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Background/Objectives Radiotherapy (RT) is a component of therapy for head and neck cancer (HNC) with a negative nutritional impact. Our aim was to compare an early versus a conventional nutritional intervention. Subjects and methods Retrospective study of HNC patients undergoing RT. Evolution before and after the establishment of a fast-track circuit was evaluated. A conventional group (CG) made up of patients submitted to the nutrition unit during RT after nutritional deterioration, was compared to an early group (EG) represented by patients included in a fast-track circuit, starting nutritional follow-up before the beginning of RT. Only patients with preserved oral intake were involved. Demographic, nutritional and clinical variables were analyzed. Data of hospitalizations and deaths were collected up to three months after RT. Results 135 subjects constituted the EG and 39 the CG. At baseline, the prevalence of malnutrition was lower in the EG (31.9% vs 69.5%, p = 0.0001), as was the need for nutritional supplements (40% vs 79.5%, p = 0.0001) or nasogastric tube (0% vs 12.8%, p = 0.0001) in comparison to the CG. Three months after RT, there were less patients with oral nutritional support in the EG (79.1% vs 96.9%, p = 0.018), and the number of emergency visits (0.75 vs 1.1 episodes per patient, p = 0.021) and hospitalizations was also lower in this group (29% vs 59%, p = 0.044). Conclusions The fast-track approach made early intervention possible. Therefore, patients maintained a better nutritional status, needed less nutritional support and their evolution improved, with a significant decrease in hospitalizations., Author(s): M. González-Rodríguez [sup.1] , R. Villar-Taibo [sup.1] , A. Fernández-Pombo [sup.1] , M. Pazos-Couselo [sup.1] [sup.2] , M. A. Sifontes-Dubón [sup.1] , S. Ferreiro-Fariña [sup.1] , A. Cantón-Blanco [sup.1] [...]

Li-Fraumeni-syndrome (LFS) is a rare, highly penetrant cancer predisposition syndrome (CPS) caused by pathogenic variants (PVs) in TP53. Physical activity (PA) and a Mediterranean diet lead to cancer reduction or survival benefits and increased quality of life (QoL), but this is yet unstudied among LFS. TP53 PV carriers (PVC) and their relatives were questioned on dietary patterns (Mediterranean Diet Adherence Screener), PA (Freiburg Questionnaire), QoL (Short-form-Health-Survey-12), smoking, alcohol consumption and perception of cancer risk in a German bi-centric study from March 2020–June 2021. The study enrolled 70 PVC and 43 relatives. Women compared to men (6.49 vs. 5.38, p = 0.005) and PVC to relatives (6.59 vs. 5.51; p = 0.006) showed a healthier diet, associated with participation in surveillance (p = 0.04) and education (diet p = 0.02 smoking p = 0.0003). Women smoked less (2.91 vs. 5.91 packyears; p = 0.03), psychological well-being was higher among men (SF-12: males 48.06 vs. females 41.94; p = 0.004). PVC rated their own cancer risk statistically higher than relatives (72% vs. 38%, p < 0.001) however, cancer risk of the general population was rated lower (38% vs. 70%, p < 0.001). A relative’s cancer-related death increased the estimated personal cancer risk (p = 0.01). The possibilities of reducing cancer through self-determined health behavior among PVC and relatives has not yet been exhausted. Educating families with a CPS on cancer-preventive behavior requires further investigation with regard to acceptance and real-life implementation.

Introduction: Undocumented immigrants are excluded from benefits that help compensate for scheduled outpatient hemodialysis (HD), compelling them to use emergency departments (ED) for HD. Consequently, these patients can receive “emergency-only” HD after presenting to the ED with critical illness due to untimely dialysis. Our objective was to describe the impact of emergency-only HD on hospital cost and resource utilization in a large academic health system that includes public and private hospitals. Methods: This retrospective observational study of health and accounting records took place at five teaching hospitals (one public, four private) over 24 consecutive months from January 2019 to December 2020. All patients had emergency and/or observation visits, renal failure codes (International Classification of Diseases, 10th Rev, Clinical Modification), emergency HD procedure codes, and an insurance status of “self-pay.” Primary outcomes included frequency of visits, total cost, and length of stay (LOS) in the observation unit. Secondary objectives included evaluating the variation in resource use between persons and comparing these metrics between the private and public hospitals. Results: A total of 15,682 emergency-only HD visits were made by 214 unique persons, for an average of 36.6 visits per person per year. The average cost per visit was $1,363, for an annual total cost of $10.7 million. The average LOS was 11.4 hours. This resulted in 89,027 observation-hours annually, or 3,709 observation-days. The public hospital dialyzed more patients compared to the private hospitals, especially due to repeat visits by the same persons. Conclusion: Health policies that limit hemodialysis of uninsured patients to the ED are associated with high healthcare costs and a misuse of limited ED and hospital resources.

Therapeutic methods to modulate skin pigmentation has important implications for skin cancer prevention and for treating cutaneous hyperpigmentary conditions. Towards defining new potential targets, we followed temporal dynamics of melanogenesis using a cell-autonomous pigmentation model. Our study elucidates 3 dominant phases of synchronized metabolic and transcriptional reprogramming. The melanogenic trigger is associated with high MITF levels along with rapid uptake of glucose. The transition to pigmented state is accompanied by increased glucose channelisation to anabolic pathways that support melanosome biogenesis. SREBF1-mediated up-regulation of fatty acid synthesis results in a transient accumulation of lipid droplets and enhancement of fatty acids oxidation through mitochondrial respiration. While this heightened bioenergetic activity is important to sustain melanogenesis, it impairs mitochondria lately, shifting the metabolism towards glycolysis. This recovery phase is accompanied by activation of the NRF2 detoxication pathway. Finally, we show that inhibitors of lipid metabolism can resolve hyperpigmentary conditions in a guinea pig UV-tanning model. Our study reveals rewiring of the metabolic circuit during melanogenesis, and fatty acid metabolism as a potential therapeutic target in a variety of cutaneous diseases manifesting hyperpigmentary phenotype.

The purpose of this study is evaluate and compare technical efficiency of water users association by the approach of the stochastic frontier production function in Maragheh county. Accordingly, for scientific and real understanding of the performance of these associations, the efficiency of productive units is considered. In order to perform this study, the required data were collected through a questionnaire from 147 farmers of Maragheh County. To achieve the aim of this research, stochastic frontier production function was used in which farmers was a function of seed variables, nitrogen fertilizer, phosphate fertilizer and water. Results showed which average efficiency of producing in wheat fields of the sample is 78.9%. So on these farms with available inputs, there is an average of 21.1% chance to increasing the production. Based on the results, it is observed that in a stochastic frontier production function, nitrogen fertilizers,hosphate fertilizers, water and wheat seeds Variables have a significant effect on wheat production. Also Variables such as age, education, participation in extension courses, marriage and cultivating have a significant effect on technical efficiency. Between studied cases, Varjoy water users association, with average efficiency about 83.07%, has the highest technical efficiency. Therefore, participation in extension courses, adopting measures on land integration and benefiting from the experiences of successful Water Users Association will be an important step towards increasing the efficiency of the Water Users Association studied.

Background: Cobalt toxicity-related cardiomyopathy in hip arthroplasty has recently been reported in the literature. The purpose of this review is to identify and assess available published evidence of cardiomyopathy in hip arthroplasty patients and to derive recommendations for management. Methods: We evaluated 23 cases reported until October 2018 and stratified them into 3 categories, based upon pre-existing risk factors for cardiomyopathy, histological confirmation, and evidence of systemic signs of cobalt toxicity. Results: Cobalt toxicity was considered to be the definite cause of cardiomyopathy in 8 cases, and probably contributory in 13 cases. Two cases were considered to have developed cardiomyopathy secondary to pre-existing risk factors. Majority of the patients had a good recovery of cardiac function after hip revision and cardiac management, but 5 cases deteriorated and died. Conclusions: Although cobalt-related cardiomyopathy has been reported in a small number of cases of hip arthroplasty, a delay or missed diagnosis may lead to significant morbidity and mortality. Timely diagnosis, removal of causative implant, and avoidance of metal articulations in revision for fractured ceramic implants may help in an effective management. Keywords: Cardiomyopathy, Cobalt, Metal-on-metal, Hip arthroplasty, Toxicity

The rapid developments in transition metal dichalcogenide materials as a saturable absorber (SAs) have been demonstrated to be an effective method for generating Q-switched fiber laser. This work, reports on the generation of Q-switched fiber laser in the 1-micron region using samarium oxide (Sm2O3) saturable absorber (SA). The Sm2O3 thin film SA was fabricated in- The rapid developments in transition metal dichalcogenide materials as saturable absorbers (SAs) have been reported to be efficient materials for generating Q?switched fiber lasers. In this paper, we report on the use of samarium oxide (Sm2O3) saturable absorber (SA) for 1-micron Q-switched fiber laser generation. The Sm2O3 thin film SA was constructed in-house through which the Sm2O3 powder was mixed and stirred in polyvinyl alcohol (PVA) solution. It was then integrated into the ytterbium-doped fiber laser (YDFL) ring cavity, hence producing a sequence of Q-switched pulsed lasers at 1062.49 nm wavelength. The stable pulse train appeared from 69.97 to 111.1 kHz between the applied pump power of 57 mW to 96 mW. The signal-to-noise ratio (SNR) of 38.56 dB was recorded at the 57 mW pump power, whereas the pulse energy raised until 15.21 nJ at 96 mW. These results showed that the Sm2O3 could be a favourable SA material to iniatiate Q-switched ytterbium-doped pulsed fiber laser. ABSTRAK: Perkembangan pesat dalam bahan logam peralihan dichalcogenide sebagai bahan penyerap boleh larut (SAs) telah dilaporkan sebagai kaedah yang berkesan bagi menjana laser fiber Q-switched. Kajian ini menggunakan samarium oksida (Sm2O3) saturable absorber (SA) bagi menjana laser gentian Q-switched 1-Micron. Filem nipis Sm2O3 SA telah dihasilkan melalui campuran serbuk Sm2O3 ke dalam cecair polivinil alkohol (PVA) dalam persekitaran makmal. Kemudian, ia diintegrasi ke dalam rongga gelang laser gentian dop-ytterbium (YDFL), lalu menghasilkan denyut laser Q-switched stabil pada jarak gelombang 1062.49 nm. Denyutan stabil muncul dari 69.97 kepada 111.1 kHz pada kuasa pam yang dikenakan antara 57 mW hingga 96 mW. Nisbah isyarat-hinggar (SNR) pada 38.56 dB telah direkodkan pada pam kuasa 57 mW, sementara denyut tenaga ditingkatkan kepada 15.21 nJ pada 96 mW. Keputusan menunjukkan Sm2O3 merupakan bahan SA penggalak yang memuaskan bagi menjana denyut laser gentian dop-ytterbium Q-switched. house. It was integrated into the ytterbium-doped fiber laser (YDFL) ring cavity, hence producing a stable passively Q-switched laser operating at 1062.49 nm wavelength. Stable pulse train appeared from 69.97 to 111.1 kHz at the tunable pump power of 57 mW to 96 mW. The pulse energy of up to 15.21 nJ and signal-to-noise ratio (SNR) of 38.56 dB for the fundamental frequency were recorded. The results showed that the Sm2O3 could be a favourable SA material for the broadband generation of Q-switched fiber laser.

Background: Cobalt (Co) toxicity-related cardiomyopathy (CMP) in hip arthroplasty has recently been reported in the literature. The purpose of this review was to identify and assess available published evidence of CMP in hip arthroplasty patients and to derive recommendations for management. Methods: We evaluated 23 cases reported till October 2018 and stratified into three categories, based on pre-existing risk factors for CMP, histological confirmation and evidence of systemic signs of Co toxicity. Results: Co toxicity was considered to be the definite cause of CMP in 8 cases and probably contributory in 13 cases. Two cases were considered to have developed CMP secondary to pre-existing risk factors. Majority of the patients had good recovery of cardiac function after hip revision and cardiac management, but five cases deteriorated and died. Conclusion: Although Co-related CMP has been reported in a small number of cases of hip arthroplasty, a delay or missed diagnosis may lead to significant morbidity and mortality. Timely diagnosis, removal of causative implant and avoidance of metal articulations in revision for fractured ceramic implants may help in effective management.

Der Einsatz von Open Educational Resources (OER) im deutschen Bildungssystem wird mit zunehmender Tendenz diskutiert (s. KMK 2015; HRK 2016). Im Hochschulsystem gibt es bisher jedoch kaum breitenwirksame Erfahrungen mit frei zugänglichen bzw. frei lizenzierten Lehr-/ Lernmaterialien. Insbesondere in den Auseinandersetzungen zur wissenschaftlichen Weiterbildung ist der Einsatz von OER bisher selten im Fokus (vgl. Blees et al. 2015). Gleichwohl gibt es in diesem Sektor spezielle Gelingensbedingungen und strategierelevante Optionen bei der Einbindung von OER. Der Artikel setzt sich mit den grundlegenden Aspekten auseinander, die bei der Implementierung von OER in der wissenschaftlichen Weiterbildung und in dazugehörigen Fernstudienszenarien von Bedeutung sind. Es werden – u.a. flankiert durch Ergebnisse einer Befragung von Akteuren – Chancen und Herausforderungen in Bezug auf OER aufgezeigt und diskutiert.

Zircaloy-4 was found to be susceptible to stress corrosion cracking in 1 M NaCl, 1 M KBr and 1 M KI aqueous solutions at potentials above the pitting potential. In all the solutions tested crack propagation was initially intergranular and then changed to transgranular. The effect of strain rate and temperature on the SCC propagation was investigated. An increase in the strain rate was found to lead to an increase in the crack propagation rate. The crack propagation rate increases in the three solutions tested as the temperatures increases between 20 and 90 °C. The Surface-Mobility SCC mechanism accounts for the observation made in the present work, and the activation energy predicted in iodide solutions is similar to that found in the literature.

The present work is a study of the corrosion susceptibility of steel drums in contact with cemented ion-exchange resins contaminated with different types and concentrations of aggressive species. A special type of specimen was manufactured to simulate the cemented ion-exchange resins in the drum. The evolution of the corrosion potential and the corrosion rate of the steel, as well as the electrical resistivity of the matrix were monitored over a time period of 900 days. The aggressive species studied were chloride ions (the main ionic species of concern) and sulphate ions (produced during radiolysis of the cationic exchange-resins after cementation). The work was complemented with an analysis of the corrosion products formed on the steel in each condition, as well as the morphology of the corrosion products. When applying the results obtained in the present work to estimate the corrosion depth of the steel drumscontaining the cemented radioactive waste after a period of 300 years (foreseen durability of the Intermediate Level Radioactive Waste facility in Argentina) , it is found that in the most unfavourable case (high chloride contamination), the corrosion penetration will be considerably lower than the thickness of the wall of the steel drums.

Ensuring the sustainability and circularity of mixed crop-ruminant livestock systems is essential if they are to deliver on the enhancement of long-term productivity and profitability with a smaller footprint. The objectives of this study were to select indicators in the environmental, economic and social dimensions of sustainability of crop-livestock systems, to assess if these indicators are relevant in the operational schedule of farmers, and to score the indicators in these farm systems. The scoring system was based on relevance to farmers, data availability, frequency of use, and policy. The study was successful in the assemblage of a suite of indicators comprising three dimensions of sustainability and the development of criteria to assess the usefulness of these indicators in crop-ruminant livestock systems in distinct agro-climatic regions across the globe. Except for ammonia emissions, indicators within the Emissions to air theme obtained high scores, as expected from mixed crop-ruminant systems in countries transitioning towards low emission production systems. Despite the inherent association between nutrient losses and water quality, the sum of scores was numerically greater for the former, attributed to a mix of economic and policy incentives. The sum of indicator scores within the Profitability theme (farm net income, expenditure and revenue) received the highest scores in the economic dimension. The Workforce theme (diversity, education, succession) stood out within the social dimension, reflecting the need for an engaged labor force that requires knowledge and skills in both crop and livestock husbandry. The development of surveys with farmers/stakeholders to assess the relevance of farm-scale indicators and tools is important to support direct actions and policies in support of sustainable mixed crop-ruminant livestock farm systems., 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 © 2024 Elsevier B.V. All rights reserved.)

Cluster helicates are a new type of supramolecular architecture that consists of a metal cluster wrapped around by ligands arranged in a helical mode. This class of compounds combines the unique properties of metal clusters with the sophisticated chiral arrangement found in helicates. Therefore, these architectures show promising applications in the development of advanced materials with specific electronic, magnetic, optical, catalytic and biological properties. This review delves into a few pioneering studies on cluster helicates and their applications as nanomagnetic, nanoelectric and catalyst materials. Furthermore, it emphasises the necessity for further exploration in this area and the fields related to the functional applications that cluster helicates can bring to the future of materials science.

The ligand design factors that may influence the isolation of metallosupramolecular helicates or mesocates still deserve to be investigated. In this sense, dinuclear nickel(II), copper(II) and zinc(II) compounds were obtained by electrochemical synthesis using a family of five Schiff base ligands, H 2 L n ( n = 1-5), derived from bisphenylmethane and functionalized with bulky tert -butyl groups in the periphery and ethyl groups in the spacer. Six of the new complexes were characterized by X-ray crystallography, thus demonstrating that the helicate structure is predominant in the solid state. 1 H NMR studies were performed for the zinc complexes to analyze if the helical architecture of the metal complexes is retained in solution. These studies reveal that the presence of a tert -butyl group in the ortho position with respect to the OH group is an essential factor identified for the existence of a helicate conformation in solution.