Search Results (9)

Background: Extended half-life (EHL) factor IX (FIX) concentrates allow for prophylaxis with prolonged dosing intervals and high bleeding protection in persons with hemophilia B. Long-term real-world studies are lacking. Methods: In a retrospective–prospective study, the six-year use of prophylaxis with the EHL recombinant FIX–albumin fusion protein (rIX-FP) was analyzed, comparing outcomes with previous standard half-life (SHL) FIX in patients already on prophylaxis. Results: Prophylaxis with rIX-FP was prescribed in 15 patients (10 severe, 5 moderate; follow-up: 57 ± 17 months). Based on a pharmacokinetic assessment and clinical needs, the first regimen was 47 ± 7 IU/Kg every 9 ± 2 days. All but one patient remained on rIX-FP prophylaxis, adjusting infusion frequency and/or dose; the last prescribed frequency was ≥10 days in 10/13 patients, being reduced in seven and increased in four vs. the first regimen. The weekly FIX dose was unchanged; FIX trough levels were >5% in all patients. The annual infusion number and FIX IU/Kg significantly decreased (~60%) in eight patients previously on SHL FIX prophylaxis, with similar concentrate costs. Very low bleeding rates (most traumatic bleeds and the last quartile of the infusion interval), improved orthopedic and pain scores, unchanged HEAD-US scores and problem joints, and high treatment adherence (>90%) and satisfaction were registered. Conclusions: Personalized, carefully adjusted rIX-FP regimens contribute to the diffusion and optimization of prophylaxis in persons with severe and moderate hemophilia B, with long-term favorable bleeding, joint, and patient-reported outcomes. Full article

In breast tomosynthesis, multiple low-dose projections are acquired in a single scanning direction over a limited angular range to produce cross-sectional planes through the breast for three-dimensional imaging interpretation. We built a next-generation tomosynthesis system capable of multidirectional source motion with the intent to customize scanning motions around “suspicious findings”. Customized acquisitions can improve the image quality in areas that require increased scrutiny, such as breast cancers, architectural distortions, and dense clusters. In this paper, virtual clinical trial techniques were used to analyze whether a finding or area at high risk of masking cancers can be detected in a single low-dose projection and thus be used for motion planning. This represents a step towards customizing the subsequent low-dose projection acquisitions autonomously, guided by the first low-dose projection; we call this technique “self-steering tomosynthesis.” A U-Net was used to classify the low-dose projections into “risk classes” in simulated breasts with soft-tissue lesions; class probabilities were modified using post hoc Dirichlet calibration (DC). DC improved the multiclass segmentation (Dice = 0.43 vs. 0.28 before DC) and significantly reduced false positives (FPs) from the class of the highest risk of masking (sensitivity = 81.3% at 2 FPs per image vs. 76.0%). This simulation-based study demonstrated the feasibility of identifying suspicious areas using a single low-dose projection for self-steering tomosynthesis. Full article

The reuse of food by-products is crucial for the well-being of the planet. Considering the high content of nutrients and other bioactive compounds in many of them, investigating their suitability for use as human food ingredients is an interesting challenge. In this study, in addition to the proximate composition, phenol content and antioxidant activity (AOA = 3.2 mmol Trolox equivalent (TE)/100 g, db) of orange juice powder by-product (CoP), different in vitro properties related to carbohydrate metabolism have been characterised. Specifically, the glycaemic index (GI), the glycaemic load (GL), the glucose dialysis retardation index (GDRI = 13.6%), the glucose adsorption capacity (GAC = 22.5 mM) and the inhibition capacity of α-amylase (α-A = 46.9%) and α-glucosidase (α-G = 93.3%) of powdered orange juice waste have been determined and related to fibre and phenolics composition. Taking advantage of the high fibre content of the by-product (36.67%), its GL was calculated for a CoP dose that allows labelling the food to which it is added as a source of fibre. The low GI value (24.4%) and the low GL (0.918 g available carbohydrates per serving) allowed us to conclude that the product studied could be an interesting opportunity for the food industry to offer it as a healthy food ingredient to be included in the diet, especially for those suffering from type 2 diabetes mellitus. Of the total phenolic compounds (TP = 509 mg equivalent of gallic acid (GAE)/100 g, db), 68% were found in free fraction (FP), and their contribution to the total AOA was 40.6%, while this was 54.9% for the 32% of phenols bound to plant tissues (BP). Full article

This study evaluates ultra-low-dose computed tomography (ULDCT) protocols concerning the detectability of pulmonary nodules. The influence of tube current settings, kernels, strength levels of third-generation iterative reconstruction algorithms, and pitch was investigated. A chest phantom with artificial spherical nodules of different densities and diameters was examined with a third-generation dual-source CT. Scanning and post-processing protocols, tube current levels, and ultra-high and non-high pitch modes were applied. Images were reconstructed with filtered back-projection (FBP) or advanced model-based iterative reconstruction (ADMIRE) algorithms. Sharp (Bl57) or medium-soft (Br36) convolution kernels were applied. The reading was performed by an experienced and an inexperienced reader. The highest observer sensitivity was found using a non-high pitch protocol at tube currents of 120 mAs and 90 mAs with the sharp kernel and iterative reconstruction level of 5. Non-high pitch protocols showed better detectability of solid nodules. Combinations with the medium-soft kernel achieved slightly higher observer sensitivity than with the sharp kernel. False positives (FP) occurred more often for subsolid nodules, at a tube current level of 120 mAs, and with the sharp kernel. A tube current level of 90 mAs combined with the highest iterative reconstruction level achieved the highest accuracy in lung nodule detection regardless of size, density, and reader experience. Full article

Pulmonary nodule detection with low-dose computed tomography (LDCT) is indispensable in early lung cancer screening. Although existing methods have achieved excellent detection sensitivity, nodule detection still faces challenges such as nodule size variation and uneven distribution, as well as excessive nodule-like false positive candidates in the detection results. We propose a novel two-stage nodule detection (TSND) method. In the first stage, a multi-scale feature detection network (MSFD-Net) is designed to generate nodule candidates. This includes a proposed feature extraction network to learn the multi-scale feature representation of candidates. In the second stage, a candidate scoring network (CS-Net) is built to estimate the score of candidate patches to realize false positive reduction (FPR). Finally, we develop an end-to-end nodule computer-aided detection (CAD) system based on the proposed TSND for LDCT scans. Experimental results on the LUNA16 dataset show that our proposed TSND obtained an excellent average sensitivity of 90.59% at seven predefined false positives (FPs) points: 0.125, 0.25, 0.5, 1, 2, 4, and 8 FPs per scan on the FROC curve introduced in LUNA16. Moreover, comparative experiments indicate that our CS-Net can effectively suppress false positives and improve the detection performance of TSND. Full article

Macroscopic vascular invasion (MVI) is a poor prognostic factor in hepatocellular carcinoma (HCC). Hepatic arterial infusion chemotherapy (HAIC) is a promising treatment in MVI-HCC. However, it is not clear which regimens are suitable for HAIC. In this study, we aimed to compare the therapeutic effects between New FP (a fine-powder cisplatin suspended with lipiodol plus 5-fluorouracil) and low dose FP (LFP/cisplatin plus 5-fluorouracil) in the treatment of MVI-HCC patients with Child–Pugh class A. New FP is a regimen that consists of a fine-powder cisplatin suspended with lipiodol and 5-fluorouracil. Fifty-one patients were treated with LFP, and 99 patients were New FP. We compared the therapeutic effects of LFP and New FP and assessed factors that associated with the therapeutic effects. The median survival and progression-free survival times of LFP and New FP were 16.1/24.7 and 5.4/8.8 months, respectively (p < 0.05, p < 0.05). The complete response (29%) and objective response rate (76%) of New FP were significantly higher than those of LFP (p < 0.001, p < 0.01). Factors associated with better therapeutic response were better ALBI-grade and New FP treatment choice. New FP is a more powerful regimen than LFP in HAIC for MVI-HCC. New FP represents a recommended HAIC regimen for the treatment of patients with MVI-HCC. Full article

Optical fiber sensors (OFS) are a potential candidate for monitoring physical parameters in nuclear environments. However, under an irradiation field the optical response of the OFS is modified via three primary mechanisms: (i) radiation-induced attenuation (RIA), (ii) radiation-induced emission (RIE), and (iii) radiation-induced compaction (RIC). For resonance-based sensors, RIC plays a significant role in modifying their performance characteristics. In this paper, we numerically investigate independently the effects of RIC and RIA on three types of OFS widely considered for radiation environments: fiber Bragg grating (FBG), long-period grating (LPG), and Fabry-Perot (F-P) sensors. In our RIC modeling, experimentally calculated refractive index (RI) changes due to low-dose radiation are extrapolated using a power law to calculate density changes at high doses. The changes in RI and length are subsequently calculated using the Lorentz–Lorenz relation and an established empirical equation, respectively. The effects of both the change in the RI and length contraction on OFS are modeled for both low and high doses using FIMMWAVE, a commercially available vectorial mode solver. An in-depth understanding of how radiation affects OFS may reveal various potential OFS applications in several types of radiation environments, such as nuclear reactors or in space. Full article

The present study considers a possible role of enzymatic reactions in the adaptive response of cells to the beta-emitting radionuclide tritium under conditions of low-dose exposures. Effects of tritiated water (HTO) on the reactions of bacterial luciferase and NAD(P)H:FMN-oxidoreductase, as well as a coupled system of these two reactions, were studied at radioactivity concentrations ≤ 200 MBq/L. Additionally, one of the simplest enzymatic reactions, photobiochemical proton transfer in Coelenteramide-containing Fluorescent Protein (CLM-FP), was also investigated. We found that HTO increased the activity of NAD(P)H:FMN-oxidoreductase at the initial stage of its reaction (by up to 230%); however, a rise of luciferase activity was moderate (<20%). The CLM-FP samples did not show any increase in the rate of the photobiochemical proton transfer under the exposure to HTO. The responses of the enzyme systems were compared to the ‘hormetic’ response of luminous marine bacterial cells studied earlier. We conclude that (1) the oxidoreductase reaction contributes significantly to the activation of the coupled enzyme system and bacterial cells by tritium, and (2) an increase in the organization level of biological systems promotes the hormesis phenomenon. Full article

Crude extracts and essential oils of A. conyzoides were tested with larva and adult stages of Ae. aegypti mosquitoes to determine their insecticidal properties. The crude extracts and essential oils came from three varieties of A. conyzoides (with white flowers, purple flowers, or white-purple flowers) and from two places on each plant (leaves and flowers), giving six types overall: leaf-white (LW); leaf-purple (LP); leaf white-purple (LW-P); flower-white (FW); flower-purple (FP); and flower white-purple (FW-P). Chemical constituents and components of the essential oils were identified using gas chromatography-mass spectrometry (GC-MS). Electron microscopic and histopathological studies were performed to determine the toxicological effects on mosquitoes in terms of morphological alterations. The six types of crude extracts exhibited no activity against individuals in the larval stages. However, six types of essential oils were effective against adult Ae. aegypti females. The mortality of adult Ae. aegypti females was higher from leaf extracts, particularly LP (median lethal dose, LD₅₀ = 0.84%). The number of chemical constituents identified by GC-MS was high in flowers, especially W-P. Precocene I was the most abundant chemical component among the five types of essential oils, except in LP, in which precocene II was the most abundant. Histopathological alterations in adult Ae. aegypti females included compound eye degeneration, muscular damage with cellular infiltration, gut epithelial degeneration and necrosis, pyknotic nuclei in the malpighian epithelium and ovarian cell degeneration. FW and FP plant types exhibited the highest severity of histopathological alterations in mosquitoes compared with other plants, probably owing to the presence of monoterpene compounds in their tissues. The present study demonstrated LP plant extracts from A. conyzoides could be effective adulticides against adult Ae. aegypti. As natural products are biodegradable and exhibit low toxicity to mammalian and non-target organisms, they are suitable candidates for use in vector control programmes. Full article