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Objective. Provide benchmarks for the rates of complications by type and timing. Study Design. Prospective multicenter database. Background. Complication rates following adult spinal deformity (ASD) surgery have been previously reported. However, the interplay between timing and complication type warrants further analysis. Methods. The data for this study were sourced from a prospective, multicenter ASD database. The date and type of complication were collected and classified into three severity groups (minor, major, and major leading to reoperation). Only complications occurring before the two-year visit were retained for analysis. Results. Of the 1260 patients eligible for two-year follow-up, 997 (79.1%) achieved two-year follow-up. The overall complication rate was 67.4% (N=672). 247 patients (24.8%) experienced at least one complication on the day of surgery (including intraoperatively), 359 (36.0%) between postoperative day 1 and six weeks postoperatively, 271 (27.2%) between six weeks and one-year postoperatively, and finally 162 (16.3%) between one year and two years postoperatively. Using Kaplan-Meier survival analysis, the rate of remaining complication-free was estimated at different time points for different severities and types of complications. Stratification by type of complication demonstrated that most of the medical complications occurred within the first 60 days. Surgical complications presented over two distinct timeframes. Operative complications, incision-related complications, and infections occurred early (within 60 d), while implant-related and radiographic complications occurred at a constant rate over the two-year follow-up period. Neurological complications had the highest occurrence within the first 60 days but continued to increase up to the two-year visit. Conclusion. Only one-third of ASD patients remained complication- free by two years, and 2 of 10 patients had a complication requiring a reoperation or revision. An estimation of the timing and type of complications associated with surgical treatment may prove useful for more meaningful patient counseling and aid in assessing the cost-effectiveness of treatment. [ABSTRACT FROM AUTHOR]

Patients with cardiovascular diseases who experience disease‐related short‐term events, such as hospitalizations, often exhibit diverse long‐term survival outcomes compared to others. In this study, we aim to improve the prediction of long‐term survival probability by incorporating two short‐term events using a flexible varying coefficient landmark model. Our objective is to predict the long‐term survival among patients who survived up to a pre‐specified landmark time since the initial admission. Inverse probability weighting estimation equations are formed based on the information of the short‐term outcomes before the landmark time. The kernel smoothing method with the use of cross‐validation for bandwidth selection is employed to estimate the time‐varying coefficients. The predictive performance of the proposed model is evaluated and compared using predictive measures: area under the receiver operating characteristic curve and Brier score. Simulation studies confirm that parameters under the landmark models can be estimated accurately and the predictive performance of the proposed method consistently outperforms existing methods that either do not incorporate or only partially incorporate information from two short‐term events. We demonstrate the practical application of our model using a community‐based cohort from the Atherosclerosis Risk in Communities (ARIC) study. [ABSTRACT FROM AUTHOR]

Summary: Background & Aims: The natural progression of hepatic decompensation in metabolic dysfunction‐associated steatotic liver disease (MASLD) is not well‐characterised. We aimed to describe it by conducting a retrospective analysis. Methods: This longitudinal, retrospective analysis of well‐characterised MASLD cohorts followed for hepatic decompensation and death. The sequence of liver‐related events was evaluated, and the median time between hepatic decompensation episodes and death versus. transplantation was measured. Results: Of the 2016 patients identified, 220 (11%) developed at least one episode of hepatic decompensation during a median follow‐up of 3.2 years. Ascites was the most common first liver‐related event [153 (69.5%)], followed by hepatic encephalopathy (HE) [55 (25%)] and variceal haemorrhage (VH) [30 (13.6%)]. Eighteen out of the 220 (8.1%) patients had more than one liver‐related event as their first hepatic decompensation. Among the patients who had the first episode, 87 (39.5%) had a second episode [44 (50.5%) HE, 31 (35.6%) ascites, and 12 (13.7%) VH]. Eighteen out of 220 (8.1%) had a third episode [10 (55.5%) HE, 6 (33.3%) VH, and 2 (11.1%) ascites]. Seventy‐three out of 220 (33.1%) died, and 31 (14%) received liver transplantation. The median time from the first episode to the second was 0.7 years and 1.3 years from the second episode to the third. The median survival time from the first episode to death or transplantation was 2.0 years. Conclusion: The most common first liver‐related event in MASLD patients is ascites. The median survival from the first hepatic decompensation to either death or transplantation is 2 years. [ABSTRACT FROM AUTHOR]

Background: Global life expectancy is rising, with the 60 + age group projected to hit 2 billion by 2050. Aging impacts the immune system. A notable marker of immune system aging is the presence of Aging-Related Immune Cell Phenotypes (ARIPs). Despite their importance, links between immune cell phenotypes including ARIPs and mortality are underexplored. We prospectively investigated 16 different immune cell phenotypes using flow cytometry and IL-6 in relation to survival outcome among dementia-free Framingham Heart Study (FHS) offspring cohort participants who attended the seventh exam (1998–2001). Results: Among 996 participants (mean age 62 years, range 40 to 88 years, 52% female), the 19-year survival rate was 65%. Adjusting for age, sex, and cytomegalovirus (CMV) serostatus, higher CD4/CD8 and Tc17/CD8 + Treg ratios were significantly associated with lower all-cause mortality (HR: 0.86 [0.76–0.96], 0.84 [0.74–0.94], respectively), while higher CD8 regulatory cell levels (CD8 + CD25 + FoxP3 +) were associated with increased all-cause mortality risk (HR = 1.17, [1.03–1.32]). Elevated IL-6 levels correlated with higher all-cause, cardiovascular, and non-cardiovascular mortality (HR = 1.43 [1.26–1.62], 1.70 [1.31–2.21], and 1.36 [1.18–1.57], respectively). However, after adjusting for cardiovascular risk factors and prevalent cancer alongside age, sex, and CMV, immune cell phenotypes were no longer associated with mortality in our cohort. Nonetheless, IL-6 remained significantly associated with all-cause and cardiovascular mortality (HRs: 1.3 [1.13–1.49], 1.5 [1.12–1.99], respectively). Conclusions: In 19-year follow-up, higher Tc17/CD8 + Treg and CD4/CD8 ratios were associated with lower all-cause mortality, while the CD8 + CD25 + FoxP3 + (CD8 + Treg) phenotype showed increased risk. Elevated IL-6 levels consistently correlated with amplified mortality risks. These findings highlight the links between immune phenotypes and mortality, suggesting implications for future research and clinical considerations. [ABSTRACT FROM AUTHOR]

Background: Osteosarcoma is a bone tumor that is characterized by high malignancy and a high mortality rate, and that originates from primitive osteoblastic mesenchymal cells and is most common in rapidly growing long bones. PSMD14, also known as RPN11 or POH1, is a member of the JAMM isopeptidase family, which is able to remove the substrate protein ubiquitination label, thereby regulating the stability and function of the substrate protein. In this study, we explored the expression and potential biological significance of the PSMD14 deubiquitinating enzyme in osteosarcoma. Methods: Immunohistochemical methods were used to detect the expression of PSMD14 in biopsies of 91 osteosarcoma patients, and the specimens were classified into high and low PSMD14 expression groups. The correlation between PSMD14 expression and clinical indicators and prognosis was compared.SiRNA was used to downregulate PSMD14 in two osteosarcoma cell lines (HOS and SJSA-1), and the effects of downregulation of PSMD14 on the viability, proliferation, and invasion ability of osteosarcoma cells were analyzed. Results: We identified significant differences in recurrence, metastasis, and survival time of the osteosarcoma patients on the basis of PSMD14 expression. High expression of PSMD14 in osteosarcoma patients was associated with a low survival rate and high risk of metastasis and recurrence. Down-regulation of PSMD14 inhibited the viability, proliferation, and invasiveness of osteosarcoma cell lines. Conclusions: PSMD14 may be a new prognostic marker and therapeutic target for osteosarcoma. [ABSTRACT FROM AUTHOR]

Refractory out-of-hospital cardiac arrest (OHCA) has a very poor prognosis, with survival rates at around 10%. Extracorporeal membrane oxygenation (ECMO) for patients in refractory arrest, known as ECPR, aims to provide perfusion to the patient whilst the underlying cause of arrest can be addressed. ECPR use has increased substantially, with varying survival rates to hospital discharge. The best outcomes for ECPR occur when the time from cardiac arrest to implementation of ECPR is minimised. To reduce this time, systems must be in place to identify the correct patient, expedite transfer to hospital, facilitate rapid cannulation and ECMO circuit flows. We describe the process of activation of ECPR, patient selection, and the steps that emergency department clinicians can utilise to facilitate timely cannulation to ensure the best outcomes for patients in refractory cardiac arrest. With these processes in place our survival to hospital discharge for OHCA patients is 35%, with most patients having a good neurological function. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions To assess the association among preoperative total testosterone levels, postoperative sexual function, and prognosis after robot‐assisted radical prostatectomy.Patients who underwent robot‐assisted radical prostatectomy in our institution were included in the study. Based on preoperative total testosterone levels, they were divided into low (<3.0 ng/mL) and high (≥3.0 ng/mL) total testosterone groups. Sexual function was evaluated using the International Index of Erectile Function scores, Expanded Prostate Cancer Index Composite scores, and the potency rate from preoperatively to 12 months after surgery. Oncological outcomes were evaluated based on biochemical recurrence.Out of 233 patients included, no significant difference in sexual function was found between the high (n = 183) and the low (n = 50) total testosterone groups at any point before or after surgery. However, in nerve‐sparing cases, preservation in postoperative sexual function was observed only in the high total testosterone group (International Index of Erectile Function scores and Expanded Prostate Cancer Index Composite sexual function scores, at any point after surgery, p < 0.05; potency rate, at 3, 6, and 12 months after surgery; p < 0.05). Additionally, the high total testosterone group showed better biochemical recurrence‐free survival than the low total testosterone group (p = 0.008).In the high total testosterone group, preservation in sexual function was observed after the nerve‐sparing procedure, while the biochemical recurrence rate was low. Therefore, patients with high levels of total testosterone may be advised to consider nerve‐sparing interventions. [ABSTRACT FROM AUTHOR]

Introduction: Glioblastoma, as the most common and lethal primary malignant brain tumor, has estimated mean survival of 15 months. GBM is reported more in men. Malignant glioma is the cause of 2.5% of cancer deaths. The standard therapy for patients with newly diagnosed GBM includes tumor resection surgeries, followed by radiotherapy and chemotherapy. The prognosis of glioma is a major challenge, and the outcome of GBM has remained almost unchanged for past years. The present study aimed to determine patient survival. Methods: Patients with glioblastoma tumors who visited Al-Zahra and Kashani hospitals from 2013 to 2021 were included in this study. All patients were classified with morphological codes according to the International Classification of Diseases for Oncology. The patients' information was recorded in the checklist, and then, the patients were followed up by phone. The data were measured regarding age, gender, exposure to chemicals, body mass index (BMI), and survival from the patient's surgery to death. Several questions were asked from the families of deceased patients and survivors based on the KPS Status Scale. Finally, the sample was analyzed with SPSS version 26. Result: The patient's mean age was 51.93 years, and the male–female ratio was 1:1.7. The patients' mean overall survival was 29 months and a total of 9 patients survived. There was a significant difference between the age groups in terms of 1-year survival so that more deaths were observed in the age group of more than 50 years. The mean tumor size was 5.2 ± 2.1 cm. The survival analysis indicated that the temporal lobe was more than the other in 2-year survival. The most common symptom of patients before surgery was headache (31.8%) followed by motor dysfunction. The 1-year, 2-year, 5-year, and overall survival of the patients was 4.5%, 18.38%, 37.13%, and 33.68%, respectively. Conclusions: The results of the present study indicated that the patients' survival improved over time with the advancement of adjuvant therapies. Therefore, if patients care get better for the first year after surgery, their survival will improve from the second year after the operation. [ABSTRACT FROM AUTHOR]

Rectal cancer affects almost every aspect of an individual's daily life. However, there are gaps in understanding the complete spectrum of experiences spanning from diagnosis to recovery. Therefore, the aim of this study was to explore the treatment trajectories of individuals diagnosed with rectal cancer. Adopting an interpretative phenomenological approach, seven participants were recruited using purposive sampling. Data were collected using semi-structured, in-depth interviews that were digitally recorded, transcribed and analysed using thematic analysis. Study rigour was established following the four-dimension criteria of credibility, dependability, transferability and confirmability. Four prominent themes emerged from the participants' experiences of undergoing rectal cancer treatment: uncovering the inner battles; navigating the physical challenges; anchors of support and conquering the summit. These findings contribute to knowledge and practice by highlighting the importance of providing a comprehensive and individualised treatment plan for individuals that takes account of the physical and psycho-emotional implications of rectal cancer treatment. [ABSTRACT FROM AUTHOR]

Kidney cancer is the 14th most common cancer globally. The 5-year relative survival rate of kidney cancer at a localized stage is 92.9% and it declines to 17.4% in metastatic stage. Currently, the most accurate method of its diagnosis is tissue biopsy. However, the invasive and costly nature of biopsies makes it undesirable in many patients. Therefore, novel biomarkers for diagnosis and prognosis should be explored. Urinary extracellular vesicles (uEVs) are small vesicles (50-200 nm) in urine carrying nucleic acids, proteins and lipids as their cargos. These uEVs' cargos can provide non-invasive alternative to monitor kidney health. In this review, we have summarized recent studies investigating potential use of uEVs' cargos as biomarkers in kidney cancer for diagnosis, prognosis and therapeutic intervention. [ABSTRACT FROM AUTHOR]

Background: National Malaria Programmes (NMPs) monitor the durability of insecticide-treated nets (ITNs) to inform procurement and replacement decisions. This is crucial for new dual active ingredients (AI) ITNs, for which less data is available. Pyrethroid-only ITN (Interceptor®) and dual AI (Interceptor® G2, and PermaNet® 3.0) ITNs were assessed across three health districts over 36 months in southern Burkina Faso to estimate median ITN survival, insecticidal efficacy, and to identify factors contributing to field ITN longevity. Methods: Durability was monitored through a prospective study of a cohort of nets distributed during the 2019 mass campaign. Three health districts were selected for their similar pyrethroid-resistance, environmental, epidemiological, and population profiles. Households were recruited after the mass campaign, with annual household questionnaire follow-ups over three years. Each round, ITNs were withdrawn for bioassays and chemical residue testing. Key measures were the percentage of cohort ITNs in serviceable condition, insecticidal effectiveness, and chemical residue content against target dose. Cox proportional hazard models were used to identify determinants influencing ITN survival. Results: At endline, the median useful life was 3.2 (95% CI 2.5–4.0) years for PermaNet® 3.0 ITNs in Orodara, 2.6 (95% CI 1.9–3.2) years for Interceptor® G2 ITNs in Banfora and 2.4 (95% CI 1.9–2.9) years for Interceptor® ITNs in Gaoua. Factors associated with ITN survival included cohort ITNs from Orodara (adjusted hazard ratio (aHR) = 0.58, p = 0.026), households seeing less rodents (aHR = 0.66, p = 0.005), female-headed households (aHR = 0.66, p = 0.044), exposure to social behavior change (SBC) messages (aHR = 0.52, ≤ 0.001) and folding nets when not in use (aHR = 0.47, p < 0.001). At endline, PermaNet® 3.0 ITN recorded 24-h mortality of 26% against resistant mosquitos on roof panels, with an 84% reduction in PBO content. Interceptor® G2 ITN 72-h mortality was 51%, with a 67% reduction in chlorfenapyr content. Interceptor® ITN 24-h mortality was 71%, with an 84% reduction in alpha-cypermethrin content. Conclusion: Only PermaNet® 3.0 ITNs surpassed the standard three-year survival threshold. Identified protective factors should inform SBC messaging. Significant decreases in chemical content and resulting impact on bioefficacy warrant more research in other countries to better understand dual AI ITN insecticidal performance. [ABSTRACT FROM AUTHOR]

Osmia solitary bees are important pollinators of various crops worldwide. Refrigeration has been widely used to synchronize the emergence time of Osmia species from cocoons with the blooming time of different crops, but the fitness of Osmia after refrigeration remains unknown. Here, the effects of long‐term refrigeration at 0 °C on the vitality, flight ability, and metabolism of Osmia excavata, which is known as the "king of pollination" in China, were studied. The survival rate (>90% before 120 d), weight loss rate (<15% after 170 d), and mean flight speed of O. excavata were not greatly affected after long‐term refrigeration. The content of fats, which have antifreeze and energy storage properties, was not significantly altered in O. excavata before 130 d of refrigeration, which might explain why the survival rates and flight speed of O. excavata remained high after long‐term refrigeration. However, the flight duration and distance decreased significantly (P < 0.05), and both were positively correlated with the reduced trehalose levels in O. excavata (r = [+0.69] – [+0.71]; P < 0.05). Overall, these findings indicate that the pollination potential of O. excavata for various crops with different flowering periods is high after long‐term refrigeration; however, long‐term refrigeration may decrease pollination efficiency. Our findings highlight new research directions that could improve the ecological service function of refrigerated O. excavata. [ABSTRACT FROM AUTHOR]

Due to innumerable confounding factors and a high number of types and brands of dental restorative materials, the clinical performance of restorative materials are sought predicted by various in vitro tests. However, only few such tests have been found to correlate well with clinical findings. Thus, the present study determined the in vitro dentin bond strength and marginal adaptation of Class II restorations and correlated the results to their clinical outcomes. Dentin bond strength (µTBS and µSBS) and marginal gap formation of Class II restorations (replica technique and SEM) were measured after 24 h and 6 m water storage using eight combinations of adhesive and resin composite. Clinical outcomes (mean survival time, Hazard Ratio, annual failure rate; n = 10.695) were gained from a data set of a retrospective multicenter study of direct restorations. Significant differences were found for dentin bond strength and marginal gap formation between the restorative material groups, and negative effects of long-term storage were observed. µTBS correlated significantly with certain clinical outcomes of Class I restorations, while µSBS correlated with certain clinical outcomes of Class II, III, IV and V restorations. Marginal gap formation in enamel and number of paramarginal fractures correlated with certain clinical outcomes of Class II restorations. Using the same restorative materials in vitro as in vivo, gave significant, but weak correlations between in vitro bond strength or marginal adaptation and clinical outcomes, lending support to the use of in vitro tests in early stages of material selection. • In vitro outcomes differed significantly between the restorative material groups. • µTBS correlated significantly with certain clinical outcomes of Class I restorations. • µSBS correlated with certain clinical outcomes of Class II - V restorations. • Marginal integrity parameters correlated with certain clinical outcomes of Class II restorations. • In vitro tests can predict clinical performance to some extent. [ABSTRACT FROM AUTHOR]

This study aimed to determine the accuracy and consistency of established methods of extrapolating mean survival for immuno-oncology (IO) therapies, the extent of any systematic biases in estimating long-term clinical benefit, what influences the magnitude of any bias, and the potential implications for health technology assessment. A targeted literature search was conducted to identify published long-term follow-up from clinical trials of immune-checkpoint inhibitors. Earlier published results were identified and Kaplan-Meier estimates for short- and long-term follow-up were digitized and converted to pseudo–individual patient data using an established algorithm. Six standard parametric, 5 flexible parametric, and 2 mixture-cure models (MCMs) were used to extrapolate long-term survival. Mean and restricted mean survival time (RMST) were estimated and compared between short- and long-term follow-up. Predicted RMST from extrapolation of early data underestimated observed RMST in long-term follow-up for 184 of 271 extrapolations. All models except the MCMs frequently underestimated observed RMST. Mean survival estimates increased with longer follow-up in 196 of 270 extrapolations. The increase exceeded 20% in 122 extrapolations. Log-logistic and log-normal models showed the smallest change with additional follow-up. MCM performance varied substantially with functional form. Standard and flexible parametric models frequently underestimate mean survival for IO treatments. Log-logistic and log-normal models may be the most pragmatic and parsimonious solutions for estimating IO mean survival from immature data. Flexible parametric models may be preferred when the data used in health technology assessment are more mature. MCMs fitted to immature data produce unreliable results and are not recommended. • Treatment with immune-checkpoint inhibitors can result in a proportion of patients achieving durable response, generating a long tail to the survival distribution. Conventional extrapolation methods applied to short-term data may not perform well in estimating mean survival in these circumstances. • Both standard parametric and spline-based flexible parametric models (FPMs) tend to underestimate survival benefit for immuno-oncology therapies. Performance seems to worsen as the proportion of durable responders increases. More flexible models perform better than restrictive models, but with some risk of overfitting to short-term data. Mixture-cure models fitted to early data cuts produce unreliable results and may substantially overestimate mean survival. • Log-logistic and log-normal models may be the most pragmatic and parsimonious solutions for estimating mean survival from short-term data when the proportion of durable responders is expected to be low. FPMs using odds or normal scale may be better options when the data used in health technology assessment are more mature. When the expected proportion of durable responders is high, neither standard nor FPMs are expected to perform well and methods integrating external information should be considered. [ABSTRACT FROM AUTHOR]

A randomized non-inferiority trial showed worse survival in women with early-stage cervical cancer treated with radical hysterectomy by minimally invasive approach compared to laparotomy; the impact of surgical approach on survival following radical trachelectomy is unknown. To examine oncologic outcomes in women with early-stage cervical cancer who underwent robotic or vaginal radical trachelectomy at Canadian cancer centers with the highest volumes of radical trachelectomy procedures. Retrospective multi-centre cohort analysis which includes patients who had surgery between 2006 and 2019. Women with International FIGO 2009 stage IA-IB cervical cancer who underwent radical trachelectomy and lymph node assessment were grouped by surgical approach (vaginal versus robotic surgery). A total of 197 patients were included from 4 regional referral centres. 56 women underwent robotic radical trachelectomy and 141 underwent vaginal radical trachelectomy. All patients had lymph node assessment by a minimally invasive technique. Median age was 32 years, median tumor size was 12 mm, and median depth of invasion was 5 mm. Recurrence-free survival was 97% in both groups at a median follow-up of 57 months. On multivariable analysis, after adjusting for previously chosen confounders (high risk pathologic criteria, tumor size, and LVSI) there was no statistically significant difference in PFS between the 2 groups (HR 2.1, 95%CI 0.3–7.1, p = 0.5). Tumor size larger than 2 cm (HR 9.4, 95%CI 2.8–26, p = 0.003) was the only variable predictive of recurrence. Survival outcomes were excellent in both cohorts of patients undergoing robotic vs. vaginal radical trachelectomy. The surgical approach was not significantly associated with risk of recurrence after adjusting for clinically important confounders. • In carefully selected patients, RRT and VRT are associated with excellent oncologic outcomes. • Tumor size >2 cm is a strong predictor of recurrence. • Further research is necessary to define the role of non-radical fertility sparing surgery in early cervical cancer. [ABSTRACT FROM AUTHOR]

Objectives: To compare the clinical and radiological outcomes of novel fully tapered tissue‐level implants in immediate implant placement (type 1) versus late implant placement (type 4) for the first time. Materials and Methods: For this clinical study, 318 fully tapered tissue‐level implants in 65 patients were inserted immediately (n = 68 implants) or late (n = 250 implants) in two different centers. Implant survival and success rates and marginal bone levels were analyzed. Results: After a mean follow‐up of 12.0 ± 5 months, implant survival rates were 97.8% for all implants. No statistically significant difference in implant survival rates between type 1 and type 4 could be detected (98.5% vs 97.6%, HR 0.70, 95%‐CI 0.084–5.81). Neither for implant length (HR 0.53, 95%‐CI 0.055–5.08) nor for implant width (HR 0.27, CI 0.028–2.55), a significant influence on implant survival could be detected. Type of used biomaterial for filling the gap and immediate loading showed no effect on implant survival. Mean marginal bone loss was 0.02 ± 0.05 mm for type 1 and 0.04 ± 0.1 for type 4. Conclusions: Within the limitations of this retrospective study and the short follow‐up, the results demonstrated comparable high survival and success rates and stable marginal bone levels for type 1 and type 4 placement of this novel tissue‐level implant (no clinical trial registration as retrospective study design). [ABSTRACT FROM AUTHOR]

Differential censoring, which refers to censoring imbalance between treatment arms, may bias the interpretation of survival outcomes in clinical trials. In 146 phase III oncology trials with statistically significant time-to-event surrogate primary endpoints, we evaluated the association between differential censoring in the surrogate primary endpoints, control arm adequacy, and the subsequent statistical significance of overall survival results. Twenty-four (16%) trials exhibited differential censoring that favored the control arm, whereas 15 (10%) exhibited differential censoring that favored the experimental arm. Positive overall survival was more common in control arm differential censoring trials (63%) than in trials without differential censoring (37%) or with experimental arm differential censoring (47%; odds ratio = 2.64, 95% confidence interval = 1.10 to 7.20; P  = .04). Control arm differential censoring trials more frequently used suboptimal control arms at 46% compared with 20% without differential censoring and 13% with experimental arm differential censoring (odds ratio = 3.60, 95% confidence interval = 1.29 to 10.0; P  = .007). The presence of control arm differential censoring in trials with surrogate primary endpoints, especially in those with overall survival conversion, may indicate an inadequate control arm and should be examined and explained. [ABSTRACT FROM AUTHOR]

Background: Pregnant women with coronavirus disease 2019 (COVID-19) are at increased risk of severe disease progression. Comorbidities, such as chronic arterial hypertension, diabetes mellitus, advanced maternal age and high body mass index, may predispose to severe disease. The management of pregnant COVID-19 patients on the intensive care unit (ICU) is challenging and requires careful consideration of maternal, fetal and ethical issues. Objective: Description and discussion of intensive care treatment strategies and perinatal anesthesiological management in patients with COVID-19 acute respiratory distress syndrome (CARDS). Material and methods: We analyzed the demographic data, maternal medical history, clinical intensive care management, complications, indications and management of extracorporeal membrane oxygenation (ECMO) and infant survival of all pregnant patients treated for severe CARDS in the anesthesiological ICU of a German university hospital between March and November 2021. Results: The cohort included 9 patients with a mean age of 30.3 years (range 26–40 years). The gestational age ranged from 21 + 3 weeks to 37 + 2 weeks. None of the patients had been vaccinated against SARS-CoV‑2. Of the nine patients seven were immigrants and communication was hampered by inadequate Central European language skills. Of the patients five had a PaO2/FiO2 index < 150 mm Hg despite escalated invasive ventilation (FiO2 > 0.9 and a positive end-expiratory pressure [PEEP] of 14 mbar) and were therefore treated with repeated prolonged prone positioning maneuvers (5–14 prone positions for 16 h each, a total of 47 prone positioning treatments) and 2 required treatment with inhaled nitric oxide and venovenous ECMO. The most common complications were bacterial superinfection of the lungs, urinary tract infection and delirium. All the women and five neonates survived. All newborns were delivered by cesarean section, two patients were discharged home with an intact pregnancy and two intrauterine fetal deaths were observed. None of the newborns tested positive for SARS-CoV‑2 at birth. Conclusion: High survival rates are possible in pregnant patients with CARDS. The peripartum management of pregnant women with CARDS requires close interdisciplinary collaboration and should prioritize maternal survival in early pregnancy. In our experience, prolonged prone positioning, an essential evidence-based cornerstone in the treatment of ARDS, can also be safely used in advanced stages of pregnancy. Inhaled nitric oxide (iNO) and ECMO should be considered as life-saving treatment options for carefully selected patients. For cesarean section, neuraxial anesthesia can be safely performed in patients with mild CARDS if well planned but the therapeutic anticoagulation recommended for COVID-19 may increase the risk of bleeding complications, making general anesthesia a more viable alternative, especially in severe disease. [ABSTRACT FROM AUTHOR]

Crassostrea arakensis is one of the main fouling organisms in the ocean, which has a significant impact on marine aquaculture facilities and marine engineering equipment. Short wavelength and high-energy ultraviolet radiation (UV-C, 200-280 nm) can damage the DNA and protein structure of shellfish larvae, affecting their survival and attachment. They can be used to prevent biological fouling. This study selected the larvae of Crassostrea arakensis as the research object. The single variable method was used to study the lethal response of larvae under different intensities and doses of UV-C, as well as the differences in attachment rates of larvae under different UV-C irradiation frequencies and distances. The research results showed significant differences (P<0. 05) between some treatment groups and the control group during the observation period in the 10 W shortwave UV-C irradiation experiment. After 24 hours, there were no surviving larvae in all treatment groups in the experimental units, and the survival rate of the control group was (26. 3±1. 9)%; In the 20W UV-C irradiation test, there was a significant difference in survival rates between the treatment group and the control group at all observation periods (P<0. 05). After 24 hours, there were no surviving larvae in all treatment groups in the experimental units, and the survival rate of the control group was (22. 3±1. 3)%; when the irradiation frequency reached 5 minutes/ h, the average adhesion rate decreased from (12. 83±1. 17)% to (3. 31±0. 69)%, significantly reducing the adhesion rate; There was no significant difference in the irradiation effect of the attachment rate between the distance of 15 and 20 cm, and both groups were able to reduce attachment compared to the control group effectively. This study can provide references for the design of equipment for UV-C prevention and control of biological fouling. [ABSTRACT FROM AUTHOR]

Background: Drug survival, which refers to the time from treatment initiation to discontinuation, provides a surrogate measure of the effectiveness of a biologic in a real‐world setting (J Invest Dermatol, 2015, 135, 1). The aim of this study was to determine the drug survival of biologics that are currently available in Australia. We also analysed the treatment efficacy of these biologics and reasons for discontinuation. Methods: Retrospective data from outpatient Dermatology biologic clinics in Westmead Hospital and Royal Prince Alfred Hospital (Sydney, Australia) from April 2006 to December 2020 were collected. Kaplan–Meier analysis was used to calculate drug survival. Results: A total of 306 patients who underwent 566 treatment courses were analysed. Guselkumab was observed to have the longest drug survival, with cumulative drug survival rates of 94.2% ± 4.0 at 1‐ and 5‐years. This was followed by ixekizumab which had a 1‐year survival rate of 87.2% ± 4.5 and 5‐year survival rate of 59.4% ± 9.5. Ixekizumab and guselkumab were also noted to have superior treatment efficacy compared with other biologics, with PASI‐75 rates of 94.9% and 93.8%, respectively. The most common reasons for treatment discontinuation were a lack of initial efficacy to treatment and a loss of efficacy over time despite an initial response, respectively. Conclusion: To our knowledge, this is the first Australian study to report on outcomes of multiple new biologics that are currently in use for the treatment of chronic plaque psoriasis. Overall, this study provides insight into patterns of care from a local experience that may help guide the management of moderate‐to‐severe psoriasis. [ABSTRACT FROM AUTHOR]

Summary: Background: Thyroid cancer diagnoses have increased over recent decades at a rate much higher than that of any other cancer in Australia. Rural patients are known to have reduced access to healthcare and may have different thyroid cancer presentation rates. This study examined the relationship between thyroid cancer diagnosis and patient rurality. Methods: Data from the Australia and New Zealand Thyroid Cancer Registry from 2017 to 2022 were analyzed, stratifying patient postcodes into rurality groups using the Australian Statistical Geography Standard. The American Thyroid Association (ATA) guidelines were used to stratify risk categories and management to compare treatment adequacy between the groups. Statistical analysis assessed demographic, clinical, and management differences. Results: Among 1766 patients, 70.6% were metropolitan (metro) and 29.4% were non‐metropolitan (non‐metro). Non‐metro patients were older at diagnosis (median 56 vs. 50 years, p < 0.001), presented more frequently with T stage greater than 1 (stage 2–4, 41.9% vs. 34.8%, and p = 0.005), AJCC stage greater than 1 (stage 2–4, 18.5% vs. 14.6%, and p = 0.019), and cancers larger than 4 cm (14.3% vs. 9.9%, p = 0.005). No significant differences in treatment adequacy were observed between the groups for ATA low‐risk cancers. Conclusions: Non‐metropolitan patients in the registry present with more advanced thyroid cancer, possibly due to differences in healthcare access. Further research should assess long‐term survival outcomes and influencing factors. Understanding the impact on patient outcomes and addressing healthcare access barriers can optimize thyroid cancer care across geographic regions in Australia. [ABSTRACT FROM AUTHOR]

Introduction: The relative efficacies of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) and immune checkpoint inhibitors (ICIs) for the treatment of recurrent non-small cell lung cancer (NSCLC) after surgery remain unclear. Methods: Among 801 patients with NSCLC who underwent pulmonary resection at Kanazawa Medical University between 2017 and 2021, sixty-four patients had recurrence. We retrospectively compared the efficacies of EGFR-TKIs and ICIs in these patients with recurrent NSCLC who underwent pulmonary resection. Results: The 3-year overall survival rates after recurrence were 79.3% in patients who received EGFR-TKIs, 69.5% in patients who received ICIs, and 43.7% in patients who received cytotoxic agents. There was no significant difference in overall survival between patients treated with EGFR-TKIs and ICIs (p = 0.14) or between patients treated with ICIs and cytotoxic agents (p = 0.23), but overall survival was significantly higher in patients treated with EGFR-TKIs compared with cytotoxic agents (p < 0.01). The probabilities of a 2-year response were 88.5%, 61.6%, and 25.9% in patients treated with EGFR-TKIs, ICIs, and cytotoxic agents, respectively. There was no significant difference in response periods between patients treated with EGFR-TKIs and ICIs (p = 0.18), but the response period was significantly better in patients treated with EGFR-TKIs (p < 0.01) or ICIs (p = 0.03) compared with cytotoxic agents. Percent-predicted vital capacity (p = 0.03) and epidermal growth factor receptor gene mutation (p < 0.01) were significant factors affecting the overall response to chemotherapy in multivariate analysis. Conclusion: EGFR-TKIs and ICIs are effective for treating recurrent NSCLC after surgery. Although adjuvant chemotherapy for completely resected pathological stage II to IIIA NSCLC, atezolizumab or osimertinib, has also been recently approved as adjuvant chemotherapy, there is a risk that patients who relapse after adjuvant chemotherapy will have less choice. [ABSTRACT FROM AUTHOR]

Introduction: Recent advances in dialysis therapy have made it possible to remove middle molecules. Removal of small-middle molecules, such as β2-microglobulin, can now be achieved with conventional hemodialysis (HD), and removal of large-middle molecules has become a target, particularly for α1-microglobulin (AMG, 33 kD). The AMG reduction rate has emerged as a target for improvement of various clinical symptoms, but the effects on prognosis have yet to be determined. The "Japanese study of the effects of AMG (α1-microglobulin) reduction rates on survival" (JAMREDS) was started in April 2020, with the goal of determining if the AMG reduction rate associates with the risk of mortality and cardiovascular disease (CVD) events. Methods: JAMREDS is a prospective observational study in patients on HD to examine the effects of: (1) AMG reduction rate on survival outcome and CVD events; (2) dialysis treatment modalities (HD, intermittent infusion hemodiafiltration(iHDF), pre/post-dilution online HDF) on survival and CVD events (based on AMG reduction rates with treatment mode); and (3) AMG reduction rates on survival and CVD events in patients undergoing each therapy (iHDF, pre/post-dilution online HDF). The number of planned subjects was 4,000 in preplanning. Data are collected using RED-Cap, which is an EDC system. A total of 9,930 patients were enrolled at the beginning of the study at 59 registered facilities. The JAMREDS observation period will continue until the end of 2023, after which the data will be cleaned and confirmed before analysis. Conclusion: This study may provide new evidence for the relationship between the amount of removed large-middle molecules (such as AMG) and the mortality and CVD risk. Comparisons with convection volumes will also be of interest. [ABSTRACT FROM AUTHOR]

Objective To investigate the predictive value of systemic immune inflammation index (SII) scores in longterm survival of patients with stage III squamous lung cancer treated with radical radiotherapy. Methods Clinical data of stage Ⅲ squamous lung cancer patients who underwent radical radiotherapy at the Radiotherapy Department of the Fourth Hospital of Hebei Medical University from January 2010 to December 2018 were retrospectively analyzed. The peripheral hematological indexes one week before radiotherapy were collected and recorded. X-Tile software was applied to determine the best cut-off values for continuous variables. Kaplan-Meier method was used to analyze overall survival (OS) and progression-free survival (PFS). Results A total of 453 patients were included in this study. There were 336 patients in the low SII group (＜1 277.3), and other 117 patients were in the high SII group (≥1 277.3). The median OS and median PFS in the high SII group were shorter than those in the low SII group (OS: 20.8 months vs. 31.0 months, Log-rank χ2 =18.015, P＜ 0.01; PFS: 13.0 months vs. 21.0 months, Log-rank χ2 =15.062, P＜0.01).Multivariate Cox regression analysis showed that high SII was associated with OS (HR=1.628, 95%CI: 1.294-2.047, P < 0.001) and PFS (HR=1.559, 95%CI: 1.240-1.961, P < 0.001). Other influencing factors included late TNM stage, poor radiotherapy efficacy and decreased HALP score. Conclusion SII can be used to evaluate the long-term survival of patients with stage III lung squamous cell carcinoma receiving radical radiotherapy, and the increase of SII indicates a poor prognosis. [ABSTRACT FROM AUTHOR]

Background: Leucine-rich α-2 glycoprotein 1 (LRG-1) is a secreted glycoprotein that is mainly produced in the liver. Elevated levels of LRG-1 are found in a multitude of pathological conditions including eye diseases, diabetes, infections, autoimmune diseases, and cancer. In patients with early breast cancer (BC), high intratumoral LRG-1 protein expression levels are associated with reduced survival. In this study, we assessed serum levels of LRG-1 in patients with early BC and investigated its correlation with the presence of disseminated tumor cells (DTCs) in the bone marrow and survival outcomes. Methods: Serum LRG-1 levels of 509 BC patients were determined using ELISA and DTCs were assessed by immunocytochemistry using the pan-cytokeratin antibody A45-B/B3. We stratified LRG-1 levels according to selected clinical parameters. Using the log-rank (Mantel–Cox) test and multivariate Cox regression analysis, Kaplan–Meier survival curves and prognostic relevance were assessed. Results: Mean serum levels of LRG-1 were 29.70 ± 8.67 µg/ml. Age was positively correlated with LRG-1 expression (r = 0.19; p < 0.0001) and significantly higher LRG-1 levels were found in patients over 60 years compared to younger ones (30.49 ± 8.63 µg/ml vs. 28.85 ± 8.63 µg/ml; p = 0.011) and in postmenopausal patients compared to premenopausal patients (30.15 ± 8.34 µg/ml vs. 26.936.94 µg/ml; p = 0.002). Patients with no DTCs showed significantly elevated LRG-1 levels compared to the DTC-positive group (30.51 ± 8.69 µg/ml vs. 28.51 ± 8.54 µg/ml; p = 0.004). Overall and BC-specific survival was significantly lower in patients with high serum LRG-1 levels (above a cut-off of 33.63 µg/ml) compared to patients with lower LRG-1 levels during a mean follow-up of 8.5 years (24.8% vs. 11.1% BC-specific death; p = 0.0003; odds ratio 2.63, 95%CI: 1.56—4.36). Multivariate analyses revealed that LRG-1 is an independent prognostic marker for BC-specific survival (p = 0.001; hazard ratio 2.61). Conclusions: This study highlights the potential of LRG-1 as an independent prognostic biomarker in patients with early BC. [ABSTRACT FROM AUTHOR]

Background Several factors affect heart transplant (HTx) and lung transplant (LTx) program outcomes. Variabilities in institutional and community characteristics have been shown to influence survival. At present, half of HTx centers in the United States do not possess a concomitant LTx program. This study sought to better understand the characteristics of HTx with and without LTx programs. Methods Nationwide transplant data were collected from the Scientific Registry of Transplant Recipients (SRTR) in August 2020. SRTR star rating ranges from tier 1 (lowest) to tier 5 (highest). HTx volumes and SRTR star ratings for survival were compared between the centers with heart-only (H0) programs and the centers with heart-lung (HL) programs. Results SRTR star ratings were available for 117 transplant centers with one or more HTx reported. The median number of HTx performed over 1 year was 16 (interquartile range [IQR]: 2–29). The number of HL centers (n = 67, 57.3%) were comparable to H0 centers (n = 50, 42.7%; p = 0.14). The HTx volume at the HL centers (28 [IQR: 17–41]) exceeded the HTx volume at the H0 centers (13 [IQR: 9–23]; p < 0.01), but were comparable to the LTx volume at the HL centers (31 [IQR: 16–46]; p = 0.25). The median HTx one-year survival rating was 3 (IQR: 2–4) at both the H0 and HL centers (p = 0.85). The HTx and LTx volumes were positively associated with the respective 1-year survivals (p < 0.01). Conclusion While the presence of an LTx program is not directly associated with HTx survival, it has a positive association with the HTx volume. The HTx and LTx volumes are positively associated with the 1-year survival. [ABSTRACT FROM AUTHOR]

Objective This study aimed to establish prediction models for respiratory-related mortality in microscopic polyangiitis (MPA) complicated by interstitial lung disease (ILD) using clinical characteristics. Methods We enrolled patients with MPA with ILD between May 2005 and June 2021 in a multicentre cohort of Japanese patients with MPA (REVEAL cohort). We evaluated the demographic, clinical, laboratory, radiological findings, treatments and the presence of honeycombing 1 cm above the diaphragm using chest high-resolution CT (HRCT) on admission. We explored the risk factors predictive of respiratory-related mortality. Results Of 115 patients, 26 cases died of respiratory-related diseases during a median follow-up of 3.8 years. Eighteen patients (69%) died due to respiratory infection, three (12%) had diffuse alveolar haemorrhage, and five (19%) had exacerbation of ILD. In univariate analysis, older age, lower percent forced vital capacity (%FVC), lower percent diffusing capacity of carbon monoxide (%DLCO), and the presence of honeycombing in the right lower lobe were identified as risk factors. Additionally, in multivariate analysis adjusted for age and treatment, %FVC, %DLCO and the presence of honeycombing in the right lower lobe were independently associated with respiratory-related mortality. We created prediction models based on the values of %FVC, %DLCO and presence of honeycombing on chest HRCT (termed "MPF model"). The 5-year respiratory-related death-free rate was significantly different between patients with MPA with ILD stratified by the number of risk factors based on the MPF model. Conclusions Our study indicates that the MPF model may help predict respiratory-related death in patients with MPA with ILD. [ABSTRACT FROM AUTHOR]

Background: Neuroendocrine neoplasm is a rare cancer of head and neck. This study aimed to evaluate clinical features, treatment outcomes, and prognostic factors of neuroendocrine neoplasm of head and neck treated at a single institution. Methods: Between Nov 2000 and Nov 2021, ninety-three patients diagnosed with neuroendocrine neoplasms of head and neck treated at our institution were reviewed retrospectively. The initial treatments included chemotherapy (induction, adjuvant, or concurrent) combined with radiotherapy in 40 patients (C + RT group), surgery followed by post-operative RT in 34 (S + RT group), and surgery plus salvage therapy in 19 patients (S + Sa group). Results: The median follow-up time was 64.5 months. 5-year overall survival rate (OS), progression-free survival rate (PFS), loco-regional relapse-free survival free rate (LRRFS) and distant metastasis-free survival rate (DMFS) were 64.5%, 51.6%, 66.6%, and 62.1%, respectively. For stage I–II, the 5-year LRRFS for patients' treatment regimen with or without radiotherapy (C + RT and S + RT groups versus S + Sa group) was 75.0% versus 12.7% (p = 0.015) while for stage III–IV, the 5-year LRRFS was 77.8% versus 50.0% (p = 0.006). The 5-year DMFS values for patients with or without systemic therapy (C + RT group versus S + RT or S + Sa) were 71.2% and 51.5% (p = 0.075). 44 patients (47.3%) experienced treatment failure and distant metastasis was the main failure pattern. Conclusions: Radiotherapy improved local–regional control and played an important role in the management of HNNENs. The optimal treatment regimen for HNNENs remains the combination of local and systemic treatments. [ABSTRACT FROM AUTHOR]

Methods for designing and analyzing multiple arms survival trials that incorporate patient's treatment choice are needed. In these trials, patients are randomized into two groups, random and choice. Participants in the choice group choose their treatment, which is not a current standard practice in randomized clinical trials. In this paper, we propose a new method based on the likelihood function to design and analyze these trials with time to event outcomes in the presence of non-informative right censoring. We use simulations to evaluate the methods for Weibull outcomes, complete and censored. Finally, we provide an illustration for designing a study in which we discuss some design considerations and demonstrate the methods. [ABSTRACT FROM AUTHOR]

Background: Hepatocellular carcinoma with peritoneal metastasis (HCC-PM) has a poor outlook. Traditional treatments have limited effect on survival. The safety and efficacy of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) have been shown in other peritoneal cancers. This study evaluates the role of CRS + HIPEC in HCC-PM. Methods: A retrospective analysis of HCC-PM patients treated with CRS + HIPEC at Beijing Shijitan Hospital from March 2017 to December 2023 was conducted, assessing clinical features, severe adverse events (SAEs), and overall survival (OS) rates. Results: The study population comprised 10 HCC-PM patients who underwent CRS + HIPEC. The median peritoneal cancer index (PCI) was 25, and complete cytoreduction (CC0 ~ 1) was achieved in half of the patients. Three patients experienced SAEs within 30 days postoperatively. The 1-year, 3-year, and 5-year OS rates were recorded as 89.0%, 89.0%, and 21.0% respectively, with a median OS1 of 107.8 months and OS2 of 49.9 months. The median progression-free survival (PFS) was 5.0 months. Conclusion: The application of CRS + HIPEC offers significant benefits to patients with HCC-PM. A selected group of patients may achieve prolonged PFS. Incorporating CRS + HIPEC into the treatment paradigm can thus be considered a strategic therapeutic option for patients with HCC-PM. [ABSTRACT FROM AUTHOR]

[Display omitted] • Antitubercular potential of Halosarcia indica (Willd.) was determined for the first time. • SF3K fraction was observed to be most potent fraction with a MIC of ≤ 3.125 µg/mL. • H. indica bioactive fraction was found non-toxic against Vero cell line. Tuberculosis (TB) is one of the oldest leading health diseases of mankind, caused by the bacteria Mycobacterium tuberculosis. It is still the major cause of high mortality and morbidity worldwide from a single infectious agent. Plant species belonging to the genus Halosarcia (formerly known as Salicornia) are known for their various medicinal properties like antioxidant, hepatoprotective, immunomodulatory, antimicrobial, etc., but not evaluated for their antimycobacterial property. The present study aimed to investigate the potential of Halosarcia indica (Willd.) (formerly known as Salicornia brachiata Roxb.), a halophytic plant, a source of antitubercular agents. The study involved the preparation of various extracts from different parts of the plant and the evaluation of their inhibitory activities against Mycobacterium tuberculosis H37Rv using in vitro and in vivo assays. It was observed that the aqueous extract of the roots had the highest anti-TB activity with minimum inhibitory concentration (MIC) of 50 µg/mL and a ten-fold reduction of M. tuberculosis bacilli in the lungs of treated mice. Further fractionation of aqueous extract of roots using butanol, MeOH:CHCl 3 , MeOH, MeOH:H 2 O, and H 2 O yielded fractions with varying anti-TB activity. The subfraction SF3K obtained from fraction 2 (F-2) showed the highest potency, with MIC ≤ 3.125 µg/mL and an increase of 5 days in the mean survival time of M. tuberculosis-infected and treated (with SF3K) mice. This subfraction was found to be non-cytotoxic (in vitro) and non-toxic (during in vivo efficacy evaluation). The present study, for the first time, provides scientific evidence for the use of H. indica in the treatment of tuberculosis. [ABSTRACT FROM AUTHOR]

• Agave marmorata is important for the production of a traditional alcoholic beverage called mezcal and pulque. • The immersion frequency and culture medium volume had an effect during in vitro multiplication of A. marmorata. • The immersion frequency and culture medium volume had an effect on chlorophyll content of A. marmorata. • The Temporary Immersion Bioreactor is an alternative for micropropagation of A. marmorata. Agave marmorata is an important wild species in Mexico for mezcal and pulque production. Propagation by suckers and seeds is not sufficient to restore wild populations. The aim of this study was to develop a protocol for large-scale micropropagation of A. marmorata using a temporary immersion bioreactor (TIB). The effect of liquid medium using a TIB and semi-solid medium as the control treatment was compared. Different immersion frequencies and culture medium volumes per explant were evaluated in the TIB. In all treatments, the percentage of hyperhydricity, number of shoots per explant, shoot length, and total chlorophyll and carotenoid content were evaluated. In addition, the survival rate during acclimatization was evaluated. The results obtained show that the TIB with an immersion of 2 min every 8 h and with a culture medium volume of 50 mL had the best developmental parameters, with 19.60 shoots per explant, a shoot length of 1.74 cm and a percentage of hyperhydricity of 3.33 %. The highest chlorophyll content was observed in temporary immersion every 8 h, with 100, 75 and 50 mL of culture medium per explant. Regarding carotenoid content, the highest content was found at the 8 and 12 h immersion frequencies, with the culture medium volumes of 100, 75 and 50 mL per explant. For acclimatization, no differences were found in the survival rate between the culture systems evaluated. In conclusion, this study demonstrates that the use of a TIB is an alternative for large-scale micropropagation of A. marmorata. [ABSTRACT FROM AUTHOR]

Introduction: Pulmonary arterial hypertension (PAH) is a leading cause of mortality in systemic sclerosis (SSc). This nationwide study aims to describe real world treatment characteristics and assess survival rates of patients with SSc-PAH. Methods: In this retrospective cohort study, patients with SSc-PAH were identified from Turkish Ministry of Health National Electronic Database (from January 2016 to September 2022), using ICD-10 codes. Data on demographics, treatment characteristics, and death was collected. Kaplan–Meier curves were used to calculate cumulative probabilities of survival at 1, 3, and 5 years. Results: Five hundred forty-seven patients (90.7% female) with SSc-PAH were identified. Median age at PAH diagnosis was 59.9 (50.0–67.4) years. During a median follow-up duration of 3.2 (1.5–4.8) years, 199 (36.4%) deaths occurred. Estimated survival rates at 1, 3, and 5 years were 90.2%, 73.2%, and 56.6%, respectively. Survival was similar among patients with and without interstitial lung disease (p = 0.20). Patients who used immunosuppressives had better survival than those who did not (p < 0.001). No difference was observed in survival rates according to initial PAH-specific treatment regimen (monotherapy or combination) (p = 0.49). Conclusion: Compared to most of historical cohorts, higher survival rates for SSc-PAH were observed in this study. Early diagnosis of PAH may have contributed to these findings. The impact of immunosuppressive therapy on prognosis of SSc-PAH needs to be further investigated in prospective studies. Key Points • Early diagnosis is pivotal for better outcomes in SSc-PAH. • Implementation of PAH treatment guidelines in routine clinical practice is still poor and should be improved. • Effect of immunosuppressive therapies on disease course has to be defined in SSc-PAH. [ABSTRACT FROM AUTHOR]

Background Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC) recommendations are commonly used guidelines for adjuvant radiotherapy in glioblastoma. In our institutional protocol, we delineate T2-FLAIR alterations as gross target volume (GTV) with reduced clinical target volume (CTV) margins. We aimed to present our oncologic outcomes and compare the recurrence patterns and planning parameters with EORTC and RTOG delineation strategies. Methods Eighty-one patients who received CRT between 2014 and 2021 were evaluated retrospectively. EORTC and RTOG delineations performed on the simulation computed tomography and recurrence patterns and planning parameters were compared between delineation strategies. Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM, Armonk, NY, USA) was utilized for statistical analyses. Results Median overall survival and progression-free survival were 21 months and 11 months, respectively. At a median 18 month follow-up, of the 48 patients for whom recurrence pattern analysis was performed, recurrence was encompassed by only our institutional protocol's CTV in 13 (27%) of them. For the remaining 35 (73%) patients, recurrence was encompassed by all separate CTVs. In addition to the 100% rate of in-field recurrence, the smallest CTV and lower OAR doses were obtained by our protocol. Conclusions The current study provides promising results for including the T2-FLAIR alterations to the GTV with smaller CTV margins with impressive survival outcomes without any marginal recurrence. The fact that our protocol did not result in larger irradiated brain volume is further encouraging in terms of toxicity. [ABSTRACT FROM AUTHOR]

Background Glioblastoma (GBM) poses therapeutic challenges due to its aggressive nature, particularly for patients with poor functional status and/or advanced disease. Hypofractionated radiotherapy (RT) regimens have demonstrated comparable disease outcomes for this population while allowing treatment to be completed more quickly. Here, we report our institutional outcomes of patients treated with 2 hypofractionated RT regimens: 40 Gy/15fx (3w-RT) and 50 Gy/20fx (4w-RT). Methods A single-institution retrospective analysis was conducted of 127 GBM patients who underwent 3w-RT or 4w-RT. Patient characteristics, treatment regimens, and outcomes were analyzed. Univariate and multivariable Cox regression models were used to estimate progression-free survival (PFS) and overall survival (OS). The impact of chemotherapy and RT schedule was explored through subgroup analyses. Results Median OS for the entire cohort was 7.7 months. There were no significant differences in PFS or OS between 3w-RT and 4w-RT groups overall. Receipt and timing of temozolomide (TMZ) emerged as the variable most strongly associated with survival, with patients receiving adjuvant-only or concurrent and adjuvant TMZ having significantly improved PFS and OS (P <.001). In a subgroup analysis of patients that did not receive TMZ, patients in the 4w-RT group demonstrated a trend toward improved OS as compared to the 3w-RT group (P =.12). Conclusions This study demonstrates comparable survival outcomes between 3w-RT and 4w-RT regimens in GBM patients. Receipt and timing of TMZ were strongly associated with survival outcomes. The potential benefit of dose-escalated hypofractionation for patients not receiving chemotherapy warrants further investigation and emphasizes the importance of personalized treatment approaches. [ABSTRACT FROM AUTHOR]

Background Glioblastoma (GBM) is widely treated using large radiotherapy margins, resulting in substantial irradiation of the surrounding cerebral structures. In this context, the question arises whether these margins could be safely reduced. In 2018, clinical target volume (CTV) expansion was reduced in our institution from 20 to 15 mm around the gross target volume (GTV) (ie, the contrast-enhancing tumor/cavity). We sought to retrospectively analyze the impact of this reduction. Methods All adult patients with GBM treated between January 2015 and December 2020 with concurrent chemoradiation (60Gy/2Gy or 59.4Gy/1.8Gy) were analyzed. Patients treated using a 20 (CTV20, n  = 57) or 15 mm (CTV15, n  = 56) CTV margin were compared for target volumes, dose parameters to the surrounding organs, pattern of recurrence, and survival outcome. Results Mean GTV was similar in both groups (ie, CTV20: 39.7cm3; CTV15: 37.8cm3; P  = .71). Mean CTV and PTV were reduced from 238.9cm3 to 176.7cm3 (P  = .001) and from 292.6cm3 to 217.0cm3 (P  < .001), for CTV20 and CTV15, respectively. As a result, average brain mean dose (Dmean) was reduced from 25.2Gy to 21.0Gy (P  = .002). Significantly lower values were also observed for left hippocampus Dmean, brainstem D0.03cc, cochleas Dmean, and pituitary Dmean. Pattern of recurrence was similar, as well as patient outcome, ie, median progression-free survival was 8.0 and 7.0 months (P  = .80), and median overall survival was 11.0 and 14.0 months (P  = .61) for CTV20 and CTV15, respectively. Conclusions In GBM patients treated with chemoradiation, reducing the CTV margin from 20 to 15 mm appears to be safe and offers the potential for less treatment toxicity. [ABSTRACT FROM AUTHOR]

Background: After hypovolemic shock caused by severe burns, lipid peroxidation is an important factor in tissue edema and multiorgan dysfunction syndrome (MODS). Many studies have shown that valproic acid (VPA) inhibits lipid peroxidation and reduces tissue and organ injury. Objectives: This study investigated whether the VPA treatment of scalded rats reduced tissue edema by inhibiting lipid peroxidation, thereby improving organ function and survival rate. Materials and Methods: A total of 60 male Sprague-Dawley rats (weighing: 280–300 g) with a 50% total body surface area (TBSA) full-thickness dermal burn were randomly assigned to the following 3 groups (with 20 rats per group): (I) the no infusion resuscitation (NR) group; (II) the sodium lactate Ringer's solution (LR) group; and (III) the sodium valproate Ringer's solution (VR) group. After scalding, the following hemodynamic parameters were measured: Copper2+-Zinc2+-superoxide dismutase (Cu2+-Zn2+-SOD) activity, thiobarbituric acid reactive substances (TBARSs), oxidized glutathione (GSSG), reduced glutathione (GSH), and antioxidant enzyme activities. Organ function parameters and water content were also measured. Another 60 male Sprague-Dawley rats were used to observe the 24-h survival rate of the rats using the same scald model and fluid resuscitation. Results: VPA significantly increased the mean arterial pressure (MAP) and cardiac output (CO), and significantly decreased the pulmonary vascular permeability index (PVPI) and extravascular lung water index (ELWI). VPA also increased plasma Cu2+-Zn2+-SOD activity and decreased the plasma TBARS level. VPA reduced the TBARS level and GSSG in various tissues and increased the concentration of GSH. VPA decreased glutathione peroxidase (GPx) and catalase (CAT) activity, but significantly increased glutathione reductase (GR) activity in various tissues. VPA significantly improved organ functions and decreased water content. VPA significantly improved the survival rate, and the 24-h survival rate of the VR group was double that of the LR group. Conclusion: Resuscitation with VPA reduced tissue edema, protected visceral functions, and improved the survival rate of rats with severe burn shock (BS) by alleviating lipid peroxidation. [ABSTRACT FROM AUTHOR]

Introduction : Thoracic SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a rare and highly aggressive malignant neoplasm characterized by high-grade undifferentiated morphologic features and recurrent inactivating mutations of SMARCA4. These tumors consistently exhibit loss of SMARCA4 (BRG1) while displaying variable expression of other nonspecific markers. Recently, we encountered a SMARCA4-UT demonstrating immunoreactivity for GATA3, and we sought to characterize this phenomenon in a larger series. Methods : A total of nine SMARCA4-UTs were examined from 3 large academic institutions. The clinicopathologic and molecular characteristics were studied and GATA3 immunohistochemistry was performed. Results : The cohort included 5 male and 4 female patients, with a median age of 54 years and a median smoking history of 37 pack-years. At initial diagnosis, mediastinal lymph node involvement was observed in 5 patients (56%) while distant metastases were present in 7 patients (78%). The median survival was 6 months. Histologically, the tumors were characterized by sheets of undifferentiated epithelioid and/or rhabdoid cells, accompanied by frequent mitotic figures and necrosis. Immunohistochemically, all tumors displayed a complete loss of BRG1 expression. Notably, 4 of 9 tumors (44%) were positive for GATA3 expression, including one tumor that exhibited strong and diffuse immunoreactivity. Conclusions : GATA3 expression in SMARCA4-UT may pose diagnostic challenges, requiring differentiation from other GATA3-positive tumors. This distinction is crucial for accurate prognostication and treatment decisions. [ABSTRACT FROM AUTHOR]

Purpose: The aims of the present study were (1) to evaluate the survival of patellofemoral joint (PFJ) arthroplasty in a large cohort of patients using data obtained from an Italian regional arthroplasty registry and (2) to collect clinical outcomes of a subgroup of patients, with a minimum follow‐up of 4 years. The hypotheses were that PFJ arthroplasty is a procedure that had good survival and clinical outcomes, not inferior to those reported in the literature for primary total knee arthroplasty (TKA). Methods: The Register of Orthopaedic Prosthetic Implants (RIPO) of Emilia‐Romagna (ER) (Italy) database was searched for the inclusion of all PFJ arthroplasties implanted between 2003 and 2019. PFJ arthroplasties were excluded if they were implanted in patients who lived outside of the ER. The survival information was extrapolated from the RIPO considering the partial or total revision of the implant as failure; moreover, a subgroup of patients was contacted and interviewed by telephone to collect clinical outcomes. Descriptive statistics were used to summarise the data. The survival curve was calculated and plotted using the Kaplan–Meier method. Results: A total of 126 arthroplasties in 114 patients were included in the final analysis (mean age at surgery 60.1 ± 11.5 years old). The main causes of patellofemoral arthroplasty were primary osteoarthritis (88%) and posttraumatic arthritis (7%). The survival was 90.4 ± 30.6 and 78.8 ± 51.5 at 5 and 10 years of follow‐up, respectively. At the latest follow‐up, 23 implants failed (18.3%). The main cause of revision was osteoarthrosis progression (34.8%). A total of 44 patients were contacted by telephone to collect clinical outcomes: Western Ontario and McMaster Universities Osteoarthritis Index, functional Knee Society Score, Forgotten Joint Score and Oxford Knee Score. These patients reported good to excellent scores at a medium follow‐up of 10.3 ± 4.7 years. Conclusions: The PFJ showed good survival and clinical outcomes and could be considered a valuable option for patients affected by isolated patellofemoral osteoarthritis. Level of Evidence: Level IV. [ABSTRACT FROM AUTHOR]

Background: Hodgkin lymphoma (HL) in pediatric populations has a high survival rate but poses risks for long-term morbidities. Although [18F]fluoro‑2‑deoxy‑2‑d‑glucose positron emission tomography ([18F]FDG PET) scans offer potential for improved risk stratification, the definitive prognostic value of quantitative [18F]FDG PET parameters remains unclear for pediatric HL. Methods: A single-center, retrospective study included pediatric patients diagnosed with HL between 2016 and 2023 treated according to EuroNet-PHL-C1 and DAL/GPOH-HD protocols. Patients underwent baseline and interim PET/CT scans after two chemotherapy cycles. Event-free survival (EFS) was the primary endpoint, Deauville score was the secondary endpoint. Quantitative [18F]FDG PET parameters included SUVmax, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) that were evaluated using two segmentation methods (SUV 2.5, 41% SUVmax). Survival outcomes were assessed using Cox regression analysis. Results: A total of 115 patients (50 males, median age 14.2 years) were studied, with a median follow-up period of 35 months. During this period, 16 cases (13.9%) of relapse or progression were noted. Baseline and interim MTV 2.5, MTV 41%, TLG 2.5, and TLG 41%, along with interim SUVmax, were significantly associated with worse EFS and correlated with post-treatment Deauville scores. In multivariable analysis, interim MTV 2.5 > 0 ml (adj. hazard ratio, HR: 3.89, p = 0.009) and interim TLG 41% ≥ 30 g (adj. HR: 7.98, p = 0.006) were independent risk factors for EFS. Conclusion: Baseline and interim [18F]FDG PET parameters can serve as significant prognostic indicators for EFS and treatment response in pediatric HL. These quantitative measures could enhance individualized, risk-adapted treatment strategies for children and adolescents with HL. [ABSTRACT FROM AUTHOR]

Lung transplantation is a well‐established treatment for advanced lung disease, improving survival and quality of life. Over the last 60 years all aspects of lung transplantation have evolved significantly and exponential growth in transplant volume. This has been particularly evident over the last decade with a substantial increase in lung transplant numbers as a result of innovations in donor utilization procurement, including the use donation after circulatory death and ex‐vivo lung perfusion organs. Donor lungs have proved to be surprisingly robust, and therefore the donor pool is actually larger than previously thought. Parallel to this, lung transplant outcomes have continued to improve with improved acute management as well as microbiological and immunological insights and innovations. The management of lung transplant recipients continues to be complex and heavily dependent on a tertiary care multidisciplinary paradigm. Whilst long term outcomes continue to be limited by chronic lung allograft dysfunction improvements in diagnostics, mechanistic understanding and evolutions in treatment paradigms have all contributed to a median survival that in some centres approaches 10 years. As ongoing studies build on developing novel approaches to diagnosis and treatment of transplant complications and improvements in donor utilization more individuals will have the opportunity to benefit from lung transplantation. As has always been the case, early referral for transplant consideration is important to achieve best results. [ABSTRACT FROM AUTHOR]

Aims: To compare radiographic periapical healing and tooth survival outcomes of root canal (re)treatment performed within two care pathways (Routine Dental Care and Referred Treatment Pathway), in the United Kingdom Armed Forces (UKAF), and determine the effects of endodontic complexity on outcomes. Methodology: This retrospective cohort study included 1466 teeth in 1252 personnel who received root canal (re)treatment between 2015 and 2020. General Dental Practitioners treated 661 teeth (573 patients) (Routine cohort), whilst Dentists with a Special Interest treated 805 teeth (678 patients) (Referred cohort). The latter group were graduates of an MSc programme in Endodontics with 4–8 years of postgraduation experience. Case complexity was retrospectively determined for each tooth using the endodontic component of Restorative Index of Treatment Need (RIOTN) guidelines. Periapical healing was determined using loose radiographic criteria. The data were analysed using chi‐square tests, univariate logistic regression and Cox proportional hazards models. Results: A significantly (p < 0.0001) larger proportion of cases of low complexity had undergone root canal treatment within the Routine versus Referred cohort. The odds of periapical healing was significantly higher within the Referred versus Routine cohort, regardless of analyses using pooled (OR = 1.17; 95% CI: 1.11, 1.22) or moderate complexity (OR = 4.71; 95% CI: 2.73, 8.11) data. Within the Routine cohort, anterior teeth had higher odds of periapical healing than posterior teeth (OR = 1.13; 95% CI: 1.04, 1.22). The 60‐month cumulative tooth survival was lower (p = 0.03) in the Routine (90.5%) than the Referred (96.0%) cohort. Within the Routine cohort, the hazard of tooth loss was higher amongst posterior teeth (HR = 4.03; 95% CI: 1.92, 8.45) but lower if posterior teeth had cast restorations (HR = 0.36; 95% CI: 0.19, 0.70). For the Referred cohort, posterior teeth restored with cast restoration (vs not) had significantly lower risk of tooth loss (HR = 0.21; 95% CI: 0.08, 0.55). Conclusions: For UKAF patients, root canal (re)treatment provided within the Referred pathway was significantly more likely to achieve periapical healing and better tooth survival than those provided within the Routine pathway. Posterior teeth restored with an indirect restoration had a higher proportion of tooth survival. This study supported the utility of the endodontic component of RIOTN for assessing case complexity. [ABSTRACT FROM AUTHOR]

Background: Cutaneous melanoma is characterized by a high risk of metastasis to distant organs and a substantial mortality rate. For planning treatment and assessing outcomes, the Breslow micrometric measurement is critical. The tumor macroscopic dimension is not considered a prognostic parameter in cutaneous melanoma, although there are studies showing that tumor size is an independent prognostic factor for melanoma‐specific survival. Therefore, this study aimed to evaluate the macroscopic dimension of melanoma and other known prognostic factors (i.e., Breslow index, mitoses, regression, and ulceration) as predictors of sentinel lymph node outcome and survival outcome. Methods: We performed a retrospective cross‐sectional study of 227 melanoma lesions subjected to sentinel lymph node biopsy at two Brazilian referral centers. Results: On univariate analysis, there was a statistically significant correlation between the largest macroscopic tumor dimension and the sentinel lymph node result (P = 0.001); however, on multivariate analysis considering all evaluated parameters, there was no significant difference between the sentinel lymph node result and the tumor macroscopic dimension (P = 0.2689). Regarding melanoma‐specific survival, the macroscopic dimension showed no significant correlation (P = 0.4632) in contrast to Breslow's dimension (P < 0.0001). Conclusion: The Breslow thickness was the only significant factor related to both the sentinel lymph node outcome and melanoma specific survival among the evaluated variables. [ABSTRACT FROM AUTHOR]

Background: Current practice patterns suggest open rather than minimally invasive (MIS) approaches for thymomas >4 cm. We hypothesized there would be similar perioperative outcomes and overall survival between open and MIS approaches for large (>4 cm) thymoma resection. Methods: The National Cancer Database was queried for patients who underwent thymectomy from 2010 to 2020. Surgical approach was characterized as either open or MIS. The primary outcome was overall survival and secondary outcomes were margin status, and length of stay (LOS). Differences between approach cohorts were compared after a 1:1 propensity match. Results: Among 4121 thymectomies, 2474 (60%) were open and 1647 (40%) were MIS. Patients undergoing MIS were older, had fewer comorbidities, and had smaller tumors (median; 4.6 vs 6 cm, P <.001). In the unmatched cohort, MIS and open had similar 90-day mortality (1.1% vs 1.8%, P =.158) and rate of positive margin (25.1% vs 27.9%, P =.109). MIS thymectomy was associated with shorter LOS (2 (1-4) vs 4 (3-6) days, P <.001). Propensity matching reduced the bias between the groups. In this cohort, overall survival was similar between the groups by log-rank test (P =.462) and multivariate cox hazard analysis (HR.882, P =.472). Multivariable regression showed shorter LOS with MIS approach (Coef −1.139, P <.001), and similar odds of positive margin (OR 1.130, P =.150). Discussion: MIS has equivalent oncologic benefit to open resection for large thymomas, but is associated with shorter LOS. When clinically appropriate, MIS thymectomy may be considered a safe alternative to open resection for large thymomas. [ABSTRACT FROM AUTHOR]

Background: Esophageal cancer is a prevalent malignant tumor of the upper gastrointestinal tract. The aim of this study was to examine the impact of surgical adherence on the prognosis of patients with locally advanced lower esophageal cancer and to analyze the factors that affect surgical adherence. Methods: Patients diagnosed with locally advanced (IIA-IVA) lower esophageal cancer between 2004 and 2015 were screened from the Surveillance, Epidemiology, and End Results (SEER) database. We utilized multifactorial logistic regression to analyze the correlates affecting surgical adherence. Furthermore, we employed Kaplan-Meier curves and Cox regression to determine the impact of surgical adherence on cancer-specific survival (CSS) and overall survival (OS). Results: Of the 4922 patients screened, 2372 individuals were advised to undergo surgery, out of which 2025 ultimately underwent the procedure while the remaining 347 refused. Lower surgical adherence was associated with older age, unmarried, SEER classification of "distant," and squamous cell carcinoma. Adherence to surgery proved to be an independent factor affecting OS and CSS. The Cox regression analysis showed that patients who refused surgery had lower OS (OR : 1.657; 95% CI : 1.429∼1.927; P <.001) and CSS (OR : 1.487; 95% CI : 1.309∼1.690; P <.001) than those who underwent surgery. Kaplan-Meier curves showed that patients who underwent surgical treatment had a better prognosis. Discussion: Good surgical adherence can improve the prognosis of patients with locally advanced (IIA-IVA) lower esophageal cancer, while poor surgical adherence is associated with older age, unmarried, SEER classification of "distant," and squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

Brain metastasis in osteosarcoma (BMO) is rare and its clinical characteristics are often buried among studies on brain metastasis of bone and soft tissue sarcomas. The aim of the present study was to summarize the incidence, clinical characteristics, treatment and outcomes of patients with BMO. This retrospective study included 7 patients with BMO who received treatment in our center between 2005 and 2019. The clinical medical records of the 7 patients, together with data of 70 BMO patients published in 33 articles and retrieved by means of PubMed and Medline, were analyzed, retrospectively. Data analysis of the 97 BMO patients showed a high correlation between the interval from the primary diagnosis to BMO occurrence and the interval from the primary diagnosis to prior metastases. Multivariate analysis showed that chemotherapy, radiotherapy and surgery were three main factors affecting the overall survival of BMO patients (HR = 0.427; HR = 0.372; HR = 0.296). Surgery combined with chemotherapy or radiotherapy offered a better overall survival than surgery alone. Patients with BMO may obtain survival benefits from regular neuroimaging and early aggressive multi-disciplinary interventions including surgical resection, postoperative radiotherapy and chemotherapy. This is a retrospective study describing the characteristics of metastasic intervals, locations, clinical features and prognosis in 97 patients with brain metastasis of osteosarcoma (BMO). Multivariate analysis showed that chemotherapy was effective as surgery and radiotherapy for the treatment of BMO. Our findings emphasize the importance of regular neuroimaging and early aggressive multi-disciplinary interventions including surgical resection, postoperative radiotherapy and chemotherapy. [ABSTRACT FROM AUTHOR]

Laser interstitial thermal therapy (LITT) is a minimally invasive treatment method in managing primary brain neoplasms, brain metastases, radiation necrosis, and epileptogenic lesions, many of which are located in operative corridors that would be difficult to address. Although the use of lasers is not a new concept in neurosurgery, advances in technology have enabled surgeons to perform laser treatment with the aid of real-time MRI thermography as a guide. In this report, we present our institutional series and outcomes of patients treated with LITT. We retrospectively evaluated 19 patients (age range, 28–77 years) who underwent LITT at one or more targets from 2015 to 2019. Primary endpoint observed was mean progression free survival (PFS) and overall survival (OS). Seven patients with glial neoplasms and 12 patients with metastatic disease were reviewed. Average hospitalization was 2.4 days. Median PFS was 7 and 4 months in the metastatic group and primary glial neoplasm group, respectively (p = 0.01). Median OS from time of diagnosis was 41 and 32 months (p = 0.02) and median OS after LITT therapy was 25 and 24 months (p = 0.02) for the metastatic and primary glial neoplasm groups, respectively. One patient experienced immediate post-procedural morbidity secondary to increased intracerebral edema peri-lesionally while one patient experienced post-operative mortality and expired secondary to hemorrhage 1-month post-procedure. Median follow-up was 10 months. Laser interstitial thermal therapy (LITT) is a safe, minimally invasive treatment method that provides surgeons with cytoreductive techniques to treat neurosurgical conditions. Both PFS and OS appear to be more favorable after LITT in patients with metastatic disease. In properly selected patients, this modality offers improved survival outcomes in conjunction with other salvage therapies. [ABSTRACT FROM AUTHOR]

The α-mixture model, as a flexible family of distributions, is an effective tool for modeling heterogeneity inS population. This article investigates the hazard rate of α-mixture in terms of hazard rates of mixed baseline distributions. In particular, when the baseline hazard rate follows either additive or multiplicative models an inverse problem to obtain the baseline hazard is solved. We, also, study the α-mixture hazard rate ordering for the ordered mixing distributions in the sense of likelihood ratio order. Sufficient conditions to order two finite α-mixtures in the sense of dispersive ordering are provided. Finally, it is shown that the hazard rate of the finite α-mixture in the multiplicative model tends to the hazard rate of the strongest (weakest) population as α → + ∞ ( − ∞ ). Several examples are presented to illustrate theoretical findings. [ABSTRACT FROM AUTHOR]

Aim: To compare the marginal bone level of immediately placed implants, with either immediate or delayed provisionalization (IP or DP), in the maxillary aesthetic zone after 10 years of function. Materials and Methods: Participants with a failing tooth in the maxillary aesthetic zone were randomly assigned to immediate implant placement with either IP (n = 20) or DP (n = 20) after primary wound closure with a free gingival graft. The final restoration was placed 3 months after provisionalization. The primary outcome was change in marginal bone level. In addition, implant survival, restoration survival and success, peri‐implant tissue health, mucosa levels, aesthetic indices, buccal bone thickness and patient satisfaction were evaluated. Results: After 10 years, the mean mesial and distal changes in marginal bone level were −0.47 ± 0.45 mm and −0.49 ± 0.52 mm in the IP group and −0.58 ± 0.76 mm and −0.41 ± 0.72 mm in the DP group (p =.61; p =.71). The survival rate was 100% for the implants; for the restorations, it was 88.9% in the IP group and 87.5% in the DP group. Restoration success, according to modified USPHS criteria, was 77.8% in the IP group and 75.0% in the DP group. The prevalence of peri‐implant mucositis was 38.9% and 35.7% and of peri‐implantitis 0.0% and 6.3%, respectively, in the IP group and DP group (p = 1.0; p =.40). The Pink Esthetic Score and White Esthetic Score was 15.28 ± 2.32 in the IP group and 14.64 ± 2.74 in the DP group, both clinically acceptable (p =.48). The buccal bone thickness was lower in the DP group. Patient satisfaction was similar in both groups (p =.75). Conclusions: The mean marginal bone level changes after immediate implant placement with IP were similar to those after immediate placement with DP. Clinical Trial Registration: Registered in the National Trial Register (NL9340). [ABSTRACT FROM AUTHOR]

Objectives: To examine trends in incidence and mortality and evaluate overall survival (OS) of oral cancer in Singapore between 1968 and 2017. Methods: All diagnosed oral cancers by anatomical sites and population size were extracted from the Singapore Cancer Registry and the Department of Statistics Singapore. The trend of age‐standardized incidence rate (ASIR) and mortality rate (ASMR) (per 100 000 person‐years) of the lip, oral cavity and salivary gland cancers were evaluated by Prais‐Winsten regressions for each ethnicity and gender. Kaplan–Meier curves were performed to evaluate the OS by anatomical sites in each age group by ethnicity and sex. Results: Overall, 49, 3494 and 1066 people were diagnosed, and 28, 2310 and 476 died from lip, oral cavity and salivary gland cancers, respectively. The oral cavity cancer ASIR and ASMR reduced from 3.07 (1968–1972) to 2.01(2008–2012) and from 2.06 (1978–1982) to 1.21 (2013–2017) per 100 000 person‐years, respectively, with both highest in Indians throughout the whole period. Male:Female ratio ranged from 3.43 (1973–1977) to 1.75 (2013–2017) and from 3.41 (1978–1982) to 2.40 (2013–2017) for ASIR and ASMR, respectively. However, both salivary gland cancer ASIR and ASMR increased from 0.50 (1968–1972) to 0.80 (2008–2012) and from 0.18 (1968–1982) to 0.42 (1988–1992) per 100 000 person‐years, respectively, with both higher in males since 1993. Oral cavity cancer ASIR decreased for males aged ≥60, and Indian females ≥25, but increased among Chinese females aged ≥60. Oral cavity cancer ASMR decreased among Chinese aged 25–59, and among Malay males and Indian females. Salivary gland cancer ASIR increased among Chinese males aged ≥60 and Malay males aged 25–59; while ASMR increased among Chinese males aged ≥60. The median OS for oral cavity, lip and salivary gland cancers were 3.0, 9.3 and 18.1 years, respectively, with females surviving longer than males. Conclusions: Singapore has experienced a decline in the incidence and mortality of lip, oral cancer, an increase in in the incidence and mortality of salivary gland cancer, with an increase in the median overall survival rate. Monitoring the magnitude of oral cancer burden and the demographic, and temporal variations is necessary for tailoring health planning and setting priorities for future clinical care and research. [ABSTRACT FROM AUTHOR]