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Plants as animals have cell membrane equipped with ion channels. These channels embedded in the membrane allowed ion to move in or out the cell. Therefore these proteins are involved in several physiological processes such as nutrition, sensing (of environmental factors) and long-distance communication. In this “slide presentation” we report the possible role of ion channels in sensing oscillation and in long distance signalling in plant. The first example concerns the mechanosensitive channels of the MSL (Mechanosensitive channel Small conductance-Like) family and illustrate how it possibly behave as an oscillation sensor for the plant. The function of such a channel is consistent with the capacity of terrestrial plants to react to repetitive mechanical load produced by wind. The second example concerns the role of mechano-gated and voltage-gated channels in the generation and long distance propagation of electrical signal in plant. More precisely, it illustrate how Action Potential and Slow Wave of depolarization are generated and propagate along plant tissues. Eventually the relevance of such electrical signals in plant is illustrated by two examples.

BACKGROUND: The 2015 American Society of Clinical Oncology guidelines recommend first-line treatment of hormone receptor (HR)-positive breast cancer with endocrine therapy plus or minus palbociclib, a selective cyclin-dependent kinase (CDK)4/6 inhibitor. In 2018, the U.S. Food and Drug Administration approved ribociclib, a new orally available selective CDK4/6 inhibitor. While gains in progression-free survival (PFS) and overall survival (OS) from ribociclib are important for clinical and treatment outcomes, trade-offs in adverse events (AEs) and additional costs necessitate cost-effectiveness analysis (CEA) to assist consideration by third-party payer systems, physicians, and patients. OBJECTIVES: To (a) develop a Markov model and (b) determine the cost-effectiveness of ribociclib plus endocrine therapy versus endocrine therapy alone as treatment for premenopausal and perimenopausal patients with HR-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer. METHODS: A lifetime 3-state Markov model (stable, progressed, and dead health states) was developed using a U.S. payer perspective. Transition probabilities were calculated based on OS and PFS outcomes from the randomized controlled phase 3 trial MONALEESA-7. These Kaplan-Meier curves were extended to lifetime by estimating best-fit distributions using loglogistic distribution for ribociclib curves and Weibull distribution for placebo curves. Costs were obtained from national data sources using 2019 U.S. dollars (USD) and discounted by 3%. Utilities were obtained via published breast cancer literature and were included for each health state and for time spent with each AE. Results were expressed as an incremental cost-effectiveness ratio (ICER) expressed as USD per quality-adjusted life-year (QALY) saved. Treatments were assumed to be cost-effective based on a willingness-to-pay (WTP) threshold of $150,000 per QALY gained. Base-case, 1-way sensitivity tornado diagrams and probabilistic sensitivity analyses demonstrated changes in the ICER and were driven by the cost of ribociclib and the utility of remaining in the stable health state. RESULTS: Ribociclib plus endocrine therapy was cost-effective at an ICER of $124,513 per QALY when compared with endocrine therapy alone at a WTP threshold of $150,000. The ribociclib plus endocrine therapy arm had an effectiveness of 5.28 QALYs and a total cost of $385,112, while placebo plus endocrine therapy provided only 2.46 QALYs at a lower total cost of $67.246. The model was sensitive to the cost of ribociclib and the utility of time spent in the stable health state. Probabilistic sensitivity analysis demonstrated that endocrine therapy alone was cost-effective until a WTP of $125,000 and was cost-effective 72% of the time at the WTP threshold. CONCLUSIONS: Ribociclib plus endocrine therapy is more cost-effective than endocrine therapy alone. Professionals in managed care settings should consider the pharmacoeconomic benefits of ribociclib for the treatment of HR-positive, HER2-negative breast cancer as they make value-based formulary decisions. Further CEAs should be considered as direct treatment comparison trials between CDK4/6 inhibitors are completed in the future. DISCLOSURES: No outside funding supported this study. The authors have nothing to disclose.

BackgroundThe AspireAssist is the first Food and Drug Administration-approved endoluminal device indicated for treatment of class II and III obesity.ObjectivesWe earlier reported 1-year results of the PATHWAY study. Here, we report 4-year outcomes.SettingUnited States-based, 10-center, randomized controlled trial involving 171 participants with the treatment arm receiving Aspiration Therapy (AT) plus Lifestyle Therapy and the control arm receiving Lifestyle Therapy (2:1 randomization).MethodsAT participants were permitted to continue in the study for an additional year up to a maximum of 5 years providing they maintained at least 10% total weight loss (TWL) from baseline at each year end. For AT participants who continued the study, 5 medical monitoring visits were provided at weeks 60, 68, 76, 90, and 104 and thereafter once every 13 weeks up to week 260. Exclusion criteria were a history of eating disorder or evidence of eating disorder on a validated questionnaire. Follow-up weight, quality of life, and co-morbidities were compared with the baseline levels. In addition, rates of serious adverse event, persistent fistula, withdrawal, and A-tube replacement were reported. All analyses were performed using a per-protocol analysis.ResultsOf the 82 AT participants who completed 1 year, 58 continued to this phase of the trial. Mean baseline body mass index of these 58 patients was 41.6 ± 4.5 kg/m2. At the end of first year (at the beginning of the follow-up study), these 58 patients had a body mass index of 34.1 ± 5.4 kg/m2 and had achieved an 18.3 ± 8.0% TWL. On a per protocol basis, patients experienced 14.2%, 15.3%, 16.6%, and 18.7% TWL at 1, 2, 3, and 4 years, respectively (P < .01 for all). Forty of 58 patients (69%) achieved at least 10% TWL at 4 years or at time of study withdrawal. Improvements in quality of life scores and select cardiometabolic parameters were also maintained through 4 years. There were 2 serious adverse events reported in the second through fourth years, both of which resolved with removal or replacement of the A tube. Two persistent fistulas required surgical repair, representing approximately 2% of all tube removals. There were no clinically significant metabolic or electrolytes disorders observed, nor any evidence for development of any eating disorders.ConclusionsThe results of this midterm study have shown that AT is a safe, effective, and durable weight loss alternative for people with class II and III obesity and who are willing to commit to using the therapy and adhere to adjustments in eating behavior.

Objectives: Artificial intelligence (AI) is an emerging field in dentistry. AI is gradually being integrated into dentistry to improve clinical dental practice. The aims of this scoping review were to investigate the application of AI in image analysis for decision‐making in clinical dentistry and identify trends and research gaps in the current literature. Material and Methods: This review followed the guidelines provided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses Extension for Scoping Reviews (PRISMA‐ScR). An electronic literature search was performed through PubMed and Scopus. After removing duplicates, a preliminary screening based on titles and abstracts was performed. A full‐text review and analysis were performed according to predefined inclusion criteria, and data were extracted from eligible articles. Results: Of the 1334 articles returned, 276 met the inclusion criteria (consisting of 601,122 images in total) and were included in the qualitative synthesis. Most of the included studies utilized convolutional neural networks (CNNs) on dental radiographs such as orthopantomograms (OPGs) and intraoral radiographs (bitewings and periapicals). AI was applied across all fields of dentistry ‐ particularly oral medicine, oral surgery, and orthodontics ‐ for direct clinical inference and segmentation. AI‐based image analysis was use in several components of the clinical decision‐making process, including diagnosis, detection or classification, prediction, and management. Conclusions: A variety of machine learning and deep learning techniques are being used for dental image analysis to assist clinicians in making accurate diagnoses and choosing appropriate interventions in a timely manner. [ABSTRACT FROM AUTHOR]

Purpose: Pre-optimization of obese patients prior to abdominal wall reconstruction (AWR) is essential in mitigating their increased preoperative risks. Traditionally diet, exercising, bariatric surgery are the tools typically prescribed for weight loss. The advent of glucagon-like peptide-1 agonists (GLP-1A) which stimulate insulin secretion and inhibit gastric emptying have improved the weight loss armamentarium. However, there is a limited amount of literature on GLP-1A effectiveness and postoperative outcomes in AWR patients. This study compares the efficacy of GLP-1A to Bariatric Surgery (BAS) in perioperative AWR patient. Methods: A prospectively maintained database was retrospectively reviewed to identify all patients undergoing AWR at our institution between January 2021 and March 2024. We included patients who required GLP-1A or BAS for weight optimization prior to AWR. We excluded patients on GLP1-A or history BAS not performed for AWR preoptimization. Basic demographics such as age, sex, race, weight and BMI at initial clinic visit and at surgery were compared. Primary endpoints included time to surgery, time to bowel recovery and length of stay (LOS). Time to surgery was defined as the number of months between the initial clinic visit and AWR. Time to bowel recovery was defined as the number of days it took for the first postoperative bowel function. Secondary endpoints included standard 30-days postoperative variables. Nominal variables were analyzed using a Fisher exact test and continuous variables were analyzed with Student's T test. Results: 35 patients were included in this study (GLP-1A: 17, BAS: 18). The GLP-1A cohort had a lesser BMI at the initial clinic visit (40.8 vs 43.4, p = 0.188). GLP-1A cohort made it to the operating room faster (9.1 months vs 13.5 months, p = 0.06) from the first clinic visit; and (7.9 months vs 9.7 months, p = 0.4) from initiation of weight loss intervention. Albeit losing less weight (14.9 kg vs 27.1 kg, p = 0.008) with a lesser reduction in the BMI (4.69 vs 9.23, p = 0.004). The GLP-1A cohort showed a non-significant elevated LOS (5.2 days vs 3.6 days, p = 0.25) and an increased ileus rate (17.6% vs 0%, p = 0.1). However, there were no differences noted in time to bowel recovery (2.9 days vs 3.1 days, p = 0.76). Conclusion: GLP-1A is effective in optimizing patients needing weight loss before AWR. They shorten the timeline to AWR intervention and have comparable peri-operative outcomes to BAS patients. [ABSTRACT FROM AUTHOR]

Background: With the increased use of robotic surgery, robotic transabdominal preperitoneal repair (R-TAPP) has become a commonly used approach for inguinal hernia repair. The laparoscopic totally extraperitoneal repair (L-TEP) has the advantage of not entering the peritoneal cavity; however, it has greater technical difficulty. Robotic surgery has demonstrated superiority over laparoscopy in many surgical settings, but there is limited evidence comparing L-TEP and R-TAPP. Methods: This was a retrospective review of patients who underwent L-TEP and R-TAPP at Baylor University Medical Center between December 2011 and January 2022. Information on patient demographic characteristics, comorbidities, postoperative complications, hospital length of stay, and postoperative complications requiring a procedure was collected. Results: A total of 298 patients were analyzed; 245 underwent R-TAPP and 53 underwent L-TEP. Hernia recurrence was significantly decreased in those who underwent R-TAPP (1.2%) compared to L-TEP (9.4%) (P = 0.01). Postoperative pain was also significantly decreased in the R-TAPP group (5.3%) as compared to the L-TEP group (13.2%) (P = 0.01). Conclusions: With the transition from L-TEP to R-TAPP over recent years, there is limited evidence supporting this change in practice. Our single-center retrospective review demonstrates that R-TAPP is noninferior to L-TEP and has significantly decreased hernia recurrence. [ABSTRACT FROM AUTHOR]

The proliferation of digital technologies is substantially transforming inspection methodologies for construction activities. Although the implementation of a three-dimensional (3D) model has emerged as an advantageous, feasible inspection application, the selection of the most suitable 3D models is challenging due to multiple technology options. The primary objectives of this study were to investigate current trends and identify future technologies for 3D models in the construction industry. This study utilized systematic reviews by identifying and selecting quality journals, analyzing selected articles, and conducting content analysis and meta-analysis to identify dominant themes in 3D models. Results showed that the top technologies used to model construction projects are building information models, remote sensing, stereo vision system/photo processing programs, and augmented reality/virtual reality. The main benefits and challenges of these technologies for modeling were also determined. This study identified three areas with significant knowledge gaps for future research: (1) the amalgamation of two or more technologies to overcome project obstacles; (2) solution optimization for inspections in remote areas; and (3) the development of algorithm-based technologies. This research contributes to the body of knowledge by exploring current trends and future directions of 3D model technologies in the construction industry. [ABSTRACT FROM AUTHOR]

Background: Australia imposes restrictions for people living with HIV (PLHIV) applying for permanent residency (PR), including spending less than AUD51,000 on medical costs over 10 years. Some PLHIV opted for suboptimal and cheaper antiretroviral therapy (ART) regimens to increase their chances of receiving PR. We collated a case series to examine PLHIV on suboptimal ART because of visa issues. Methods: We identified all patients applying for a PR in Australia who obtained nevirapine, efavirenz or zidovudine between July 2022 and July 2023 from the Melbourne Sexual Health Centre. Pathology results and records detailing psychological issues relating to the patients' wishes to remain on suboptimal ART were extracted from clinical records by two researchers. Results: We identified six patients with a mean age of 39 years migrating from Asian and European countries. Three patients used efavirenz, and three used nevirapine. All desired to remain on cheaper, suboptimal ART to stay below visa cost thresholds, which they considered to aid favourably with their application. Four displayed stress and anxiety arising from visa rejections, appeal deadlines and the lengthy visa application process. Conclusions: Despite access to more effective and safer ART, we identified patients who chose to remain on cheaper ART to improve chances of obtaining an Australian visa, potentially putting their health at risk. We found significant evidence of stress and anxiety among patients. There is a need to review and revise current migration policies and laws in Australia that discriminate against PLHIV and jeopardise public health. Even in the modern day, people living with HIV (PLHIV) are often subjected to poorer physical and mental health outcomes. Such health outcomes were identified in this case series, whereby six patients were noted to be experiencing significant stress, anxiety and medication side effects from electing to receive cheap, suboptimal HIV treatments to remain below Australian visa medical cost thresholds. These findings reinforce the need to review Australian migration laws which currently discriminate against PLHIV. [ABSTRACT FROM AUTHOR]