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Developmental dysplasia of the hip is a prevalent condition in newborns. However, predicting the duration of conservative treatment remains challenging. This study aimed to determine the duration of treatment more precisely by analyzing associated factors. We conducted a retrospective analysis and developed a linear regression model based on 503 patients treated at our institution over the last 10 years. A linear regression model (GLM) was used for predicting treatment duration (df residuals 371, df model 3, Pearson Chi2 78.9, Number of iterations 15). The baseline scenario thereby feature a child with an average age at the beginning of treatment (35th day of life), both sides pathologically affected, and a minimum alpha angle of 29 degrees. The GLM identified age at treatment onset, alpha angle, and bilaterality as significant predictors of treatment duration. A four-week delay in treatment initiation extended the duration by one week, while a 5-degree increase in the alpha angle reduced it by two weeks. Bilaterality added 19 days to treatment duration. However, sex and clinical hip instability did not significantly affect the treatment time. These findings enable the calculation of treatment duration based on identified factors, potentially improving the management and planning of conservative therapies for developmental dysplasia of the hip in newborns. [ABSTRACT FROM AUTHOR]

Abstract Background Complications from prolonged esophageal foreign body impaction are well-documented, yet the significance of non-foreign body factors has not been thoroughly explored. This study aims to investigate non-foreign body risk factors for complications during esophageal foreign-body removal and to evaluate the impact of treatment timing. Study We conducted a retrospective evaluation of patients diagnosed with esophageal foreign bodies requiring gastroscopic removal in our hospital between January 2019 and December 2020. Non-foreign body factors, such as whether endoscopic treatment was on the day of the visit, visiting time, complaint time (from ingestion to presentation), anesthesia method, and holidays, were considered. Results In total, 831 patients were included. The success rate of endoscopic treatment was 97.8%. The overall probabilities of mucosal injury, bleeding, and perforation were 90.3%, 53.3%, and 6.9%, respectively. The treatment was performed on the day of the patient’s visit for 70.4% patients, under sedation anesthesia for 50.7% patients, and in the early night for 44.6% patients. Treatment on the day of the visit did not affect the success rate. Same-day treatment was a protective factor for mucosal injury and perforation on univariate logistic regression analysis, but did not independently influence mucosal injury, bleeding, or perforation on multivariate analysis. Visiting time, complaint time, and holidays affected the complication rate. During the COVID-19 period in China, visiting time and anesthesia method were found to be independent predictors of same-day treatment. Conclusions Complaint time, visiting time and same-day treatment are significant and practical factors influencing the complications of endoscopic foreign-body removal. Certain patients, notably night-time visitors, might benefit from delaying treatment until the following day to utilize sedative anesthesia to minimize risks.

Background: Complications from prolonged esophageal foreign body impaction are well-documented, yet the significance of non-foreign body factors has not been thoroughly explored. This study aims to investigate non-foreign body risk factors for complications during esophageal foreign-body removal and to evaluate the impact of treatment timing. Study: We conducted a retrospective evaluation of patients diagnosed with esophageal foreign bodies requiring gastroscopic removal in our hospital between January 2019 and December 2020. Non-foreign body factors, such as whether endoscopic treatment was on the day of the visit, visiting time, complaint time (from ingestion to presentation), anesthesia method, and holidays, were considered. Results: In total, 831 patients were included. The success rate of endoscopic treatment was 97.8%. The overall probabilities of mucosal injury, bleeding, and perforation were 90.3%, 53.3%, and 6.9%, respectively. The treatment was performed on the day of the patient's visit for 70.4% patients, under sedation anesthesia for 50.7% patients, and in the early night for 44.6% patients. Treatment on the day of the visit did not affect the success rate. Same-day treatment was a protective factor for mucosal injury and perforation on univariate logistic regression analysis, but did not independently influence mucosal injury, bleeding, or perforation on multivariate analysis. Visiting time, complaint time, and holidays affected the complication rate. During the COVID-19 period in China, visiting time and anesthesia method were found to be independent predictors of same-day treatment. Conclusions: Complaint time, visiting time and same-day treatment are significant and practical factors influencing the complications of endoscopic foreign-body removal. Certain patients, notably night-time visitors, might benefit from delaying treatment until the following day to utilize sedative anesthesia to minimize risks. [ABSTRACT FROM AUTHOR]

Chronotherapy is the timing of medications to circadian rhythms to optimize beneficial and minimize adverse outcomes. We reviewed the US Online Prescribers' Digital Reference for the specified administration schedule of medications prescribed to manage coronary heart disease (CHD) and its major risk factors. For arterial hypertension, dosing of terazosin and guanfacine is recommended in the evening and thiazide, thiazide-like, and sulfonamide diuretics morning; Verapamil (Verelan®) morning, its "PM" formulation evening, and long-acting diltiazem (Cardizem® LA), per clinical goal, morning or evening. Most hyperlipidemia medications are recommended in the evening. Many hyperglycemia medications are intended for morning ingestion, but, when indicated, some may be prescribed in unequal doses or intervals. For obesity, administration of appetite suppressant psychostimulants and sympathomimetics is stipulated for morning ingestion. Sleep insufficiency medications are to be taken before bedtime. For tobacco dependence, transdermal nicotine patch application is recommended in the morning, and bupropion early, but not late, during the wake span. For alcohol dependence, disulfiram is intended for morning ingestion. For thromboembolism prophylaxis, factor Xa inhibitor rivaroxaban is recommended at dinner and low-dose acetylsalicylic acid before bedtime. Medications for angina pectoris and edema of congestive heart failure are stipulated for morning administration. Overall, >200 medications prescribed to manage CHD and its risk factors qualify as chronotherapies. [ABSTRACT FROM AUTHOR]

Purpose: A higher minimum monitor unit (minMU) for pencil‐beam scanning proton beams in intensity‐modulated proton therapy is preferred for more efficient delivery. However, plan quality may be compromised when the minMU is too large. This study aimed to identify the optimal minMU (OminMU) to improve plan delivery efficiency while maintaining high plan quality. Methods: We utilized clinical plans including six anatomic sites (brain, head and neck, breast, lung, abdomen, and prostate) from 23 patients previously treated with the Varian ProBeam system. The minMU of each plan was increased from the current clinical minMU of 1.1 to 3–24 MU depending on the daily prescribed dose (DPD). The dosimetric parameters of the plans were evaluated for consistency against a 1.1‐minMU plan for target coverage as well as organs‐at‐risk dose sparing. DPD/minMU was defined as the ratio of DPD to minMU (cGy/MU) to find the OminMU by ensuring that dosimetric parameters did not differ by >1% compared to those of the 1.1‐minMU plan. Results: All plans up to 5 minMU showed no significant dose differences compared to the 1.1‐minMU plan. Plan qualities remained acceptable when DPD/minMU ≥35 cGy/MU. This suggests that the 35 cGy/MU criterion can be used as the OminMU, which implies that 5 MU is the OminMU for a conventional fraction dose of 180 cGy. Treatment times were decreased by an average of 32% (max 56%, min 7%) and by an average of 1.6 min when the minMU was increased from 1.1 to OminMU. Conclusion: A clinical guideline for OminMU has been established. The minMU can be increased by 1 MU for every 35 cGy of DPD without compromising plan quality for most cases analyzed in this study. Significant treatment time reduction of up to 56% was observed when the suggested OminMU is used. [ABSTRACT FROM AUTHOR]

Background: Longer treatment time has been shown to be associated with lower crime recidivism among forensic psychiatric patients, but it is not known if this applies also to mortality. In this study, we aim to research whether treatment time is associated with risk of post-discharge mortality in Finnish forensic psychiatric patients. Materials and methods: The study population consisted of 989 patients committed to compulsory forensic psychiatric hospital treatment in Finland from 1980 to 2009 who were released from care by the end of 2018. Each patient included in the cohort was linked with the Statistics Finland register, which includes all data on dates and causes of deaths in Finland. Crude cumulative rate of mortality were estimated using Kaplan-Meier method and compared using logrank-test. Adjusted cumulative rate analyzed using Cox regression model. A possible nonlinear relationship between the treatment time and the hazard of death was assessed by using 3-knot-restricted cubic spline regression. Adjusted models included age, sex, and SUD (substance use disorder) as covariates. Results: The mean duration of care was 7.1 (SD 6) years. The duration of treatment variable was divided into tertiles of treatment duration less than 3.5 years, 3.5-7.9 years and equal or more than 8 years. The risk of mortality was highest in the first tertile, and lowest in the last tertile. The risk of mortality was higher for patients suffering from SUD, for patients of male sex and for those released at younger age. Conclusions: Longer treatment time is associated with reduced post-discharge mortality in forensic psychiatric patients in Finland. Especially males and individuals with SUD are at highermortality risk after release, but longer treatment durationmay mitigate these risks. Longer periods of hospitalization have to be, however, viewed against the backdrop of institutionalization and loss of self-determination. [ABSTRACT FROM AUTHOR]

Background: The advent of 3D printing technology has revolutionized orthodontic treatment, enabling the production of customized orthodontic brackets tailored to individual patients. These customized brackets are hypothesized to reduce treatment time and improve clinical outcomes by providing better alignment precision and minimizing the need for adjustments. Materials and Methods: A randomized controlled trial was conducted with 60 patients aged 12–25 years requiring orthodontic treatment. The participants were randomly assigned to two groups: the experimental group (n = 30) received 3D-printed customized orthodontic brackets, while the control group (n = 30) received conventional brackets. Treatment duration, the number of adjustment visits, and the quality of alignment were recorded over an 18-month period. Quality of alignment was assessed using the American Board of Orthodontics (ABO) grading system. Statistical analysis was performed using a paired t-test to compare the outcomes between the two groups. Results: The average treatment time for the experimental group was significantly shorter, with a mean duration of 14.2 months (SD ± 1.8) compared to 18.6 months (SD ± 2.3) in the control group (P < 0.01). The number of adjustment visits was reduced by 35% in the experimental group (mean = 8 visits) compared to the control group (mean = 12 visits). Furthermore, the quality of alignment, as measured by the ABO grading system, was significantly higher in the experimental group (mean score = 90.5) compared to the control group (mean score = 78.2) (P < 0.05). Conclusion: The use of 3D-printed customized orthodontic brackets significantly reduces treatment time and improves the quality of orthodontic outcomes compared to conventional brackets. These findings suggest that customized brackets offer a promising approach for enhancing the efficiency and effectiveness of orthodontic treatment, potentially leading to better patient satisfaction and reduced clinical workload.

ABSTRACT: Background: The advent of 3D printing technology has revolutionized orthodontic treatment, enabling the production of customized orthodontic brackets tailored to individual patients. These customized brackets are hypothesized to reduce treatment time and improve clinical outcomes by providing better alignment precision and minimizing the need for adjustments. Materials and Methods: A randomized controlled trial was conducted with 60 patients aged 12–25 years requiring orthodontic treatment. The participants were randomly assigned to two groups: the experimental group (n = 30) received 3D-printed customized orthodontic brackets, while the control group (n = 30) received conventional brackets. Treatment duration, the number of adjustment visits, and the quality of alignment were recorded over an 18-month period. Quality of alignment was assessed using the American Board of Orthodontics (ABO) grading system. Statistical analysis was performed using a paired t -test to compare the outcomes between the two groups. Results: The average treatment time for the experimental group was significantly shorter, with a mean duration of 14.2 months (SD ± 1.8) compared to 18.6 months (SD ± 2.3) in the control group (P < 0.01). The number of adjustment visits was reduced by 35% in the experimental group (mean = 8 visits) compared to the control group (mean = 12 visits). Furthermore, the quality of alignment, as measured by the ABO grading system, was significantly higher in the experimental group (mean score = 90.5) compared to the control group (mean score = 78.2) (P < 0.05). Conclusion: The use of 3D-printed customized orthodontic brackets significantly reduces treatment time and improves the quality of orthodontic outcomes compared to conventional brackets. These findings suggest that customized brackets offer a promising approach for enhancing the efficiency and effectiveness of orthodontic treatment, potentially leading to better patient satisfaction and reduced clinical workload. [ABSTRACT FROM AUTHOR]

The OBJECTIVE was to study the results of minimally invasive methods of treatment of nonparasitic spleen cysts.METHODS AND MATERIALS. A prospective nonrandomized study of 71 patients with nonparasitic spleen cysts was carried out. Depending on the method of treatment, the patients were divided into 2 groups: in the l group, patients (n=49) underwent laparoscopic operations, in the ll – puncture sclerosing treatment under US control (n=22). All patients underwent clinical and laboratory tests (including serological blood tests by IHA and EIA), instrumental research methods (US, CT angiography, MRT), intraoperative express cytological examination of punctate.RESULTS. In group 1, cyst fenestration was performed in 3 patients, splenectomy with autotransplantation of the splenic tissue was performed in 15 patients, resection of the spleen with a cyst was performed in 31 patients. In group II, puncture treatment was carried out in patients with comorbid pathology, with contraindications to endotracheal anesthesia, and deep intraparenchymal cyst location.CONCLUSION. Laparoscopic methods provide better results compared to puncture sclerosing technique: the frequency of intraoperative complications is significantly lower (RR 0.26 (0.07–1.02), P=0.055), relapses after 6–36 months – 2.04 % and 18.1 %, respectively (P=0.044), the length of hospital stay was 10.0 ± 0.3 and 14.0±0.5 days, respectively (P

It is important to find the estimation methodology with the highest accuracy in order to determine the parameters of water disinfection and to provide the most ideal disinfection. In this study, the usability of artificial neural networks in predicting response disinfection efficiency in electrochemical water disinfection processes was investigated. An artificial neural network model was developed using a total of 17 data sets and Response Disinfection Efficiency values were estimated from the model. Current density, treatment time and interelectrode spacing values are defined as input parameters in the network model, which has a multilayer perceptron architecture with 10 neurons in its hidden layer. The coefficient of determination value for the developed model was 0.98682 and the average deviation rate was −0.1%. The study findings showed that neural networks are an ideal tool that can be used to predict response disinfection efficiency in electrochemical water disinfection processes. [ABSTRACT FROM AUTHOR]

Introduction: Our analysis was designed to characterize the demographics and disparities between the diagnosis of pancreas cancer during emergency presentation (EP) and the outpatient setting (OP) and to see the impact of our institutions pancreatic multidisciplinary clinic (PMDC) on these disparities. Methods: Institutional review board-approved retrospective review of our institutional cancer registry and PMDC databases identified patients diagnosed/treated for pancreatic ductal adenocarcinoma between 2014 and 2022. Chi-square tests were used for categorical variables, and one-way ANOVA with a Bonferroni correction was used for continuous variables. Statistical significance was set at p < 0.05. Results: A total of 286 patients met inclusion criteria. Eighty-nine patients (31.1%) were underrepresented minorities (URM). Fifty-seven (64.0%) URMs presented during an EP versus 100 (50.8%) non-URMs (p = 0.037). Forty-one (46.1%) URMs were reviewed at PMDC versus 71 (36.0%) non-URMs (p = 0.10). No differences in clinical and pathologic stage between the cohorts (p = 0.28) were present. URMs took 22 days longer on average to receive treatment (66.5 days vs. 44.8 days, p = 0.003) in the EP cohort and 18 days longer in OP cohort (58.0 days vs. 40.5 days, p < 0.001) compared with non-URMs. Pancreatic Multidisciplinary Clinic enrollment in EP cohort eliminated the difference in time to treatment between cohorts (48.3 days vs. 37.0 days; p = 0.151). Results: Underrepresented minorities were more likely to be diagnosed via EP and showed delayed times to treatment compared with non-URM counterparts. Our PMDC alleviated some of these observed disparities. Future studies are required to elucidate the specific factors that resulted in these findings and to identify solutions. [ABSTRACT FROM AUTHOR]

Purpose: In patients with a need for frequent but intermittent apheresis, vascular access can prove challenging. We describe the migration of the use of a Vortex LP dual lumen port (Angiodynamics, Latham, NY) to one Powerflow and one ClearVUE power injectable port (Becton Dickinson, Franklin Lakes, NJ) in a series of patients undergoing intermittent apheresis. Materials and Methods: All patients had a need for long‐term intermittent apheresis. Eight had double lumen Vortex port (pre) and were exchanged for one Powerflow port and one conventional subcutaneous venous port with 90° needle entry (post) while 12 did not have any port in place and received the same configuration. IRB approval was granted. We recorded the treatment time, flow rate, and tissue plasminogen activator (tPA) use for five treatment sessions after placement. When available, we compared five treatments with the Vortex port and the new configuration. Results: The mean treatment time is reduced with the new configuration (P = 0.0033). The predicted mean treatment time, adjusting for gender, race, BMI and age and accounting for correlations within a patient is 91.18 min pre and 77.96 min post. The flow rate is higher with the new configuration (P < 0.0001). The predicted mean flow rate in mL/min is 61.59 for the Vortex port and 71.89 for the new configuration. tPA use was eliminated in the population converted from Vortex ports and had a 48% reduction when compared to all other configurations in the study. Conclusion: The introduction of a novel device configuration of venous access ports for intermittent apheresis resulted in higher flow rates and less total time for treatment. Use of tPA was greatly reduced. These results suggest that the new configuration could result in less expense for the hospital and better throughput in a busy pheresis practice. Clinical trial registration with ClinicalTrials.gov: NCT04846374. [ABSTRACT FROM AUTHOR]

This article presents a method for producing silver nanoparticles through plasma at atmospheric pressure using electrochemical techniques. Initially, an electrochemical configuration is designed using atmospheric pressure plasma (a direct current (DC) source). Subsequently, silver nanoparticles were produced in an environment without a stabilizer and evaluated according to the treatment time. The results demonstrate that the plasma-based electrochemical method, in comparison to other methods, including traditional electrochemical, can increase the accuracy in the shape and structure of nanoparticles while simultaneously accelerating the synthesized processes of nanomaterials. Analysis revealed that the synthesized nanostructures range between 2 and 3 nanometers in size and exhibit rod-like shapes, among other morphologies. [ABSTRACT FROM AUTHOR]

To investigate the impact of anaerobic soil disinfestation (ASD) treatment with different processing duration on tomato continuous cropping soil, a total of eight treatments were designed, which included two treatment temperatures of 10 °C and 30 °C, and four treatment times of 3, 4, 5 and 7 weeks (w). The results showed that whether the temperature was 10 °C or 30 °C, the pH values, TOC and available K contents in the soil treated by the ASD method were significantly increased (P<0.05), while the EC values and NO3– contents in soils treated by ASD were significantly reduced compared with the untreated group (P<0.05). The Fusarium oxysporum population in soils treated by ASD decreased with the extension of the treatment time. When the treatment temperature was 30 °C, the effect on the removal of the NO3– that had accumulated in soils treated by ASD was significantly better than the treatment temperature of 10 °C (P<0.05). When soil was treated by ASD for more than 5 w at 30 °C, the NH4+ content in soil was significantly increased (P<0.05) compared with the untreated soil. In conclusion, NO3– accumulation in soils could not be completely eliminated with treatment by ASD, even when the treatment time at 10 °C was prolonged. Whether the treatment temperature was 10 °C or 30 °C, the F. oxysporum population in soils treated by ASD decreased significantly with the extension of the treatment time to more than 5 w compared with treatment only for only 3 w. [ABSTRACT FROM AUTHOR]

Objective To analyze the clinical characteristics of pyogenic liver abscess (PLA) and explore the rationality and the duration of antibacterial treatment. Methods The clinical data of patients diagnosed as pyogenic liver abscess in our hospital from January 1, 2020 to December 31, 2022 were analyzed to explore their clinical characteristics. The rationality of antibacterial treatment was evaluated by setting evaluation criteria. The duration of antibacterial use in different treatment outcomes was counted.Results A total of 89 patients were included in the analysis. The average age was (62.0±15.6) years old, with the male accounting for 61.80%. Diabetes for 53.9% was the most common complication. Among 59 patients (66.3%) with positive culture of pos or blood, 51 cases (57.3%) were Klebsiella Pneumoniaes. Among the empirical and target treatment, 45 cases (50.6%) and 17 cases (28.8%) of antibacterial regimens were evaluated as unreasonable, respectively. Recovery treatment time was (17.0±7.6) d, and actual treatment time was (21.1±7.3) d. Conclusion Diabetes was the most common high-risk factor of PLA, and Klebsiella Pneumoniae was the main pathogenic bacteria. It is necessary to strengthen the management of antibacterial drugs, explore the appropriate duration of antibacterial treatment, and reduce the overuse of antibacterial drugs. [ABSTRACT FROM AUTHOR]

Traumatic Brain Injury (TBI) has garnered increasing attention due to its long-term effects on patients and the rising incidence of brain injuries in emergency department visits in recent years. The timing of pharmacological and surgical interventions plays a crucial role in disease progression. Correctly selecting and controlling the optimal treatment timing can greatly improve the patient prognosis.This review presents the latest advancements in research on the time effect of TBI in both basic and clinical studies. It summarizes the practical value of the surgical time window for TBI and further clarifies the impact of intervention timing on the prognosis of TBI patients, ultimately contributing to reducing healthcare burdens, improving patient quality of life,enhancing surgical outcomes,and providing accurate guidance for clinical treatment.

Background Worldwide, most people requiring kidney replacement therapy receive haemodialysis (HD) three times per week. Greater HD time and/or frequency may improve survival, but implementation requires understanding potential benefits across the range of patients. Methods Using data from the Australia and New Zealand Dialysis and Transplant Registry, we assessed whether quotidian HD (defined as >3 sessions/week and/or >5 h/session) was associated with reduced mortality in adult patients. The primary outcome of all-cause mortality was analysed by a time-varying Cox proportional hazards model with quotidian HD as the exposure of interest. Results Of 24 138 people who received HD between 2011 and 2019, 2632 (10.9%) received quotidian HD at some stage. These patients were younger, more likely male and more likely to receive HD at home. Overall, quotidian versus standard HD was associated with a decreased risk for all-cause mortality {crude hazard ratio [HR] 0.50 [95% confidence interval (CI) 0.45–0.56]}, but an interaction between quotidian HD and age was identified (P  = .005). Stratified by age groups and splitting follow-up time where proportional hazards were violated, the corresponding HR compared with standard HD was 2.43 (95% CI 1.56–3.79) for people >75 years of age in the first year of quotidian HD, 1.52 (95% CI 0.89–2.58) for 1–3 years and 0.95 (95% CI 0.51–1.78) for ≥3 years. There was no significant survival advantage in younger people. Conclusions Although quotidian HD conferred survival benefit in crude analyses, people ≥75 years of age had greater mortality with quotidian HD than standard HD. The mortality benefit in younger people was attenuated when adjusted for known confounders. [ABSTRACT FROM AUTHOR]

Introduction: Antibiotic resistance represents a growing global threat, and thus the motivation to develop novel and combined methods of bacterial inactivation is increasing. Electroporation is a technique in which electric pulses of sufficient strength are applied to permeabilize cells, including bacteria. Combining antibacterials with electroporation is a promising strategy to potentiate their bactericidal and bacteriostatic effectiveness. This approach has already proved useful for increasing bacterial inactivation, yet most studies so far have mainly focused on the maximal achievable effects, and less on the underlying mechanisms. We recently demonstrated that in the Gram-negative (G-) bacterium Escherichia coli, electroporation potentiates antibacterials targeting the peptidoglycan wall more than those with intracellular targets. However, in Gram-positive (G+) bacteria, the wall is directly accessible from the outside, and thus the dependence of potentiation on the antibacterial's target may be rather different. Here, we compare the inactivation and growth inhibition of the G+ bacterium Lactiplantibacillus plantarum for two antibiotics with different modes of action: ampicillin (inhibits cell-wall synthesis) and tetracycline (inhibits intracellular protein synthesis). Methods: We used antibiotic concentrations ranging from 0 to 30 × MIC (minimum inhibitory concentration that we predetermined for each antibiotic), a single 1-ms electric pulse with an amplitude from 0 to 20 kV/cm, and postpulse pre-dilution incubation of 24 h or 1 h. Results: Electroporation increased the inhibition and inactivation efficiency of both antibiotics, but this was more pronounced for tetracycline, with statistical significance mostly limited to 24-h incubation. In general, both inhibition and inactivation grew stronger with increasing antibiotic concentration and electric field amplitude. Discussion: Our results indicate that electroporation potentiates inactivation of G+ bacteria to a larger extent for antibiotics that inhibit intracellular processes and require transport into the cytoplasm, and to a smaller extent for antibiotics that inhibit cell-wall synthesis. This is the inverse of the relation observed in G-bacteria, and can be explained by the difference in the envelope structure: in G-bacteria the outer membrane must be breached for wall-inhibiting antibiotics to access their target, whereas in G+ bacteria the wall is inherently accessible from the outside and permeabilization does not affect this access. [ABSTRACT FROM AUTHOR]

BackgroundLonger treatment time has been shown to be associated with lower crime recidivism among forensic psychiatric patients, but it is not known if this applies also to mortality. In this study, we aim to research whether treatment time is associated with risk of post-discharge mortality in Finnish forensic psychiatric patients.Materials and methodsThe study population consisted of 989 patients committed to compulsory forensic psychiatric hospital treatment in Finland from 1980 to 2009 who were released from care by the end of 2018. Each patient included in the cohort was linked with the Statistics Finland register, which includes all data on dates and causes of deaths in Finland. Crude cumulative rate of mortality were estimated using Kaplan–Meier method and compared using logrank-test. Adjusted cumulative rate analyzed using Cox regression model. A possible nonlinear relationship between the treatment time and the hazard of death was assessed by using 3-knot-restricted cubic spline regression. Adjusted models included age, sex, and SUD (substance use disorder) as covariates.ResultsThe mean duration of care was 7.1 (SD 6) years. The duration of treatment variable was divided into tertiles of treatment duration less than 3.5 years, 3.5–7.9 years and equal or more than 8 years. The risk of mortality was highest in the first tertile, and lowest in the last tertile. The risk of mortality was higher for patients suffering from SUD, for patients of male sex and for those released at younger age.ConclusionsLonger treatment time is associated with reduced post-discharge mortality in forensic psychiatric patients in Finland. Especially males and individuals with SUD are at higher mortality risk after release, but longer treatment duration may mitigate these risks. Longer periods of hospitalization have to be, however, viewed against the backdrop of institutionalization and loss of self-determination.

Purpose: To compare the clinical performance and treatment times between glass hybrid (GH; EQUIA Forte Fil/EQUIA Forte Coat, GC) and adhesive/nanofilled resin composite restorations (RC; OptiBond FL, Kerr/Filtek Supreme XTE, 3M Oral Care) of sclerotic non-carious cervical lesions (sNCCL). Materials and Methods: This is an 18-month interim analysis of a 36-month cluster-randomized trial (ClinicalTrials. gov Identifier: NCT02631161). Eighty-eight patients (50-70 years) with 175 sNCCLs were randomized to receive GH or RC restorations. Restorations were placed without mechanical cavity preparation, and treatment time was recorded. After 18 months, restorations were evaluated using FDI criteria. Factors associated with restoration survival were evaluated using multi-level Cox-regression analysis. Generalized linear mixed modelling was used to analyze factors associated with treatment time. Results: After a mean of 18 months (min/max: 8/25), 78 patients (160 restorations) were assessed. Fifteen restorations (18%) failed in GH, and 11 (12%) in the RC, without a significant difference in survival (p = 0.904/Cox). Retention loss was the most common reason for failure in both groups. Restorations placed in older patients showed lower risk of failure [OR (95% CI): 0.90 (0.81-0.99) per year], while mandibular teeth showed higher risks [2.89 (1.00-8.31)]. Treatment time was significantly shorter for GH (mean ± SD: 8.6 ± 4.3 min) than RC (11.7 ± 5.7 min; p < 0.001). Conclusions: GH may be a suitable alternative to RC for restoring sNCCLs, without any significant difference in survival between the two materials at this interim analysis. In addition, placing GH restorations required less chairtime than did placing RC restorations. [ABSTRACT FROM AUTHOR]

This is a response to the letter to the editor from Dr. Ali et al. from Aga Khan University, Karachi, Pakistan.

IntroductionAntibiotic resistance represents a growing global threat, and thus the motivation to develop novel and combined methods of bacterial inactivation is increasing. Electroporation is a technique in which electric pulses of sufficient strength are applied to permeabilize cells, including bacteria. Combining antibacterials with electroporation is a promising strategy to potentiate their bactericidal and bacteriostatic effectiveness. This approach has already proved useful for increasing bacterial inactivation, yet most studies so far have mainly focused on the maximal achievable effects, and less on the underlying mechanisms. We recently demonstrated that in the Gram-negative (G–) bacterium Escherichia coli, electroporation potentiates antibacterials targeting the peptidoglycan wall more than those with intracellular targets. However, in Gram-positive (G+) bacteria, the wall is directly accessible from the outside, and thus the dependence of potentiation on the antibacterial’s target may be rather different. Here, we compare the inactivation and growth inhibition of the G+ bacterium Lactiplantibacillus plantarum for two antibiotics with different modes of action: ampicillin (inhibits cell-wall synthesis) and tetracycline (inhibits intracellular protein synthesis).MethodsWe used antibiotic concentrations ranging from 0 to 30 × MIC (minimum inhibitory concentration that we predetermined for each antibiotic), a single 1-ms electric pulse with an amplitude from 0 to 20 kV/cm, and post-pulse pre-dilution incubation of 24 h or 1 h.ResultsElectroporation increased the inhibition and inactivation efficiency of both antibiotics, but this was more pronounced for tetracycline, with statistical significance mostly limited to 24-h incubation. In general, both inhibition and inactivation grew stronger with increasing antibiotic concentration and electric field amplitude.DiscussionOur results indicate that electroporation potentiates inactivation of G+ bacteria to a larger extent for antibiotics that inhibit intracellular processes and require transport into the cytoplasm, and to a smaller extent for antibiotics that inhibit cell-wall synthesis. This is the inverse of the relation observed in G– bacteria, and can be explained by the difference in the envelope structure: in G– bacteria the outer membrane must be breached for wall-inhibiting antibiotics to access their target, whereas in G+ bacteria the wall is inherently accessible from the outside and permeabilization does not affect this access.

Martinique is the second French Region with the lowest physician-to-population ratio, which may affect waiting times for access to care. To assess (i) factors influencing waiting times from diagnosis to cancer-related treatments in breast cancer women in Martinique, and (ii) the impact of waiting times on patients' survival. Retrospective observational study. Data on women diagnosed with invasive breast cancer between 1st January 2013 and 31st December 2017 and initially treated by surgery were extracted from the Martinique population-based registry. A cox model was performed to find predictive factors for waiting times. A log-rank test was used to compare time-to-treatment between groups. In total, 713 patients were included (mean age: 58 ± 13). Median time from diagnosis to surgery was 40 [25–60] days. Age at diagnosis was found to predict variations in waiting times. Patients > 75 had longer waiting time to surgery than those < 40 or [40–50] (P = 0.016 and P < 0.001, respectively). Women with a time-to-treatment ≥ 4 months had a significant lower survival (P < 0.01). Specific interventions are needed to improve waiting time from diagnosis to initial treatment, as they are longer than recommended and affect survival time. [ABSTRACT FROM AUTHOR]

Introduction: The association of time to treatment (TTT) with survival remains unclear in pancreatic adenocarcinoma (PDAC). In this study, we evaluate the recent trends in TTT, causes for delay, and its effect on survival. Methods: We included patients with PDAC of all stages from the National Cancer Database (2004–2020) who underwent either surgery or chemotherapy/radiotherapy (CT/RT). TTT was defined as the duration between tissue diagnosis and first treatment. Linear regression (β) was used to study the temporal trends in time delay. Results: A total of 239,638 patients were included. The median TTT was 25 days. Using multivariable analysis, we found that increasing age (OR 1.48), female gender (OR 1.04), Black race (OR 1.3), lower educational status (OR 1.2), Medicaid, Medicare insurance, and uninsured (OR 1.2, 1.5, and 1.2, respectively), treatment at academic centers (OR 1.3), higher Charlson–Deyo comorbidity index (OR 1.2), and CT/RT (OR 1.5) were associated with increased TTT. There was a steady rise in median TTT from 21 to 28 days between 2004 and 2020 (β = 0.3), suggestive of a worsening trend. Concurrently, there was an increasing trend in utilization of neoadjuvant CT/RT between 2004 and 2020 in early-stage PDAC. On Cox regression, TTT delay was associated with poor overall survival in stage I–IV patients (HR 1.1, 1.1, 1.09, and 1.53, respectively). Conclusions: Delayed treatment approaching 2 months was observed in 10% of the population. The rising temporal trend in TTT may be attributed to the increasing shift toward neoadjuvant CT/RT in early-stage PDAC and/or the increasing use of tissue biopsy prior to surgery. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to look into the attitudes of Iraqi orthodontists towards the extraction of maxillary second premolars rather than maxillary first premolars and the usage of skeletal anchoring devices. Methods: 400 Iraqi orthodontists received an online questionnaire. The data was analyzed using descriptive and chi-square statistics. Results: The poll received 89 responses from orthodontists (22.25 percent). The larger the carious lesion in the upper second premolar, the more likely it is to be extracted over the healthy upper first premolar. Furthermore, the duration of therapy was associated to the extraction decisions made by orthodontists. In this study, orthodontists determined that using a mini-implant as a temporary anchorage device was acceptable. Conclusions: When orthodontists determined which teeth to extract for orthodontic therapy, the condition of the teeth was the most important factor to consider. Furthermore, while most orthodontists utilize mini-implants to improve anchorage during orthodontic treatment, there are still some elements of mini-implant use that orthodontists need to understand.

The annual phosphate (PO43−) utilization has increased, leading to a depletion of existing sources of phosphorus (P). To overcome this, digestate as a source to recover P is being investigated. Due to the abundance of nutrients, the digestate from an agricultural biogas plant is used as fertilizer for crops. The separation of solids and liquids from the digestate by a screw press is the simplest form of concentrating, therefore, recovering PO43−. This is the most commonly employed method in existing biogas plants. However, the separation is not very efficient as only 20–30% of P is recovered in the solid phase. The goal of this study is to increase the separation efficiency and recover more P into the solid phase, in order to improve the transportability. For this, separation trials at a laboratory scale were performed for five experimental groups, with biochar and straw flour as non-reactive additives and kieserite as a reactive additive. In addition, untreated digestate was studied as a control. The control and the treatment with biochar and straw flour were carried out at 25 °C, while the treatment with kieserite was performed at 25 °C and 50 °C. The separation trails were performed at treatment times of 0 h, 1 h, 2 h, 8 h, and 20 h. The results showed that the treatment with additives had a beneficial effect on the recovery of P. It was noted that kieserite treatment at 25 °C and 50 °C bound about 61% of the total P present in the digestate to the solid phase. A sequential extraction was performed to study the effect of additives on the recovery of different P species. The results concluded that, compared to biochar and straw flour, kieserite was efficient in recovering the non-labile fractions (NaOH-P and HCl-P) of P, which act as slow-release fertilizers. This study shows that the use of additives, especially kieserite, has a positive influence on recovering P from digestate, and further research to optimize the recovery process would be beneficial. [ABSTRACT FROM AUTHOR]

Background: Forensic psychiatric care in Finland is provided to individuals who have committed a crime due to a serious mental disorder and are in need of psychiatric care. The reconviction (recidivism) rates for this patient group vary in time and between countries, likely due to different treatment practices and requirements for forensic care. Materials and methods: We set out to study criminal recidivism in a national cohort of all patients released from forensic psychiatric care in Finland between 1999 and 2018. National registries were used to identify the patients and gain information on their criminal sentences. Forensic psychiatric examinations were used to record demographic information for the cohort. The cohort was followed up from hospital discharge to the end of 2019. Results: We identified a total of 501 patients who were released from forensic psychiatric care (mean age: 46.6years [SD 13.4), 434 (86.6%) were male). The mean and median times spent in treatment for the cohort was 10.0years [SD 6.5] and 8.7years, respectively. 91% of the patients had schizophrenia spectrum disorder (F2*), and 63.5% had a substance use disorder. A total of 83 patients (16.6%) committed any crime after being released from care, and the mean time to recidivism was 3.8years. The recidivism rate was 2015 per 100,000 person years. A total of 48 patients (9.6%) committed a violent crime. The mean time to violent recidivism was 4.2years. The violent recidivism rate was 1,083 per 100,000 person years. A longer duration of treatment was associated with a decreased risk of general recidivism (HR 0.95, 95% CI 0.90 to 1.00, p=0.05). Factors associated with higher recidivism were male sex, having a comorbid substance use disorder and younger age at discharge. Conclusion: The recidivism rate in Finland was markedly lower than has been previously reported for other Western countries, and the mean duration of treatment was also longer. A longer treatment time may reduce the risk of criminal recidivism in forensic psychiatric patients. The results suggest, as previous studies have found, that more effort is indicated on the treatment of substance abuse. [ABSTRACT FROM AUTHOR]

Copyright of Revista Internacional de Investigación en Adicciones is the property of Centros de Integracion Juvenil A.C. (CIJ) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Introduction Paediatric patients (individuals below 18 years of age) requiring cranial‐spinal irradiation (CSI) at our institution are commonly planned and treated using a three isocentre (3‐ISO) volumetric modulated arc therapy (VMAT) technique. A modified two isocentre (2‐ISO) VMAT technique was investigated with the aim to improve workflow and reduce planning and treatment time. Methods Five CSI paediatric patients previously treated with a 3‐ISO VMAT technique were retrospectively replanned using a 2‐ISO VMAT technique. The 2‐ISO VMAT plans were reviewed and approved by a radiation oncologist (RO) before undergoing patient‐specific quality assurance (QA) procedures, performed by a radiation oncology medical physicist (ROMP). Planning target volume (PTV) coverage, organ‐at‐risk (OAR) dose as well as planning and treatment durations of the first five patients utilising 2‐ISO technique were compared with 3‐ISO technique. Results The average percentage difference in PTV coverage by 95% reference dose between the 2‐ISO and 3‐ISO is 0.14%, and the average difference in OAR median dose is 0.68 Gy. Conformity and homogeneity indices have the same averages at 1.18 and 0.4 respectively. Patient‐specific physics QA results were all comparable with the 3‐ISO averages at 98.84% and the 2‐ISO at 98.71%. Planning duration for the 2‐ISO was reduced by up to 75%, and daily treatment duration was reduced by up to 50%. Of all the previously treated CSI patients using a 3‐ISO technique, 45% were suitable for the 2‐ISO technique. Conclusion The 2‐ISO VMAT technique provided comparable dose distribution based on PTV coverage, OAR dose and plan metric indices. Reduced planning and treatment duration with the 2‐ISO technique facilitated improved workflow with decreased sedation time for paediatric patients requiring a general anaesthesia.

BackgroundForensic psychiatric care in Finland is provided to individuals who have committed a crime due to a serious mental disorder and are in need of psychiatric care. The reconviction (recidivism) rates for this patient group vary in time and between countries, likely due to different treatment practices and requirements for forensic care.Materials and methodsWe set out to study criminal recidivism in a national cohort of all patients released from forensic psychiatric care in Finland between 1999 and 2018. National registries were used to identify the patients and gain information on their criminal sentences. Forensic psychiatric examinations were used to record demographic information for the cohort. The cohort was followed up from hospital discharge to the end of 2019.ResultsWe identified a total of 501 patients who were released from forensic psychiatric care (mean age: 46.6 years [SD 13.4), 434 (86.6%) were male). The mean and median times spent in treatment for the cohort was 10.0 years [SD 6.5] and 8.7 years, respectively. 91% of the patients had schizophrenia spectrum disorder (F2*), and 63.5% had a substance use disorder. A total of 83 patients (16.6%) committed any crime after being released from care, and the mean time to recidivism was 3.8 years. The recidivism rate was 2015 per 100,000 person years. A total of 48 patients (9.6%) committed a violent crime. The mean time to violent recidivism was 4.2 years. The violent recidivism rate was 1,083 per 100,000 person years. A longer duration of treatment was associated with a decreased risk of general recidivism (HR 0.95, 95% CI 0.90 to 1.00, p = 0.05). Factors associated with higher recidivism were male sex, having a comorbid substance use disorder and younger age at discharge.ConclusionThe recidivism rate in Finland was markedly lower than has been previously reported for other Western countries, and the mean duration of treatment was also longer. A longer treatment time may reduce the risk of criminal recidivism in forensic psychiatric patients. The results suggest, as previous studies have found, that more effort is indicated on the treatment of substance abuse.

Inadequate handling of infectious medical waste may promote the spread of the virus through secondary transmission during the transfer process. Microwave plasma, an ease-of-use, device-compact, and pollution-free technology, enables the on-site disposal of medical waste, thereby preventing secondary transmission. We developed atmospheric-pressure air-based microwave plasma torches with lengths exceeding 30 cm to rapidly treat various medical wastes in situ with nonhazardous exhaust gas. The gas compositions and temperatures throughout the medical waste treatment process were monitored by gas analyzers and thermocouples in real time. The main organic elements in medical waste and their residues were analyzed by an organic elemental analyzer. The results showed that (i) the weight reduction ratio of medical waste achieved a maximum value of 94%; (ii) a water–waste ratio of 30% was beneficial for enhancing the microwave plasma treatment effect for medical wastes; and (iii) substantial treatment effectiveness was achievable under a high feeding temperature (≥ 600 °C) and a high gas flow rate (≥ 40 L/min). Based on these results, we built a miniaturized and distributed pilot prototype for microwave plasma torch-based on-site medical waste treatment. This innovation could fill the gap in the field of small-scale medical waste treatment facilities and alleviate the existing issue of handling medical waste on-site. [ABSTRACT FROM AUTHOR]

Plasma treatment technology is considered a feasible method for wastewater remediation. This paper reports the use of in situ dielectric barrier discharge (DBD) plasma to degrade various organic pollutants dissolved in batik wastewater. In this study, the wastewater was treated continuously at a flow rate range of 60–160 mL/min with a treatment time of 0–270 min. The wastewater characteristics, such as absorbance, pH, temperature, dissolved oxygen (DO), electrical conductivity, total dissolved solids (TDS) and total suspended solids were measured before and after plasma treatment. As a result, treatment time and flow rate affect wastewater's physical and chemical characteristics due to the reaction between plasma species and pollutants. The absorbance of wastewater decreases with a longer treatment time and greater flow rate. The TDS, DO, conductivity and temperature increase with increase in treatment time and flow rate. The TSS value and pH decrease as treatment time and flow rate increase. The greatest degradation efficiency was 99.95%, achieved at 270 min of plasma treatment. From the cost analysis, the plasma treatment can save up to 21% of the cost of conventional methods. The experimental findings of this study exhibit DBD plasma treatment presented here as a potential method for wastewater treatment. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The electrochemical treatment of canal water was investigated in a batch-wise system in the presence of stainless steel 316-grade electrodes. Three effective process parameters, including current density, reaction time, and electrode spacing, were evaluated in the range of 0.25–2.5 mA/cm2, 1–10 min, and 0.5–2.5 cm, respectively. Operational variables of electrochemical disinfection are optimized in response surface methodology (RSM) using Box–Behnken design. Before electrochemical disinfection, a pretreatment process of coagulants mixing for turbidity removal was conducted. Results revealed that a 10 ppm dosage of Ferric chloride (FeCl3.6H2O) and alum (Al2(SO4)3·16H2O) at neutral pH is appropriate. Furthermore, the RSM analysis shows that interelectrode spacing is the most prominent factor affecting the disinfection performance, and increasing electrode spacing inversely affects the disinfection efficiency. Results revealed that 1.52 mA/cm2 current density, 6.35 min reaction time, and 1.13 cm of electrode spacing are the optimum conditions, resulting in a statistically 98.08% disinfection of the total coliform. The energy required for electrochemically disinfection of water at optimum conditions was 0.256 kWh/m3. [ABSTRACT FROM AUTHOR]

The main challenge of modern land management is the need to increase the yield of cultivated crops, while maintaining quality, minimising total energy inputs into cultivation and minimising the negative impact on the environment. This is quite possible if we have healthy seeds characterised, first of all, by improved sowing qualities. In order to realise the mentioned approaches, it is possible to use seed preparation for sowing, using for this purpose various electrophysical effects, including treatment of seed material in the electric field of high voltage. The purpose of the presented article is to analyse the results obtained to study the process of treatment of cereal seeds before sowing in the electric field of constant and alternating high voltage, as well as the electric field of pulsed high-voltage discharges. A universal experimental laboratory setup was assembled for the research. According to the results of the experiments, there was a clear dependence of the speed and friendliness of germination of winter triticale and barley seeds on the effects of electrical nature on them. Efficiency of such influences is also shown in plant protection against various pests, so against bread fleas and meromysa it is treatment in the electric field of alternating high voltage with duration of 120 s, as well as against Swedish fly, but with duration of treatment of 60 s; against wheat thrips – in the electric field of constant high voltage with duration of 60 s. Besides optimisation of phytosanitary condition of crops, the stimulating effect of high voltage electric field on yield structure of cereal crops (winter barley and triticale) was revealed, as productivity increases, bushiness and more dense productive stalks are formed. Electrostimulation has a positive effect on such hard-to-regulate parameter as ear fineness – the total number of grains in the ear increases by 13.8…31.0%; the weight of 1000 grains slightly increases – by 3.0…6.2%; grain yield to total weight increases by 40.3…57.8%; positive effect on all elements of yield structure is traced.

This study investigates the potential of ferrite nanoparticles (BaFe _12 O _19 , MnFe _2 O _4 , NiFe _2 O _4, and Co _1–0.5 Ni _0.5 Fe _2 O _4 ) as eco-friendly adsorbents for the removal of heavy metals (Zn ^2+ , Ni ^2+ , Co ^2+ , and Mn ^2+ ) from wastewater. Moreover, the adsorption experiments were conducted under varying contact times (30 min, 1 h, 2 h, and 4 h) and pH levels (2, 7, and 12) for five cycles to evaluate their significant dynamic effects on the removal efficiency. All ferrite nanoparticles were synthesized by the co-precipitation method and characterized (XRD, FT-IR, and SEM) to ascertain their crystal structure, morphology, size distribution, and crystallographic structures before wastewater treatments. The results demonstrated that BaFe _12 O _19 had a particle size of 8.65 nm and achieved maximum adsorption ability of 93%, 91%, 94%, and 91% for Zn ^2+ , Ni ^2+ , Co ^2+ , and Mn ^2+ , respectively, at a pH of 7 after 4 h of treatment. Since the neutral pH value affects the binding of heavy metal ions, therefore governing the adsorption efficiency and selectivity. In contrast, NiFe _2 O _4 (1.41 nm) revealed maximum removal of Zn ^2+ , Ni ^2+ , Co ^2+ , and Mn ^2+ were 78%, 71%, 88%, and 83%, respectively, at a pH of 12 after 4 h. This was attributed to the negatively charged surface leading to stronger electrostatic attractions between the positively charged metal ions and the adsorbent surface, resulting in higher adsorption uptake. Notably, the higher removal rate of ions was observed during initially 1 h, suggesting a decline in efficiency rate with extended treatment time. Additionally, the experimental study over five cycles concluded that the adsorbent could be effectively regenerated and reused.

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In order to improve the interface and mechanical properties of aramid fiber (AF)-reinforced epoxy resin (EP) composites (AF/EPs), the surface modification of AF was carried out with atmospheric pressure air plasma, and the effects of plasma treatment time and discharge power on the AF surface and the interface and mechanical properties of AF/EPs were investigated. The results show that, when plasma treatment time was 10 min and discharge power was 400 W, AF showed the best modification effect. Compared to the unmodified material, the total content of active groups on the surface of AF increased by 82.4%; the contact angle between AF and EP decreased by 20%; the interfacial energy and work of adhesion increased by 77.1% and 19.1%, respectively; the loss of AF monofilament tensile strength was controlled at only 8.6%; and the interlaminar shear strength and tensile strength of AF/EPs increased by 45.5% and 10.4%, respectively. The improvement in AF/EP interfacial and mechanical properties is due to the introduction of more active groups on the AF surface with suitable plasma processing parameters, which strengthens the chemical bonding between the AF and EP matrix. At the same time, plasma treatment effectively increases the surface roughness of AF, and the mechanical meshing effect between the AF and EP matrix is improved. The synergistic effect of chemical bonding and mechanical meshing improves the wettability and interfacial bonding strength between the AF and EP matrix, which enables the load to be transferred from the resin to the fiber more efficiently, thereby improving the mechanical properties of the AF/EP. [ABSTRACT FROM AUTHOR]

Background: Orthodontic treatment in adult patients is hindered by several problems, such as little time for regular dental visits and financial costs. In recent years, photobiomodulation (PBM) has been shown to significantly reduce the duration of orthodontic treatment and significantly increase patient compliance. Objective: This study aimed to investigate the efficacy of PBM in shortening the orthodontic treatment duration in adult patients while ensuring optimal patient compliance. Methods: A total of 170 orthodontic patients with a Little's irregularity index (LII) ≥ 3 mm treated with Invisalign clear aligners (Align Technology, Santa Clara, CA, USA) were included. The treatment group (PBM) (n = 90 patients) was trained in the use of the OrthopulseTM device (Biolux Research, Vancouver, Canada) according to an application protocol of 5 min per day. The control group (n = 80 patients) was treated with transparent Invisalign® without PBM applications. The LII was measured at a baseline and each aligner change until the end of the treatment when the LII was less than 1 mm. The crowding resolution rate (CRR), expressed in mm/week, and the total treatment time were measured. Results: The alignment rate of the PBM group was significantly higher than that of the control group (0.33 mm/week vs. 0.21 mm/week) with a reduction in the treatment time of 57.5 weeks in the PBM group compared with the control group. Conclusion: The PBM performed with the Orthopulse™ is shown to be an effective and noninvasive technique for accelerating teeth movements and can contribute in a relevant way to increase access to orthodontic treatment by the adult population as well as increase its compliance. [ABSTRACT FROM AUTHOR]

Background: Chronic hemodialysis (HD) patients are at high risk of severe COVID-19 with a high risk of death. The organization of dialysis units to treat chronic HD patients with COVID-19 is demanding to prevent virus transmission both in COVID-free patients and the staff. These constraints may have an impact on the dialysis delivery to COVID-free HD patients. We report our experience in French NephroCare (NC) centers. Methods: We report retrospectively dialysis and nutritional indicators among COVID-free prevalent chronic HD patients' cohort treated in French NC units from February 2020 to April 2020. The COVID-free HD patients were split into 2 subgroups for the analysis, Paris region and other regions because the incidence of COVID-19 was different according to the French regions. Results: The Paris region was the most impacted by COVID-19 with 73% of all the contaminations that occurred in French NC units (n = 118). The dialysis frequency was not reduced all over the NC regions. 2,110 COVID-free HD patients were split into 2 subgroups including Paris region (748 patients) and other regions (1,362 patients). The weekly treatment time decreased significantly in Paris region from February to April (723–696 min [p < 0.00001]) but remained stable in the other regions. The processed blood volume, KT/V, and convective volume declined significantly in the Paris region subgroup but not in other regions. The 3-month weight loss significantly increased in the whole group of patients whatever the region from 0.0 to 0.2% between February 2020 and April 2020 (p < 0.00001). Ultrafiltration rate (UFR) and the normalized proteic catabolic rate remained stable all along the period. The stepwise regression analysis identified February serum albumin level and April UFR as negatively associated with 3-month weight loss. Conclusion: HD delivery to COVID-free HD patients was negatively impacted in the Paris region because of the strong constraints on units' organization related to the treatment of COVID-19+ HD patients and with a higher proportion of limited care/self-care units with less staff resources. The 3-month weight loss increase may be related to the suppression of intradialytic snack that impacted mostly the more malnourished patients or patients with lower interdialytic weight gain. These consequences of the COVID-19 crisis on COVID-free HD patients must be recognized and corrected to prevent further deleterious effects on patients' outcomes. [ABSTRACT FROM AUTHOR]

The curve of Spee (CoS) is an important parameter for an individualized treatment plan. The available information regarding a potential association of the depth of the curve of Spee with various skeletal craniofacial characteristics is conflicting and it is also unknown whether certain craniofacial parameters affect the duration of the levelling phase of orthodontic treatment. A prospective sample of 32 patients with mild to moderate crowding that underwent orthodontic treatment with full fixed appliances was used to study these topics. The craniofacial characteristics were captured on pre-treatment lateral cephalometric radiographs and measurements of the CoS were performed on the initial 3D digital dental models using the Viewbox 4 software. Non-parametric statistics and Spearman's correlations were applied. Weak negative correlations were detected between the CoS depth and the SNA and SNB angles. There was no other association between the CoS and craniofacial parameters, including various anteroposterior measurements. Furthermore, there was no significant association of any craniofacial parameter with the duration of the levelling. Contrary to certain clinical beliefs, it can be argued that the craniofacial characteristics are not associated with the CoS and the time required for its levelling in subjects with moderate pre-treatment CoS depth. [ABSTRACT FROM AUTHOR]

Introduction: Paediatric patients (individuals below 18 years of age) requiring cranial‐spinal irradiation (CSI) at our institution are commonly planned and treated using a three isocentre (3‐ISO) volumetric modulated arc therapy (VMAT) technique. A modified two isocentre (2‐ISO) VMAT technique was investigated with the aim to improve workflow and reduce planning and treatment time. Methods: Five CSI paediatric patients previously treated with a 3‐ISO VMAT technique were retrospectively replanned using a 2‐ISO VMAT technique. The 2‐ISO VMAT plans were reviewed and approved by a radiation oncologist (RO) before undergoing patient‐specific quality assurance (QA) procedures, performed by a radiation oncology medical physicist (ROMP). Planning target volume (PTV) coverage, organ‐at‐risk (OAR) dose as well as planning and treatment durations of the first five patients utilising 2‐ISO technique were compared with 3‐ISO technique. Results: The average percentage difference in PTV coverage by 95% reference dose between the 2‐ISO and 3‐ISO is 0.14%, and the average difference in OAR median dose is 0.68 Gy. Conformity and homogeneity indices have the same averages at 1.18 and 0.4 respectively. Patient‐specific physics QA results were all comparable with the 3‐ISO averages at 98.84% and the 2‐ISO at 98.71%. Planning duration for the 2‐ISO was reduced by up to 75%, and daily treatment duration was reduced by up to 50%. Of all the previously treated CSI patients using a 3‐ISO technique, 45% were suitable for the 2‐ISO technique. Conclusion: The 2‐ISO VMAT technique provided comparable dose distribution based on PTV coverage, OAR dose and plan metric indices. Reduced planning and treatment duration with the 2‐ISO technique facilitated improved workflow with decreased sedation time for paediatric patients requiring a general anaesthesia. [ABSTRACT FROM AUTHOR]

Abstract Background The objective of this study was to analyze the amplitude of translational and rotational movements occurring during stereotactic body radiotherapy (SBRT) of spinal metastases in two different positioning devices. The relevance of intra-fractional imaging and the influence of treatment time were evaluated. Methods Twenty patients were treated in the supine position either (1) on a body vacuum cushion with arms raised and resting on a clegecel or (2) on an integrated SBRT solution consisting of a SBRT table top, an Orfit™ AIO system, and a vacuum cushion. Alignments between the cone beam computed tomography (CBCT) and the planning computed tomography allowed corrections of inter- and intra-fraction positional shifts using a 6D table. The absolute values of the translational and rotational setup errors obtained for 329 CBCT were recorded. The translational 3D vector, the maximum angle, and the characteristic times of the treatment fractions were calculated. Results An improvement in the mean (SD) inter-fraction 3D vector (mm) from 7.8 (5.9) to 5.9 (3.8) was obtained by changing the fixation devices from (1) to (2) (p

Zn–Ni alloy plating is widely applied in manufacturing of automobile and construction material components because it provides better corrosion resistance and wear resistance than Zn plating. Furthermore, chromate coating treatment is gaining attention with respect to improving the corrosion resistance of Zn–Ni alloys. In this study, we investigated the effects of NaF additive concentration and treatment time on trivalent chromate coating, which has been developed as an alternative to hexavalent chromate coating. The chromate post-treatment solution used in this study comprises Cr(NO3)3·9H2O (360 g/L), CoSO4·7H2O (40 g/L), and HNO3 (35 mL/L), to which NaF is added in the concentration range of 0–30 g/L. The as-formed coating films at 1.6 pH and 60 °C treatment temperature for deposition times ranging from 30 to 120 s demonstrated a decreasing corrosion rate as the NaF concentration increased. The electrochemical and morphological analyses inferred that NaF acted as a catalyst, enhancing the rate of film formation. Furthermore, the film thickness increased with the treatment time, and the film color changed in the order of yellow, purple, and green. [ABSTRACT FROM AUTHOR]

The primary purpose of the study is to evaluate the implementation of Helical TomoTherapy (HT) for eligible stereotactic radiosurgery/stereotactic body radiotherapy/stereotactic ablative radiotherapy (SRS/SBRT/SABR) cases using TomoEDGE option. The study focuses on reduction of treatment time without compromise in plan quality using TomoEDGE. It is a mode in HT that uses a dynamic opening of the jaws during treatment delivery to reduce the dose penumbra which otherwise is not possible with fixed jaws option. Eligible SRS/SBRT/SABR cases of lung, liver, and spine were used in this study. All planning parameters such as dose prescription to target and critical organs, pitch, and modulation factor were same in all the plans of the same patient with modifications in the field width and jaw mode. First set of plans with 2.5 cm width and second set of plans with 5 cm width were done in dynamic TomoEDGE mode. Third set of plans created with 5 cm width fixed jaw mode and fourth set of plans with 2.5 cm fixed jaw mode for comparison purpose were done. Our observations achieved that a significant milestone with reduction of up to 34.3% in treatment time of liver cases, 35.2% in lung cases, and 28.7% in spine cases was observed using dynamic TomoEDGE mode with 5 cm width, while no significant variation in the planning results compared with plans using 2.5 cm dynamic TomoEDGE option. TomoEDGE is an efficient and useful mode in TomoTherapy to reduce the treatment time with bigger field width in SRS/SBRT/SABR cases without significant changes in the plan quality.

Purpose: In stereotactic radiosurgery (SRS), prescription isodoses and resulting dose homogeneities vary widely across different platforms and clinical entities. Our goal was to investigate the physical limitations of generating dose distributions with an intended level of homogeneity in robotic SRS. Methods: Treatment plans for non-isocentric irradiation of 4 spherical phantom targets (volume 0.27–7.70 ml) and 4 clinical targets (volume 0.50–5.70 ml) were calculated using Sequential (phantom) or VOLOTM (clinical) optimizers (Accuray, Sunnyvale, CA, USA). Dose conformity, volume of 12 Gy isodose (V12Gy) as a measure for dose gradient, and treatment time were recorded for different prescribed isodose levels (PILs) and collimator settings. In addition, isocentric irradiation of phantom targets was examined, with dose homogeneity modified by using different collimator sizes. Results: Dose conformity was generally high (nCI ≤ 1.25) and varied little with PIL. For all targets and collimator sets, V12Gy was highest for PIL ≥ 80% and lowest for PIL ≤ 65%. The impact of PIL on V12Gy was highest for isocentric irradiation and lowest for clinical targets (VOLOTM optimization). The variability of V12Gy as a function of collimator selection was significantly higher than that of PIL. V12Gy and treatment time were negatively correlated. Plans utilizing a single collimator with a diameter in the range of 70–80% of the target diameter were fastest, but showed the strongest dependence on PIL. Conclusion: Inhomogeneous dose distributions with PIL ≤ 70% can be used to minimize dose to normal tissue. PIL ≥ 90% is associated with a marked and significant increase in off-target dose exposure. Careful selection of collimators during planning is even more important. [ABSTRACT FROM AUTHOR]

Using a 50-kV INTRABEAM® system after breast-conserving surgery, breast skin injury and long treatment time remain the challenging problems when large-size spherical applicators are used. This study has aimed to address these problems using gold (Au) nanoparticles (NPs). For this, surface and isotropic doses were measured using a Gafchromic EBT3 film and a water phantom. The particle propagation code EGSnrc/Epp was used to score the corresponding doses using a geometry similar to that used in the measurements. The simulation was validated using a gamma index of 2%/2 mm acceptance criterion in the gamma analysis. After validation Au-NP-enriched breast tissue was simulated to quantify any breast skin dose reduction and shortening of treatment time. It turned out that the gamma value deduced for validation of the simulation was in an acceptable range (i.e., less than one). For 20 mg-Au/g-breast tissue, the calculated Dose Enhancement Ratio (DER) of the breast skin was 0.412 and 0.414 using applicators with diameters of 1.5 cm and 5 cm, respectively. The corresponding treatment times were shortened by 72.22% and 72.30% at 20 mg-Au/g-breast tissue concentration, respectively. It is concluded that Au-NP-enriched breast tissue shows significant advantages, such as reducing the radiation dose received by the breast skin as well as shortening the treatment time. Additionally, the DERs were not significantly dependent on the size of the applicators. [ABSTRACT FROM AUTHOR]