the Connor-Davidson Resilience Scale, Multidimensional Scale of Perceived Social Support, and Survey of Perceived Organisational Support were used for data collection. Data analysis was performed using descriptive and interpretive statistics (Pearson correlation coefficient test and linear regression)., Results: The mean [Standard Deviation (SD)] resilience score was 65.86 (14.01). In addition, the mean (SD) scores of organizational support and social support were 21.57 (4.46) and 65.10 (10.93), respectively. The Pearson correlation coefficient test results showed a statistically significant direct relationship between social support and resilience (r = 0.41, p < 0.001). In addition, there was a statistically significant relationship between organizational support and resilience (r = 0.16, p = 0.01). Multivariate linear regression analysis showed that for each unit increase in social support and organizational support scores, resilience scores increased by 0.41 ( p = 0.01) and 0.15 ( p < 0.001) units, respectively., Conclusions: The results of the present study showed a direct relationship between resilience and social support and organizational support in nurses. Due to the prolongation of the COVID-19 pandemic and the high prevalence of the disease in our country, nursing managers should seriously consider measures to protect their staff., Competing Interests: Nothing to declare., (Copyright: © 2024 Iranian Journal of Nursing and Midwifery Research.)

Background: Esophageal self-expandable metal stents (SEMS) are an important endoscopic tool. These stents have now been adapted successfully to manage post-bariatric surgery complications such as anastomotic leaks and strictures. In centers of expertise, this has become the primary standard-of-care treatment given its minimally invasive nature, and that it results in early oral feeding, decreased hospitalization, and overall favorable outcomes. Self-expandable metal stents (SEMS) fractures are a rare complication of unknown etiology. We aimed to investigate possible causes of SEMS fractures and highlight a unique endoscopic approach utilized to manage a fractured and impaled SEMS. Methods: This is a retrospective study of consecutive patients who underwent esophageal SEMS placement between 2015-2021 at a tertiary referral center to identify fractured SEMS. Patient demographics, stent characteristics, and possible etiologies of fractured SEMS were identified. A comprehensive literature review was also conducted to evaluate all prior cases of fractured SEMS and to hypothesize fracture theories. Results : There were seven fractured esophageal SEMS, of which six were used to manage post-bariatric surgery complications. Five SEMS were deployed with their distal ends in the gastric antrum and proximal ends in the distal esophagus. All stents fractured within 9 weeks of deployment. Most stents (5/7) were at least 10 cm in length with fractures commonly occurring in the distal third of the stents (6/7). The wires of a fractured SEMS were embedded within the esophagogastric junction in one case, prompting the use of an overtube that was synchronously advanced while steadily extracting the stent. Discussion: We suggest the following four etiologies of SEMS fractures: anatomical, physiological, mechanical, and chemical. Stent curvature at the stomach incisura can lead to strain- and stress-related fatigue due to mechanical bending with exacerbation from respiratory movements. Physiologic factors (gastric body contractions) can result in repetitive squeezing of the stent, adding to metal fatigue. Intrinsic properties (long length and low axial force) may be contributing factors. Lastly, the stomach acidic environment may cause nitinol-induced chemical weakness. Despite the aforementioned theories, SEMS fracture etiology remains unclear. Until more data become available, it may be advisable to remove these stents within 6 weeks.

Background: Cancer is a major cause of death worldwide. Colorectal cancer is the second most common type. Additional treatments like chemotherapy and radiation therapy may be recommended. Developing new techniques is vital due to drug resistance and a lack of targeted therapies., Objective: In this study, the effects of mesenchymal stem cells (MSCs) loaded with oncolytic Coxsackievirus A21 (CVA21) on a mouse model of CRC were investigated., Methods: The therapeutic potency of MSCs loaded with oncolytic CVA21 were evaluated in an experimental mouse model of colorectal cancer which received an injection CT26 cells per mouse subcutaneously. Splenocyte proliferation index, lactate dehydrogenase (LDH) assay, nitric oxide (NO) production assessment, and cytokine assay (IFN-γ, IL-4, IL-10, and TGF-β) in the splenocyte supernatant were all used to evaluate the impact of MSCs loaded with CVA21., Results: The results of this study showed that the treatment of a mouse model of colorectal cancer with MSCs loaded with oncolytic CVA21 could significantly suppress the tumor growth, which was accompanied by stimulation of splenocytes proliferation index, an increase of NO and LDH. Also, MSCs loaded with oncolytic CVA21 increased the secretion of IFN-γ and decreased the secretion of IL-4, IL-10, and TGF-β., Conclusion: The results of the current study suggest that MSCs loaded with oncolytic CVA21 therapy for the CRC mouse model may have some potential advantages. On the other hand, the results of the study showed that, in addition to activating the acquired immune system, the use of MSCs loaded with oncolytic CVA21 also stimulates the innate immune system by increasing level of nitric oxide., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: Older adults with dementia living in long-term care (LTC) have high rates of hospitalization. Two common causes of unplanned hospital visits for LTC residents are deterioration in health status and falls. Early detection of health deterioration or increasing falls risk may present an opportunity to intervene and prevent hospitalization. There is some evidence that impairments in older adults' gait, such as reduced gait speed, increased variability, and poor balance may be associated with hospitalization. However, it is not clear whether changes in gait are observable and measurable before an unplanned hospital visit and whether these changes persist after the acute medical issue has been resolved. The objective of this study was to examine gait changes before and after an unplanned acute care hospital visit in people with dementia., Methods: We performed a secondary analysis of quantitative gait measures extracted from videos of natural gait captured over time on a dementia care unit and collected information about unplanned hospitalization from health records., Results: Gait changes in study participants before hospital visits were characterized by decreasing stability and step length, and increasing step variability, although these changes were also observed in participants without hospital visits. In an age and sex-adjusted mixed effects model, gait speed and step length declined more quickly in those with a hospital visit compared to those without., Conclusions: These results provide preliminary evidence that clinically meaningful longitudinal gait changes may be captured by repeated non-invasive gait monitoring, although a larger study is needed to identify changes specific to future medical events., (© 2023. The Author(s).)

Falls are a leading cause of morbidity and mortality in older adults with dementia residing in long-term care. Having access to a frequently updated and accurate estimate of the likelihood of a fall over a short time frame for each resident will enable care staff to provide targeted interventions to prevent falls and resulting injuries. To this end, machine learning models to estimate and frequently update the risk of a fall within the next 4 weeks were trained on longitudinal data from 54 older adult participants with dementia. Data from each participant included baseline clinical assessments of gait, mobility, and fall risk at the time of admission, daily medication intake in three medication categories, and frequent assessments of gait performed via a computer vision-based ambient monitoring system. Systematic ablations investigated the effects of various hyperparameters and feature sets and experimentally identified differential contributions from baseline clinical assessments, ambient gait analysis, and daily medication intake. In leave-one-subject-out cross-validation, the best performing model predicts the likelihood of a fall over the next 4 weeks with a sensitivity and specificity of 72.8 and 73.2, respectively, and achieved an area under the receiver operating characteristic curve (AUROC) of 76.2. By contrast, the best model excluding ambient gait features achieved an AUROC of 56.2 with a sensitivity and specificity of 51.9 and 54.0, respectively. Future research will focus on externally validating these findings to prepare for the implementation of this technology to reduce fall and fall-related injuries in long-term care.

In the nonparametric data envelopment analysis literature, scale elasticity is evaluated in two alternative ways: using either the technical efficiency model or the cost efficiency model. This evaluation becomes problematic in several situations, for example (a) when input proportions change in the long run, (b) when inputs are heterogeneous, and (c) when firms face ex-ante price uncertainty in making their production decisions. To address these situations, a scale elasticity evaluation was performed using a value-based cost efficiency model. However, this alternative value-based scale elasticity evaluation is sensitive to the uncertainty and variability underlying input and output data. Therefore, in this study, we introduce a stochastic cost-efficiency model based on chance-constrained programming to develop a value-based measure of the scale elasticity of firms facing data uncertainty. An illustrative empirical application to the Indian banking industry comprising 71 banks for eight years (1998-2005) was made to compare inferences about their efficiency and scale properties. The key findings are as follows: First, both the deterministic model and our proposed stochastic model yield distinctly different results concerning the efficiency and scale elasticity scores at various tolerance levels of chance constraints. However, both models yield the same results at a tolerance level of 0.5, implying that the deterministic model is a special case of the stochastic model in that it reveals the same efficiency and returns to scale characterizations of banks. Second, the stochastic model generates higher efficiency scores for inefficient banks than its deterministic counterpart. Third, public banks exhibit higher efficiency than private and foreign banks. Finally, public and old private banks mostly exhibit either decreasing or constant returns to scale, whereas foreign and new private banks experience either increasing or decreasing returns to scale. Although the application of our proposed stochastic model is illustrative, it can be potentially applied to all firms in the information and distribution-intensive industry with high fixed costs, which have ample potential for reaping scale and scope benefits., Competing Interests: Competing interestsOn behalf of my co-authors, I declare that we have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© The Author(s) 2023.)

Natural killer T (NKT) cells are a specific T cell subset known to express the αβ-T cell receptor (TCR) for antigens identification and express typical NK cell specifications, such as surface expression of CD56 and CD16 markers as well as production of granzyme. Human NKT cells are divided into two subgroups based on their cytokine receptor and TCR repertoire. Both of them are CD1-restricted and recognize lipid antigens presented by CD1d molecules. Studies have demonstrated that these cells are essential in defense against malignancies. These cells secret proinflammatory and regulatory cytokines that stimulate or suppress immune system responses. In several murine tumor models, activation of type I NKT cells induces tumor rejection and inhibits metastasis's spread. However, type II NKT cells are associated with an inhibitory and regulatory function during tumor immune responses. Variant NKT cells may suppress tumor immunity via different mechanisms that require cross-talk with other immune-regulatory cells. NKT-like cells display high tumor-killing abilities against many tumor cells. In the recent decade, different studies have been performed based on the application of NKT-based immunotherapy for cancer therapy. Moreover, manipulation of NKT cells through administering autologous dendritic cell (DC) loaded with α-galactosylceramide (α-GalCer) and direct α-GalCer injection has also been tested. In this review, we described different subtypes of NKT cells, their function in the anti-tumor immune responses, and the application of NKT cells in cancer immunotherapy from bench to bed., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Postoperative infection in Coronary Artery Bypass Graft (CABG) is one of the most common complications for diabetic patients, due to an increase in the hospitalization and cost. To address these issues, it is necessary to apply some solutions., Objective: The study aimed to the development of a Clinical Decision Support System (CDSS) for predicting the CABG postoperative infection in diabetic patients., Material and Methods: This developmental study is conducted on a private hospital in Tehran in 2016. From 1061 CABG surgery medical records, we selected 210 cases randomly. After data gathering, we used statistical tests for selecting related features. Then an Artificial Neural Network (ANN), which was a one-layer perceptron network model and a supervised training algorithm with gradient descent, was constructed using MATLAB software. The software was then developed and tested using the receiver operating characteristic (ROC) diagram and the confusion matrix., Results: Based on the correlation analysis, from 28 variables in the data, 20 variables had a significant relationship with infection after CABG ( P <0.05). The results of the confusion matrix showed that the sensitivity of the system was 69%, and the specificity and the accuracy were 97% and 84%, respectively. The Receiver Operating Characteristic (ROC) diagram shows the appropriate performance of the CDSS., Conclusion: The use of CDSS can play an important role in predicting infection after CABG in patients with diabetes. The designed software can be used as a supporting tool for physicians to predict infections caused by CABG in diabetic patients as a susceptible group. However, other factors affecting infection must also be considered for accurate prediction., Competing Interests: None, (Copyright: © Journal of Biomedical Physics and Engineering.)

Background: Idiopathic pulmonary fibrosis (IPF) is a fatal fibrotic lung disease with limited treatment options. Plumbagin (PL) is an herbal extract with diverse pharmacological effects that have been recently used to treat various types of cancer. This study aims to explore the anti-fibrotic effect of PL and possible underlying mechanisms in IPF., Methods: We used a bleomycin-induced experimental mouse model of lung fibrosis to assess the potential anti-fibrotic effect of PL. Histological analysis of lung tissue samples by H&E and Masson's trichrome staining and hydroxyproline assay was performed to evaluate the fibrotic alterations. ELISA and real-time quantitative PCR were conducted to determine the amount of tumor necrosis factor-alpha (TNFα), tumor growth factor-beta (TGF-β), connective tissue growth factor (CTGF), and endothelin-1 (ET-1)., Results: Bleomycin exposure induced lung fibrosis, which was indicated by inflammation, collagen deposition, and structural damage. PL remarkably prevented bleomycin-induced lung fibrosis. Furthermore, PL significantly inhibited TNF-α and TGF-β production. PL also diminished the upregulated expression of CTGF and ET-1 induced by bleomycin., Conclusion: Overall, our findings suggest PL as an anti-fibrotic agent acting via down-regulation of TGF-β/CTGF or ET-1 axis, as well as TNF-α, to improve lung fibrosis., (© 2022. The Author(s).)

During pregnancy, complicated connections are formed between a mother and a fetus. In a successful pregnancy, the maternal-fetal interface is affected by dynamic changes, and the fetus is protected against the mother's immune system. Natural killer (NK) cells are one of the immune system cells in the female reproductive system that play an essential role in the physiology of pregnancy. NK cells not only exist in peripheral blood (PB) but also can exist in the decidua. Studies have suggested multiple roles for these cells, including decidualization, control of trophoblast growth and invasion, embryo acceptance and maintenance by the mother, and facilitation of placental development during pregnancy. Natural killer T (NKT) cells are another group of NK cells that play a crucial role in the maintenance of pregnancy and regulation of the immune system during pregnancy. Studies show that NK and NKT cells are not only effective in maintaining pregnancy but also can be involved in infertility-related diseases. This review focuses on NK and NKT cells biology and provides a detailed description of the functions of these cells in implantation, placentation, and immune tolerance during pregnancy and their role in pregnancy complications., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier GmbH. All rights reserved.)

Diabetic foot ulcers (DFU) are a serious complication of diabetes mellitus and associated with reduced quality of life and high mortality rate. DFUs are characterized by a deregulated immune response with decreased neutrophils due to loss of the transcription factor, FOXM1. Diabetes primes neutrophils to form neutrophil extracellular traps (NETs), contributing to tissue damage and impaired healing. However, the role of FOXM1 in priming diabetic neutrophils to undergo NET formation remains unknown. Here, we found that FOXM1 regulates reactive oxygen species (ROS) levels in neutrophils and inhibition of FOXM1 results in increased ROS leading to NET formation. Next generation sequencing revealed that TREM1 promoted the recruitment of FOXM1 + neutrophils and reversed effects of diabetes and promoted wound healing in vivo. Moreover, we found that TREM1 expression correlated with clinical healing outcomes of DFUs, indicating TREM1 may serve as a useful biomarker or a potential therapeutic target. Our findings highlight the clinical relevance of TREM1, and indicates FOXM1 pathway as a novel regulator of NET formation during diabetic wound healing, revealing new therapeutic strategies to promote healing in DFUs., (© 2022 The Authors. Published under the terms of the CC BY NC ND 4.0 license. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)

Introduction: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm of the gastrointestinal (GI) system. Most GISTs originate from the interstitial cells of Cajal (ICC), the pacemaker cell situated between the circular and longitudinal layers of the muscularis propria along the GI tract. In this population-based study using the SEER database, we sought to identify demographic, clinical, and pathologic factors that affect the prognosis and survival of patients with this neoplasm. Molecular genetic advances, current management guidelines, and advances in targeted therapy are discussed. Methods: Demographic and clinical data from GIST patients were retrieved from the SEER research plus database for the period 2000−2018. Statistical analysis was performed with IBM SPSS® v20.2 software using the Chi-square test, paired t-test, multivariate analysis, and Kaplan−Meier functions. Results: A total of 10,833 patients with GIST were identified. Most patients were between 60−74 years of age: 40%, Caucasian: 68%, and the male to female ratio was 1.1:1. The most common primary tumor sites were stomach: 63%, small intestine: 30%, rectum: 3%, and esophagus: 0.7%. When reported, the grade of differentiation was well: 38%, moderately: 32%, undifferentiated: 19%, poorly: 12%. The size of most tumors ranged between 6−10 cm: 36% and they were treated by surgical intervention: 82% and/or chemotherapy/targeted therapy: 39%. The stage was localized: 66%, advanced: 19%, and regional: 15%. The 5-year survival was 74% (95% confidence interval (95% CI) = 72.6−74.7), and the 5-year cause-specific survival 82% (95% CI = 80.7−82.6). The 5-year cause-specific survival by treatment included surgery at 86% (95% CI = 85.4−87.3), chemotherapy/targeted therapy with or without surgery at 77% (95% CI = 75.7−78.9), and radiation at 75% (95% CI = 74.5−80). On multivariable analysis tumor size > 5 cm, poorly and undifferentiated grade, age > 60, and distant metastases at presentation were associated with worse overall survival. Conclusion: GISTs comprise 1−2% of malignancies of the GI tract, usually affect male Caucasians between the ages of 60 and 74 years, most tumors occur in the stomach and small intestine, and are usually >5 cm, but still localized, at the time of diagnosis. Most tumors receive multimodality surgical and chemotherapy/targeted therapy treatment, with a 5-year overall survival of 74% and cause-specific survival of 82%. GIST patients would benefit from enrollment in large clinical trials to establish better therapy guidelines for unresectable, treatment-refractory, and recurrent tumors.

We introduce the Toronto Older Adults Gait Archive, a gait dataset of 14 older adults containing 2D video recordings, and 2D (video pose tracking algorithms) and 3D (inertial motion capture) joint locations of the lower body. Participants walked for 60 seconds. We also collected participants' scores on four clinical assessments of gait and balance, namely the Tinneti performance-oriented mobility assessment (POMA-gait and -balance), the Berg balance scale (BBS), and the timed-up-and-go (TUG). Three human pose tracking models (Alphapose, OpenPose, and Detectron) were used to detect body joint positions in 2D video frames and a number of gait parameters were computed using 2D video-based and 3D motion capture data. To show an example usage of our datasets, we performed a correlation analysis between the gait variables and the clinical scores. Our findings revealed that the temporal but not the spatial or variability gait variables from both systems had high correlations to clinical scores. This dataset can be used to evaluate, or to enhance vision-based pose-tracking models to the specifics of older adults' walking., (© 2022. The Author(s).)

Background: The optimal quantification of PET in assessment of head and neck squamous cell carcinoma (HNSCC) is still under development. The effect of partial volume correction (PVC) on the evaluation of survival in the HNSCC patients has not been investigated yet., Methodology: Pretreatment 18F-FDG-PET/CT scans of a selected group of 57 patients with advanced stage HNSCC were collected. Conventional (SUVmean and SUVmax) and volumetric [total lesion glycolysis (TLG) and metabolic tumor volume (MTV)] PET metrics were calculated. The ROVER software (ABX GmbH, Radeberg, Germany) automatically applied PVC to the PET metrics. Cox proportional hazards regression model calculated hazard ratio (HR) for assessment of predictive parameters of progression-free survival (PFS)., Results: In multivariate Cox regression analysis, including age, gender, race, human papillomavirus status, and stage, the only significant predictors of PFS were the volumetric PET parameters (TLG: HR, 1.003; 95% CI, 1.001-1.005; P = 0.02), pvcTLG (HR, 1.002; 95% CI, 1.001-1.004; P = 0.01) and MTV (HR, 1.050; 95% CI, 1.024-1.077; P < 0.01). The partial volume-corrected values were significantly higher than the noncorrected values (Wilcoxon sign test; P < 0.05). However, there was not a statistically significant difference between the nonpartial volume corrected and partial volume-corrected PET metrics for assessment of PFS., Conclusion: Volumetric PET metrics were predictors of PFS in Cox regression analysis. Applying PVC could not significantly improve the accuracy of PET metrics for assessment of PFS., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

A positive fluorine-18 labelled 2-deoxy-2-fluoroglucose ([ 18 F]FDG) positron emission tomography/computed tomography (PET/CT) has been associated with more aggressive disease and less differentiated neuroendocrine neoplasms (NEN). Although a high maximum standardized uptake value (SUV max ) predicts poor outcome in NEN, volumetric parameters from [ 18 F]FDG PET have not been evaluated for prognostication in a pure high-grade gastroenteropancreatic (GEP) NEN cohort. In this retrospective observational study, we evaluated the volumetric PET parameters total metabolic tumour volume (tMTV) and total total lesion glycolysis (tTLG) for independent prognostication of overall survival (OS). High-grade GEP NEN patients with [ 18 F]FDG PET/CT examination and biopsy within 90 days were included. Total MTV and tTLG were calculated using an adaptive thresholding software. Patients were dichotomised into low and high metabolic groups based on median tMTV and tTLG. OS was compared using Kaplan-Meier estimator and log-rank test. Uni and multivariable Cox regression was used to estimate effect sizes and adjust for tumour differentiation and SUV max . Sixty-six patients (median age 64 years) were included with 14 NET G3 and 52 NEC cases after histological re-evaluation. Median tMTV was 208 cm 3 and median tTLG 1899 g. Median OS in the low versus high tMTV-group was 21.2 versus 5.7 months (HR 2.53, p = 0.0007) and 22.8 versus 5.7 months (HR 2.42, p = 0.0012) in the tTLG-group. Adjusted for tumour differentiation and SUV max , tMTV and tTLG still predicted for poor OS, and both tMTV and tTLG were stronger prognostic parameters than SUV max . Both regression models showed a strong association between volumetric parameters and OS for both neuroendocrine tumours (NET) G3 and neuroendocrine carcinomas (NEC). OS for the tTLG low metabolic NEC was much higher than for the tTLG high metabolic NET G3 (18.3 vs. 5.7 months). High-grade GEP NEN patients with high tMTV or tTLG had a worse OS regardless of tumour differentiation (NET G3 or NEC). Volumetric PET parameters were stronger prognostic parameters than SUV max ., (© 2022 The Authors. Journal of Neuroendocrinology published by John Wiley & Sons Ltd on behalf of British Society for Neuroendocrinology.)

Drug-induced parkinsonism affects many older adults with dementia, often causing gait disturbances. New advances in vision-based human pose- estimation have opened possibilities for frequent and unobtrusive analysis of gait in long-term care settings. This work leverages spatial-temporal graph convolutional network (ST-GCN) architectures and training procedures to predict clinical scores of parkinsonism in gait from video of individuals with dementia. We propose a two-stage training approach consisting of a self-supervised pretraining stage that encourages the ST-GCN model to learn about gait patterns before predicting clinical scores in the finetuning stage. The proposed ST-GCN models are evaluated on joint trajectories extracted from video and are compared against traditional (ordinal, linear, random forest) regression models and temporal convolutional network baselines. Three 2D human pose-estimation libraries (OpenPose, Detectron, AlphaPose) and the Microsoft Kinect (2D and 3D) are used to extract joint trajectories of 4787 natural walking bouts from 53 older adults with dementia. A subset of 399 walks from 14 participants is annotated with scores of parkinsonism severity on the gait criteria of the Unified Parkinson's Disease Rating Scale (UPDRS) and the Simpson-Angus Scale (SAS). Our results demonstrate that ST-GCN models operating on 3D joint trajectories extracted from the Kinect consistently outperform all other models and feature sets. Prediction of parkinsonism scores in natural walking bouts of unseen participants remains a challenging task, with the best models achieving macro-averaged F1-scores of 0.53 ± 0.03 and 0.40 ± 0.02 for UPDRS-gait and SAS-gait, respectively. Pre-trained model and demo code for this work is available. 1 .

Background: Rheumatoid arthritis (RA) is an inflammatory disease that is characterized by the overproduction of cytokines. Among the newly discovered cytokines are the adipokines which are primarily produced by and released from the adipose tissue and some immune cells, as well as synovial cells. they are involved in various immune responses and inflammatory processes. However, there are controversial data regarding the pro-inflammatory or anti-inflammatory effects of adipokines in different conditions. C1q/TNF-related protein 5 (CTRP5) is a newly identified adipokine and adiponectin paralogous protein, which has been shown to be correlated with inflammatory diseases. Accordingly, the present study was designed to investigate the serum levels of CTRP5 in RA patients and evaluate any possible alterations in comparison to healthy individuals., Methods: Serum CTRP-5 levels were measured in 46 patients and 22 healthy controls by ELISA. The demographic, laboratory, and clinical features of the patients were also evaluated in order to find any correlations., Results: Serum levels of CTRP-5 were significantly (p < 0.0001) higher in patients with RA (14.88 ± 25.55) compared to healthy controls (4.262 ± 2.374). There was a significant correlation between serum CTRP-5 levels and triglyceride (TG) (r: - 0.3010, p: 0.0498), as well as erythrocyte sedimentation rate (ESR) (r: 0.3139, p: 0.0457), C-reactive protein (CRP) (r: 0.5140, p: 0.0008), and the number of white blood cells (WBC) (r: 0.3380, p: 0.0307), which are considered as the markers indicating the extent of inflammation. Moreover, CTRP-5 was found to be correlated with interstitial lung disease (ILD) (r: 0.3416, p: 0.0385), a comorbidity associated with RA disease., Conclusion: This study demonstrated the increased level of circulating CTRP-5 in RA patients, which correlated with some inflammation-associated parameters and RA-associated comorbidities. Our observations suggest CTRP-5 as a putative inflammatory biomarker in RA, which may be useful besides the other disease-related markers., (© 2022. The Author(s).)

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to various neurological manifestations. There is an urgent need for a summary of neuroimaging findings to accelerate diagnosis and treatment plans. We reviewed prospective and retrospective studies to classify neurological abnormalities observed in patients with the SARS-CoV-2 infection., Methods: The relevant studies published in Scopus, PubMed and Clarivate Analytics databases were analysed. The search was performed for full-text articles published from 23 January 2020 to 23 February 2021., Results: In 23 studies the number of patients with SARS-CoV-2 infection was 20,850 and the number of patients with neurological manifestations was 1996 (9.5%). The total number of patients with neuroradiological abnormalities was 602 (2.8%). SARS-CoV-2 has led to various neuroimaging abnormalities which can be categorised by neuroanatomical localisation of lesions and their main probable underlying pathogenesis. Cranial nerve and spinal root abnormalities were cranial neuritis and polyradiculitis. Parenchymal abnormalities fell into four groups of: (a) thrombosis disorders, namely ischaemic stroke and sinus venous thrombosis; (b) endothelial dysfunction and damage disorders manifested as various types of intracranial haemorrhage and posterior reversible encephalopathy syndrome; (c) hypoxia/hypoperfusion disorders of leukoencephalopathy and watershed infarction; and (d) inflammatory disorders encompassing demyelinating disorders, encephalitis, vasculitis-like disorders, vasculopathy and cytotoxic lesions of the corpus callosum. Leptomeninges disorders included meningitis. Ischaemic stroke was the most frequent abnormality in these studies., Conclusion: The review study suggests that an anatomical approach to the classification of heterogeneous neuroimaging findings in patients with SARS-CoV-2 and neurological manifestations would lend itself well for use by practitioners in diagnosis and treatment planning.

SARS-CoV-2 is a newly emerged coronavirus that has been widely transmitted since late 2019. It has caused a pandemic and infected roughly 450 million people globally.Hitherto, there is no approved anti-COVID-19 treatment, and vaccination is the only experienced preventive strategy. It mainly promotes the immune system, which is vital as a barrier against COVID-19. Humoral immunity (antibody-mediated immunity), among the various functions of the immune system against the coronavirus, plays an outstanding role in preventing infection. Consequently, we intended to assess IgG and IgM antibodies, 3 and 6 months after infection, to trend their titer and see how long COVID-19 antibodies remained in the human body. According to the research-designed criteria, only 98 patients out of 4500 suspected cases of SARS-CoV-2 infection remained for analysis. Blood samples were taken in three time periods (Day Zero ( T ), 3 and 6 months post-infection) and examined for COVID-19's IgG and IgM antibodies titration using the ELISA platform. Though both IgG and IgM were still detectable for some subjects at the end of the period, the decline in their levels (from 14.45 ± 5.88 to 2.52 ± 2.33 for IgG [85% decline of antibody titer] and 8.3 ± 0.99 to 0.37 ± 0.14 for IgM [95.5% decline of antibody titer]) was statistically significant ( 0 ), 3 and 6 months post-infection) and examined for COVID-19's IgG and IgM antibodies titration using the ELISA platform. Though both IgG and IgM were still detectable for some subjects at the end of the period, the decline in their levels (from 14.45 ± 5.88 to 2.52 ± 2.33 for IgG [85% decline of antibody titer] and 8.3 ± 0.99 to 0.37 ± 0.14 for IgM [95.5% decline of antibody titer]) was statistically significant ( P value 0.0001). There was no correlation between gender and IgG and IgM levels. Although the levels of both antibodies were overall higher in the senior group (≥ 60 years old), statistical analysis showed a significantly higher level just for IgM in this group ( P value: 0.005). Following the results, although anti-SARS-CoV-2 IgM and IgG antibodies can persist in the blood for 6 months post-infection, their levels steeply declined over time. Therefore, relying on humoral immunity as a trustworthy barrier against SARS-CoV-2 infection calls for more extensive research., Supplementary Information: The online version contains supplementary material available at 10.1007/s40995-022-01382-7., Competing Interests: Conflict of interestThe authors declare no conflict of interest., (© The Author(s), under exclusive licence to Shiraz University 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: To compare the NaF uptake in the thoracic aorta and whole heart, as an early indicator of atherosclerosis, in multiple myeloma (MM) and smoldering multiple myeloma (SMM) patients with a healthy control (HC) group., Methods: Forty-four untreated myeloma patients (35 MM and nine SMM) and twenty-six age and gender-matched HC subjects were collected. Each individual's NaF uptake in three parts of the aorta (AA: ascending aorta, AR: aortic arch, DA: descending aorta) and the whole heart was segmented. Average global standardized uptake value means were derived by sum of the product of each slice area divided by the sum of those slice areas. Results were reported as target to background ratio (TBR)., Results: There was a significant difference between the NaF uptake in the thoracic aorta of myeloma and HC groups [AA (myeloma = 1.82 ± 0.21, HC = 1.24 ± 0.02), AR (myeloma = 1.71 ± 0.19, HC = 1.28 ± 0.03) and DA (myeloma = 1.96 ± 0.28, HC = 1.38 ± 0.03); P-values < 0.001]. The difference in the whole heart NaF uptake between two groups was also significant (P < 0.001)., Conclusions: We observed a higher uptake of NaF in the thoracic aorta and whole heart of myeloma patients in comparison to the matched control group., (© 2021. American Society of Nuclear Cardiology.)

People with dementia are at risk of mobility decline. In this study, we measured changes in quantitative gait measures over a maximum 10-week period during the course of a psychogeriatric admission in older adults with dementia, with the aims to describe mobility changes over the duration of the admission, and to determine which factors were associated with this change. Fifty-four individuals admitted to a specialized dementia inpatient unit participated in this study. A vision-based markerless motion capture system was used to record participants' natural gait. Mixed effect models were developed with gait measures as the dependent variables and clinical and demographic variables as predictors. We found that gait stability, step time, and step length decreased, and step time variability and step length variability increased over 10 weeks. Gait stability of men decreased more than that of women, associated with an increased sacrum mediolateral range of motion over time. In addition, the sacrum mediolateral range of motion decreased in those with mild neuropsychiatric symptoms over 10 weeks, but increased in those with more severe neuropsychiatric symptoms. Our study provides evidence of worsening of gait mechanics and control over the course of a hospitalization in older adults with dementia. Quantitative gait monitoring in hospital environments may provide opportunities to intervene to prevent adverse events, decelerate mobility decline, and monitor rehabilitation outcomes., Competing Interests: A.J. Flint reports receiving research grant support from the U.S. National Institutes of Health, the Patient-Centered Outcomes Research Institute, the Canadian Institutes of Health Research, Brain Canada, the Ontario Brain Institute, the Alzheimer’s Association, and AGE-WELL. Dr. Flint is not an employee or consultant of any of these organizations. These funding agencies have had no role in the research reported in this article. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Older adults with dementia have a high risk of developing drug-induced parkinsonism; however, formal clinical gait assessments are too infrequent to capture fluctuations in their gait. Camera-based human pose estimation and tracking provides a means to frequently monitor gait in nonclinical settings. In this study, 2160 walking bouts from 49 participants were recorded using a ceiling-mounted camera. Recorded color videos were processed using AlphaPose to obtain 2D joint trajectories of the participant as they were walking down a hallway of the unit. A subset of 324 walking bouts from 14 participants were annotated with clinical scores of parkinsonism on the Unified Parkinson's Disease Rating Scale (UPDRS)-gait scale. Linear, random forest, and ordinal logistic regression models were evaluated for regression to UPDRS-gait scores using engineered 2D gait features calculated from the AlphaPose joint trajectories. Additionally, spatial temporal graph convolutional networks (ST-GCNs) were trained to predict UPDRS-gait scores from joint trajectories and gait features using a two-stage training scheme (self-supervised pretraining stage on all walks followed by a finetuning stage on labelled walks). All models were trained using leave-one-subject-out cross-validation to simulate testing on previously unseen participants. The macro-averaged F1-score was 0.333 for the best model operating on only gait features and 0.372 for the top ST-GCN model that used both joint trajectories and gait features as input. When accepting predicted scores that were only off by at most 1 point on the UPDRS-gait scale, the accuracy of the model that only used gait features was 82.8%, while the model that also used joint trajectories had an accuracy of 94.2%.Clinical Relevance- The combination of gait features and joint trajectories capture parkinsonian qualities in gait better than either group of data individually.

Background: Many of the available gait monitoring technologies are expensive, require specialized expertise, are time consuming to use, and are not widely available for clinical use. The advent of video-based pose tracking provides an opportunity for inexpensive automated analysis of human walking in older adults using video cameras. However, there is a need to validate gait parameters calculated by these algorithms against gold standard methods for measuring human gait data in this population., Methods: We compared quantitative gait variables of 11 older adults (mean age = 85.2) calculated from video recordings using three pose trackers (AlphaPose, OpenPose, Detectron) to those calculated from a 3D motion capture system. We performed comparisons for videos captured by two cameras at two different viewing angles, and viewed from the front or back. We also analyzed the data when including gait variables of individual steps of each participant or each participant's averaged gait variables., Results: Our findings revealed that, i) temporal (cadence and step time), but not spatial and variability gait measures (step width, estimated margin of stability, coefficient of variation of step time and width), calculated from the video pose tracking algorithms correlate significantly to that of motion capture system, and ii) there are minimal differences between the two camera heights, and walks viewed from the front or back in terms of correlation of gait variables, and iii) gait variables extracted from AlphaPose and Detectron had the highest agreement while OpenPose had the lowest agreement., Conclusions: There are important opportunities to evaluate models capable of 3D pose estimation in video data, improve the training of pose-tracking algorithms for older adult and clinical populations, and develop video-based 3D pose trackers specifically optimized for quantitative gait measurement., (© 2021. The Author(s).)

Whether higher variability in older adults' walking is an indication of increased instability has been challenged recently. We performed a computer simulation to investigate the effect of sensorimotor noise on the kinematic variability and stability in a biped walking model. Stochastic differential equations of the system with additive Gaussian white noise was constructed and solved. Sensorimotor noise mainly resulted in higher kinematic variability but its influence on gait stability is minimal. This implies that kinematic variability evident in walking gaits of older adults could be the result of internal sensorimotor noise and not an indication of instability.

Over the past few decades, different inhibitory receptors have been identified, which have played prominent roles in reducing anti-tumor immune responses. The role of immune checkpoint inhibitors in cancer was revealed by critical blockade of the cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) and programmed cell death protein-1 (PD-1) checkpoints. Immune checkpoint inhibitors, including anti-PD-1 (nivolumab and pembrolizumab), anti-PD-L1 (Atezolizumab, avelumab, and duravulumab), and anti-CTLA-4 (ipilimumab, tremelimumab), are currently FDA-approved treatment options for a broad range of cancer types. However, regarding immunotherapy advances in recent years, most studies have been focused on finding the antibodies against other inhibitory immune checkpoints in the tumor microenvironment such as lymphocyte activation gene-3 (LAG-3), T cell immunoglobulin, and mucin domain 3 (TIM-3), B7-homolog 3 (B7-H3), V-domain immunoglobulin-containing suppressor of T-cell activation (VISTA), diacylglycerol kinase-α (DGK-α), T cell immunoglobulin and ITIM domain (TIGIT), and B and T lymphocyte attenuator (BTLA). This immune checkpoint exerts differential inhibitory impacts on various types of lymphocytes. The suppression of immune responses demonstrates a surprising synergy with PD-1. Therefore, most antibodies against these immune checkpoints are undertaking clinical trials for cancer immunotherapy of advanced solid tumors and hematologic malignancies. In this review, we will summarize recent findings of immune checkpoint and the role of monoclonal antibodies in cancer immunotherapy targeting these receptors., (Copyright © 2021 Elsevier GmbH. All rights reserved.)

Cutaneous squamous cell carcinoma (cSCC) ranks second in the frequency of all skin cancers. The balance between keratinocyte proliferation and differentiation is disrupted in the pathological development of cSCC. DLX3 is a homeobox transcription factor which plays pivotal roles in embryonic development and epidermal homeostasis. To investigate the impact of DLX3 expression on cSCC prognosis, we carried out clinicopathologic analysis of DLX3 expression which showed statistical correlation between tumors of higher pathologic grade and levels of DLX3 protein expression. Further, Kaplan-Meier survival curve analysis demonstrated that low DLX3 expression correlated with poor patient survival. To model the function of Dlx3 in skin tumorigenesis, a two-stage dimethylbenzanthracene (DMBA)/12-O-tetradecanoylphorbol 13-acetate (TPA) study was performed on mice genetically depleted of Dlx3 in skin epithelium (Dlx3cKO). Dlx3cKO mice developed significantly more tumors, with more rapid tumorigenesis compared to control mice. In Dlx3cKO mice treated only with DMBA, tumors developed after ~16 weeks suggesting that loss of Dlx3 has a tumor promoting effect. Whole transcriptome analysis of tumor and skin tissue from our mouse model revealed spontaneous activation of the EGFR-ERBB2 pathway in the absence of Dlx3. Together, our findings from human and mouse model system support a tumor suppressive function for DLX3 in skin and underscore the efficacy of therapeutic approaches that target EGFR-ERBB2 pathway.

Single-cell RNA sequencing (scRNA-seq) of tissues has revealed remarkable heterogeneity of cell types and states but does not provide information on the spatial organization of cells. To better understand how individual cells function within an anatomical space, we developed XYZeq, a workflow that encodes spatial metadata into scRNA-seq libraries. We used XYZeq to profile mouse tumor models to capture spatially barcoded transcriptomes from tens of thousands of cells. Analyses of these data revealed the spatial distribution of distinct cell types and a cell migration-associated transcriptomic program in tumor-associated mesenchymal stem cells (MSCs). Furthermore, we identify localized expression of tumor suppressor genes by MSCs that vary with proximity to the tumor core. We demonstrate that XYZeq can be used to map the transcriptome and spatial localization of individual cells in situ to reveal how cell composition and cell states can be affected by location within complex pathological tissue., (Copyright © 2021 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution License 4.0 (CC BY).)

Objectives: To develop a prognostic model to predict the probability of a short-term fall (within the next 7 to 30 days) in older adults with dementia., Design: Prospective observational study., Setting and Participants: Fifty-one individuals with dementia at high risk of falls from a specialized dementia inpatient unit., Methods: Clinical and demographic measures were collected and a vision-based markerless motion capture was used to record the natural gait of participants over a 2-week baseline. Falls were tracked throughout the length of stay. Cox proportional hazard regression analysis was used to build a prognostic model to determine fall-free survival probabilities at 7 days and at 30 days. The model's discriminative ability was also internally validated., Results: Fall history and gait stability (estimated margin of stability) were statistically significant predictors of time to fall and included in the final prognostic model. The model's predicted survival probabilities were close to observed values at both 7 and 30 days. The area under the receiver operating curve was 0.80 at 7 days, and 0.67 at 30 days and the model had a discrimination performance (the Harrel concordance index) of 0.71., Conclusions and Implications: Our short-term falls risk model had fair to good predictive and discrimination ability. Gait stability and recent fall history predicted an imminent fall in our population. This provides some preliminary evidence that the degree of gait instability may be measureable in natural everyday gait to allow dynamic falls risk monitoring. External validation of the model using a separate data set is needed to evaluate model's predictive performance., (Copyright © 2020 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

Measures of gait center of pressure (COP) can be recorded using simple available technologies in clinical settings and thus can be used to characterize gait quality in older adults and its relationship to falls. The aim of this systematic review was to investigate the association between measures of gait COP and aging and falls. A comprehensive search of electronic databases including MEDLINE, Embase, Cochrane Central Register of Controlled Trials, CINAHL (EBSCO), Ageline (EBSCO) and Scopus was performed. The initial search yielded 2809 papers. After removing duplicates and applying study inclusion/exclusion criteria, 34 papers were included in the review. Gait COP has been examined during three tasks: normal walking, gait initiation, and obstacle negotiation. The majority of studies examined mean COP position and velocity as outcome measures. Overall, gait in older adults was characterized by more medial COP trajectory in normal walking and lower average anterior-posterior and medio-lateral COP displacements and velocity in both gait initiation and obstacle crossing. Moreover, findings suggest that Tai chi training can enhance older adults' balance control during gait initiation as demonstrated by greater COP backward, medial and forward shift in all three phases of gait initiation. These findings should be interpreted cautiously due to inadequacy of evidence as well as methodological limitations of the studies such as small sample size, limited numbers of 'fallers', lack of a control group, and lack of interpretation of COP outcomes with respect to fall risk. COP measures can be adopted to assess fall-related gait changes in older adults but more complex measures of COP that reveal the dynamic nature of COP behavior in step-to-step variations are needed to adequately characterize gait changes in older adults., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Salvia mirzayanii contains anti-hyperglycemic, antimicrobial, antioxidant, anti-inflammatory, and neuroprotective effects. The purpose of this study was to evaluate the anti-leishmanial efficacy of aqueous and alcoholic extracts of S. mirzayanii (both in vitro and in vivo) against Leishmania major. Aqueous and alcoholic extracts of S. mirzayanii were prepared and tested on L. major promastigotes and amastigotes. MTT test was used to evaluate the cytotoxicity of the plant against L. major. Flow cytometry was performed to assay apoptosis induced by 50 and 100 μg/ml of extracts on the promastigotes and macrophages. For the in vivo assay, the therapeutic effects of aqueous and alcoholic extracts of S. mirzayanii were tested in BALB/c mice. After 72 h, the IC50 value of aqueous and alcoholic extracts of S. mirzayanii against L. major promastigotes was 6.04 and 4.47, respectively. The inhibitory concentration (IC50) of aqueous and alcoholic extracts of S. mirzayanii to amastigotes were determined to be 47.78 μg/ml and 33.58 μg/ml, respectively. Flow cytometry revealed that the apoptosis of promastigotes using 100 μg/ml of aqueous and alcoholic extracts of S. mirzayanii was 5.81% and 5.39%, respectively, while apoptosis induced at 200 μg/ml were 5.09% and 70.71%, respectively. Lesion size was significantly decreased in in vivo experiments, and the survival rate of the treated mice improved in contrast to the control group. Given the efficacy of aqueous and alcoholic extracts of S. mirzayanii on promastigotes both in vitro and in vivo condition, the plant could be considered as a candidate source for the treatment of leishmaniosis.

Reverse electrodialysis (RED) is a promising process for harvesting energy from the salinity gradient between two solutions without environmental impacts. Seawater (SW) and river water (RW) are considered the main RED feed solutions because of their good availability. In Okinawa Island (Japan), SW desalination via the reverse osmosis (RO) can be integrated with the RED process due to the production of a large amount of RO brine (concentrated SW, containing ~1 mol/dm 3 of NaCl), which is usually discharged directly into the sea. In this study, a pilot-scale RED stack, with 299 cell pairs and 179.4 m 2 of effective membrane area, was installed in the SW desalination plant. For the first time, asymmetric monovalent selective membranes with monovalent selective layer just at the side of the membranes were used as the ion exchange membranes (IEMs) inside the RED stack. Natural and model RO brines, as well as SW, were used as the high-concentrate feed solutions. RW, which was in fact surface water in this study and close to the desalination plant, was utilized as the low-concentrate feed solution. The power generation performance investigated by the current-voltage (I-V) test showed the maximum gross power density of 0.96 and 1.46 W/m 2 respectively, when the natural and model RO brine/RW were used. These are a 50-60% improvement of the maximum gross power of 0.62 and 0.97 W/m 2 generated from the natural and model SW, respectively. The approximate 50% more power generated from the model feed solutions can be assigned to the suppression of concentration polarization of the RED stack due to the absence of multivalent ions.

Objectives: Functional imaging presents a non-invasive process that may capture the hyper-metabolic nature of red bone marrow in myeloproliferative neoplasms, such as polycythemia vera (PV)., Methods: This study analyzed the FDG-PET/CT scans (n=12) of six patients diagnosed with PV and six age-sex matched controls using a quantitative global analysis methodology., Results: All PV patients had elevated activities in the bone marrow of each skeletal structure as compared to matched controls with respect to mean standardized uptake value (femoral neck p=0.01, lumbar spine p=0.02, pelvis p=0.002, sternum p=0.04). Notable variations in splenic uptake were observed among the treated and untreated PV patients., Conclusion: Our study exemplifies the potential utility of PET in reflecting hyperactive bone marrow activity related to PV. Future studies may further substantiate and elaborate on the use of PET-derived metabolic data in PV., Competing Interests: The authors declare no conflict of interest., (© 2020 mums.ac.ir All rights reserved.)

Objectives: We aimed to assess the association between blood pressure and LV myocardial uptake of FDG, hypothesizing that subjects with raised blood pressure would have higher FDG uptake., Methods: We analyzed 86 healthy controls who underwent PET/CT imaging 180 minutes following FDG (4 MBq/Kg) administration. LV myocardial analysis was performed on axial sections using standard operator guided computer software (OsiriX MD). The average LV myocardial SUV mean (MSUV mean ) was calculated for each subject. Subjects were assessed according to the 2017 ACC/AHA guidelines for high blood pressure in adults. Mean arterial blood pressure (MABP) was calculated for each patient. Regression models were employed for statistical analysis., Results: The association of MSUV mean was more pronounced with DP (r=0.32, p=0.003) than SP (r=0.28, p=0.010); MABP was comparable (r=0.33, p=0.002). Correlations of MSUV mean with categorized BPs were: normal SP (r=0.27, p=0.010), elevated SP (r=0.28, p=0.009), stage 1 SP (r=0.27, p=0.010), stage 2 SP (r=0.28, p=0.008); normal DP (r=0.33, p=0.001), stage 1 DP (r=0.34, p=0.001), stage 2 DP (r=0.35, p=0.001). Multivariate analysis demonstrated DP (p=0.006), MABP (p=0.007), and SP (0.026)., Conclusion: LV myocardial FDG uptake was higher in subjects with elevated blood pressure and correlated positively with SBP and in particular DBP and MABP., Competing Interests: The authors declare that they have no conflicts of interest., (© 2020 mums.ac.ir All rights reserved.)

The practical application of dual-time-point-imaging (DTPI) technique still remains controversial. One of the issues is that current parameters of DTPI quantification suffer from some deficiencies, mainly limited sampling of the diseased sites by confining measurements to specific locations. We aimed to examine the correlation between the percent change from early to delayed scans in whole-bone marrow (WBM) 18 F-FDG uptake, as measured by a CT-based method of PET/CT quantification, and response to treatment in multiple myeloma (MM) patients. Pre-treatment 18 F-FDG-PET/CT scans of 36 newly diagnosed MM patients were collected in a prospective study at 1 h and 3 h post tracer injection (NCT02187731). A threshold algorithm based on bone Hounsfield units on CT was applied to segment and quantify WBM 18 F-FDG uptake. Patients were separated into two treatment groups: high-dose therapy with autologous stem cell transplant (HDT) and non-high dose therapy (non-HDT). The International Response Criteria for MM patients was used to determine each patient's response to treatment. In the HDT group, WBM 18 F-FDG uptake increased significantly in patients that had a poor response to treatment, from a median of 1.31 (IQR: 1.13-1.64) at 1 h to a median of 1.85 (1.45-2.10) at 3 h. The median percent change was 37.77% (IQR: 23.47-46.4), with a range of 6.10-50.73 ( P = 0.003). However, no significant change in uptake was observed in patients with a complete response ( P = 0.24). The same trend was observed for the non-HDT group. WBM uptake of 18 F-FDG assessed with dual-time-point imaging may have a role in predicting treatment response in MM., Competing Interests: None., (AJNMMI Copyright © 2020.)

Patients with cancer with liver metastasis demonstrate significantly worse outcomes than those without liver metastasis when treated with anti-PD-1 immunotherapy. The mechanism of liver metastases-induced reduction in systemic antitumor immunity is unclear. Using a dual-tumor immunocompetent mouse model, we found that the immune response to tumor antigen presence within the liver led to the systemic suppression of antitumor immunity. The immune suppression was antigen specific and associated with the coordinated activation of regulatory T cells (T regs ) and modulation of intratumoral CD11b + monocytes. The dysfunctional immune state could not be reversed by anti-PD-1 monotherapy unless T reg cells were depleted (anti-CTLA-4) or destabilized (EZH2 inhibitor). Thus, this study provides a mechanistic understanding and rationale for adding T reg and CD11b + monocyte targeting agents in combination with anti-PD-1 to treat patients with cancer with liver metastasis., (Copyright © 2020 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.)

During pregnancy, the fetal-maternal interface underlies several dynamic alterations to permit the fetus to be cultivated and developed in the uterus, in spite of being identifies by the maternal immune system. A large variety of decidual leukocyte populations, including natural killer cells, NKT cells, innate lymphoid cells, dendritic cells, B cells, T cells, subpopulations of helper T cells play a vital role in controlling the trophoblast invasion, angiogenesis as well as vascular remodeling. In contrast, several regulatory immunosuppressive mechanisms, including regulatory T cells, regulatory B cells, several cytokines and mediators are involved in maintain the homeostasis of immune system in the fetal-maternal interface. Nonetheless, aberrant alterations in the balance of immune inflammatory or immunosuppressive arms have been associated with various pregnancy losses and infertilities. As a result, numerous strategies have been developed to revers dysregulated balance of immune players to increase the chance of successful pregnancy. Lymphocyte immunotherapy has been developed through utilization of peripheral white blood cells of the husband or others and administered into the mother to confer an immune tolerance for embryo's antigens. However, the results have not always been promising, implying to further investigations to improve the approach. This review attempts to clarify the involvement of lymphocytes in contributing to the pregnancy outcome and the potential of lymphocyte immunotherapy in treatment of infertilities with dysregulated immune system basis., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)