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Given k$$ k $$ graphs G1,...,Gk$$ {G}_1,\dots, {G}_k $$ over a common vertex set of size n$$ n $$, what is the maximum value of ∑i∈[k]e(Gi)$$ {\sum}_{i\in \left[k\right]}e\left({G}_i\right) $$ having no "colorful" copy of H$$ H $$, that is, a copy of H$$ H $$ containing at most one edge from each Gi$$ {G}_i $$? Keevash, Saks, Sudakov, and Verstraëte denoted this number as exk(n,H)$$ {\mathrm{ex}}_k\left(n,H\right) $$ and completely determined exk(n,Kr)$$ {\mathrm{ex}}_k\left(n,{K}_r\right) $$ for large n$$ n $$. In fact, they showed that, depending on the value of k$$ k $$, one of the two natural constructions is always the extremal construction. Moreover, they conjectured that the same holds for every color‐critical graphs, and proved it for 3‐color‐critical graphs. They also asked to classify the graphs H$$ H $$ that have only these two extremal constructions. We prove their conjecture for 4‐color‐critical graphs and for almost all r$$ r $$‐color‐critical graphs when r>4$$ r>4 $$. Moreover, we show that for every non‐color‐critical non‐bipartite graphs, none of the two natural constructions is extremal for certain values of k$$ k $$. [ABSTRACT FROM AUTHOR]

Category: Diabetes; Other Introduction/Purpose: Subsequent major amputations within 1 year after initial forefoot amputations are sometimes necessary when other options for saving the foot are unavailable. Risk factors for early major amputation should be analyzed for a successful limb salvage strategy. This study aimed to analyze the risk factors for early major amputation after initial diabetic forefoot amputation. Methods: In this retrospective cohort study, clinically important variables of 808 first diabetic forefoot amputations were analyzed. Major amputations were performed in 104 patients (12.9%) throughout follow-up, and 77 (74%) of 104 patients had their major amputation within l year. Cox proportional hazards were examined to assess the risk factors for major amputation performed within 1 year. Results: In univariate analysis, 19 possible risk factors significantly differed between patients with and without early major amputation. In stepwise multivariable analysis, age, body weight, chronic renal failure (CRF), intermediate column amputation level, and C-reactive protein (CRP; mg/dl) level significantly differed. CRF showed the largest hazard ratio (HR) for early major amputation: 4.538 (95% confidence interval: 2.667-7.723, p-value < 0.0001). Age, weight, intermediate column amputation level, and CRP level had relatively low HRs: 1.032, 0.968, 1.367, and 1.078, respectively. Conclusion: CRF was a strong independent risk factor for early major amputation in the first diabetic forefoot amputation. Furthermore, patients with CRF underwent earlier and more major amputations throughout their follow-up. Before the surgical treatment, patients with CRF should be educated in terms of the high probability (>20%) of early major amputation. [ABSTRACT FROM AUTHOR]

Category: Ankle Arthritis Introduction/Purpose: The prevalence of degenerative ankle arthritis is approximately 1% based on the population of patients visiting hospitals. When considering individuals with early-stage arthritis who may not exhibit any symptoms or only mild discomfort, this figure is likely even higher. Degenerative arthritis of the ankle, mainly secondary to fractures, is well-documented, while primary degenerative ankle arthritis is relatively rare, with limited reports on its etiology and natural course. However, in a disease like degenerative ankle arthritis, long-term follow-up of ten years or more is crucial, yet research on this subject remains scarce. This study analyzed the follow-up results of primary degenerative ankle O.A.(Takakura classification I,II,IIIA) patients without surgery for natural course. Methods: We retrospectively investigated 169 patients with degenerative arthritis who visited the hospital from May 2009 to November 2023. Among them, 32 patients, who did not undergo surgery and were followed up for a minimum of 10 years, underwent clinical and radiological examinations. Initial patients included those with Takakura classification stage IIIA or lower. The degree of Takakura classification stage change was compared between the first and final visits. Hindfoot views and whole lower extremity assessments were also conducted. Visual analogue scale (VAS), Foot Function Index (FFI) scale were measured, respectively. Results: Among the initial 169 patients, 32 patients(43 ankles) had completed ten years or more of follow-up. According to the Takakura classification, 5 ankles had no change in Stage I, while 1 ankle progressed to Stage II. In Stage II, 13 ankles had no change, and 2 ankles progressed to Stage IIIA. In Stage IIIA, 13 ankles showed no change, 7 ankles deteriorated to Stage IIIB, and 3 ankles progressed to Stage IV. Overall, out of 43 ankles, 31 remained unchanged, 10 deteriorated by one stage, and 2 deteriorated by two stages. At the initial visit and the final follow-up, the FFI scores were 57 and 51, VAS scores were 4.6 (1-9) and 3.5 (0-8). Conclusion: This study analyzed the long-term outcomes of patients with Takakura stage IIIA or lower degenerative ankle arthritis over a minimum of 10 years. The radiological progression was minimal, and most of cases were improvement in clinical pain and functional scores. Therefore, in primary degenerative arthritis of the ankle, it is essential to investigate whether ankle pain is due to arthritis then should be considered carefully in the surgical treatment of degenerative ankle arthritis. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to describe a plastic scintillating plate‐based gantry‐attachable dosimetry system for pencil beam scanning proton therapy to monitor entrance proton beam fluence, and to evaluate the dosimetric characteristics of this system and its feasibility for clinical use. Methods: The dosimetry system, consisting of a plastic scintillating plate and a CMOS camera, was attached to a dedicated scanning nozzle and scintillation during proton beam irradiation was recorded. Dose distribution was calculated from the accumulated recorded frames. The dosimetric characteristics (energy dependency, dose linearity, dose rate dependency, and reproducibility) of the gantry‐attachable dosimetry system for use with therapeutic proton beams were measured, and the feasibility of this system during clinical use was evaluated by determining selected quality assurance items at our institution. Results: The scintillating plate shortened the range of the proton beam by the water‐equivalent thickness of the plate and broadened the spatial profile of the single proton spot by 11% at 70 MeV. The developed system functioned independently of the beam energy (<1.3%) and showed dose linearity, and also functioned independently of the dose rate. The feasibility of the system for clinical use was evaluated by comparing the measured quality assurance dose distribution to that of the treatment planning system. The gamma passing rate with a criterion of 3%/3 mm was 97.58%. Conclusions: This study evaluated the dosimetric characteristics of a plastic scintillating plate‐based dosimetry system for use with scanning proton beams. The ability to account for the interference of the dosimetry system on the therapeutic beam enabled offline monitoring of the entrance beam fluence of the pencil beam scanning proton therapy independent of the treatment system with high resolution and in a cost‐effective manner. [ABSTRACT FROM AUTHOR]

Glioblastoma multiforme (GBM), the most common type of brain tumor, is a very aggressive and treatment-refractory cancer, with a 5-year survival rate of approximately 5%. Hyperthermia (HT) and tumor treating fields (TTF) therapy have been used to treat cancer, either alone or in combination with other treatment methods. Both treatments have been reported to increase the efficacy of other treatment techniques and to improve patient prognosis. The present study evaluated the therapeutic effects of combining HT and TTF on GBM cell lines. Cells were subjected to HT, TTF, HT+TTF, or neither treatment, followed by comparisons of cell proliferation, apoptosis, migration and invasiveness. Clonogenic assays showed that the two treatments had a synergistic effect. The levels of cleaved PARP and cleaved caspase-3 were higher and apoptosis was increased in cells treated with HT+TTF than in cells treated with HT or TTF alone. In addition, HT+TTF showed greater inhibition of GBM cell migration and invasiveness and greater downregulation of STAT3 than either HT or TTF alone. The stronger anticancer effect of HT+TTF suggested that this combination treatment can increase the survival rate of patients with difficult-to-treat cancers such as GBM., Competing Interests: None., (AJCR Copyright © 2022.)