Search Results (55)

Background/Objectives: Head and neck squamous cell carcinoma (HNSCC) ranks sixth in the world in terms of incidence. Small proline-rich proteins (SPRRs) are precursors of the keratinocyte envelope and act as substrates of transglutaminase. A change in SPRR expression is characteristic in a few types of cancer. Our aim was to determine the concentration of SPRR1A and SPRR2A in tumours samples obtained from 61 patients with HNSCC (OSCC, OPSCC, LSCC, HPSCC, NCSCC, and SSCC). Also, we aimed to determine the relationship between protein concentration and other clinical and/or demographic variables. Methods: An ELISA test was used to determine the concentrations of SPRR in the tumour tissue homogenates. Results: In margin samples, we found a statistically significant association between SPRR1A levels and nodal status (N) and between SPRR1A levels in tumours and margins with G2 histological grade. When we analysed the effect of tobacco and alcohol habits, we found a statistically significant difference between the SPRR1A and SPRR2A amount in smokers and non-smokers in margin samples. Also, we found a statistically significant difference between the SPRR1A and SPRR2A levels in tumour and margin samples obtained from patients that either abstain and occasionally or regularly consume alcohol. Furthermore, we found in tumour and margin samples from patients with concomitant diseases an association between SPRR1A and SPRR2A levels. Our results showed altered concentrations of SPRR1A at margins, depending on HPV status. Conclusions: These results suggest that differences in SPRR proteins are determined by disease status and unhealthy behaviours, which, in a wider perspective, can influence carcinogenesis. Full article

Objectives: Although hippocampal-sparing whole-brain irradiation (HS-WBI) offers potential neurocognitive benefits, it poses challenges in treatment planning. This study aimed to compare the dose distributions of biaxially rotational dynamic radiation therapy (BROAD-RT) with a novel O-ring-type linear accelerator (OXRAY) and conventional non-coplanar volumetric modulated arc therapy (VMAT) planning (Conv-VMAT) in HS-WBI treatment plans. Methods: This study included 10 patients with brain metastases from lung cancer at our institution. The hippocampus was contoured using gadolinium-based contrast-enhanced magnetic resonance imaging, and hippocampal-sparing regions were created using a 5 mm margin around the hippocampus. Two virtual plans (BROAD-RT and Conv-VMAT) with 30 Gy in 10 fractions were created to compare the dose distributions in the planning target volume (PTV), hippocampus, eyes, and lens. All plans were analyzed using a paired t-test. Results: The mean (standard deviation [SD]) hippocampus-Dmax, -Dmean, -D100%, and -V10 were 11.10 (0.61), 7.95 (0.20), 7.01 (0.19), and 0.42 (0.34) for BROAD-RT and 16.10 (0.57), 9.89 (0.75), 8.24 (0.34), and 39.05 (25.89) for Conv-VMAT, respectively. All hippocampal parameters were significantly better with BROAD-RT than with Conv-VMAT (p < 0.01). The PTV-D98, -D50, -D2, -V35, and -homogeneity index did not exhibit significant differences between BROAD-RT and Conv-VMAT. Although lens-Dmax was significantly better in BROAD-RT than in Conv-VMAT (p < 0.01), no significant differences were observed in the eye-Dmax and chiasm-Dmax between BROAD-RT and Conv-VMAT. The mean (SD) BROAD-RT beam delivery time was 313.60 (34.91) s. Conclusions: BROAD-RT improved hippocampal sparing with acceptable PTV coverage and PTV homogeneity in HS-WBI planning. In addition, BROAD-RT has a clinically acceptable treatment duration. Full article

Background: This study evaluates non-surgical therapy combined with injectable platelet-rich fibrin (i-PRF) on the clinical parameters and the levels of matrix metalloproteinase-8 (MMP-8) in the gingival crevicular fluid (GCF) in patients with periodontitis. Methods: Forty subjects diagnosed with periodontitis were randomly divided into two groups. In the test group, scaling and root planing (SRP) was performed with the subsequent application of i-PRF into periodontal pockets, while in the control group SRP was performed alone. Clinical examination was performed before and 1, 3 and 6 months after treatment. For MMP-8 level determination, the ELISA method was used. Results: In both groups, a statistically significant reduction in full mouth probing depth (FMPD), full mouth clinical attachment level (FMCAL), full mouth bleeding on probing (FMBOP), full mouth plaque index (FMPI) and full mouth marginal bleeding index FMMBI (p < 0.001) was observed. In the test group, the reduction in FMPD and FMBOP was statistically significantly greater than in the control group (p = 0.049 and p < 0.001, respectively). A significantly greater reduction of probing depth (PD) and clinical attachment level (CAL) in pockets > 5 mm between baseline and examination after 3 and 6 months was noted in the test group. The level of MMP-8 was statistically significantly reduced in both groups (p = 0.007 and p = 0.009). Conclusions: SRP significantly improves the clinical parameters and reduces MMP-8 levels in patients with periodontitis. Addition of i-PRF may further enhance the positive effects of periodontal treatment on clinical parameters, without significant influence on MMP-8 levels. The results of the research require confirmation in a more homogeneous group, taking into account the elimination of the specified limitations. Full article

This study examines how the effective dielectric characteristics of the human torso affect the carrier-link-margin (CLM) and data-link-margin (DLM) of a biocompatible gelatin-encapsulated implantable medical device (IMD) that consists of a small implantable antenna, battery, printed circuit board (PCB), camera, and sensor operating at 2.5 GHz. The specific absorption rate (SAR) and the radio frequency (RF) link performances of the IMD are tested for ±20% changes in reference to the mean values of the effective relative permittivity, ɛ_eff, and the effective conductivity, σ_eff, of the human body model. An artificial neural network (ANN) with two inputs (ɛ_eff, σ_eff) and five outputs (SAR_1 g, SAR_10 g, fractional bandwidth, CLM, and DLM) is trained by 80% of the total scenarios and tested by 20% of them in order to provide reliable dependent analyses. The highest changes in 1 g SAR value, 10 g SAR value, fractional bandwidth, CLM, and DLM at a 4 m distance for 100 Kbps are 63%, 41.6%, 17.97%, 26.79%, and 5.89%, respectively, when compared to the reference effective electrical properties of the homogeneous human body model. This work is the first to accurately depend on the electrical analyses of the human body for the link margins of an implantable antenna system. Furthermore, the work’s uniqueness is distinguished by the application of the CLM and DLM principles in the sphere of IMD communication. Full article

Cryptorchidism consists in the failure of one or both testicles to fully descend into the scrotum. The position of the retained testes can be abdominal or inguinal and may occur unilaterally or bilaterally. This retrospective, multi-center study aimed to describe the computed tomography (CT) features of retained testes in dogs. Nineteen CT scans of dogs, with either unilateral or bilateral cryptorchidism, were analyzed with both pre- and post-contrast imaging. The location, size, shape, margins, homogeneous parenchyma, and density calculated were examined with the Hounsfield unit. Statistical analyses were performed to assess the differences between the scrotal (ST) and undescended testes (UT) and to detect any correlation between the features, ages, and size of the dog. CT identified the retained testes and provided enhanced three-dimensional visualization compared to traditional ultrasound. This study revealed that the UT were significantly smaller than ST, with UT measuring around 70% of ST size. Additionally, the UT exhibited increased density in both pre- and post-contrast scans, potentially due to the reduced or absent spermatogenesis or to histological changes occurring in the parenchyma. While CT showed clear advantages, such as three-dimensional spatial resolution and deeper tissue penetration, limitations such as general anesthesia and radiation exposure should also be considered. However, the present study showed that CT could serve as a valuable second step tool in cases where ultrasound fails, particularly in challenging anatomical situations. Full article

Forests grow under dynamic conditions influenced by vegetation structure and environmental factors. However, empirical models to enhance growing stock volume GSV) estimation are commonly established based on structural information from airborne laser scanning (ALS) data, raising important questions regarding the models’ performance across time (temporal transferability). This study presents the integration of ALS and microclimate and site-specific data to assess the temporal transferability of GSV models at the plot level in a mixed forest located in Milicz, Poland, between 2007 (t₁) and 2015 (t₂). We compared random forest (RF), multiple linear regression (MLR), and generalized additive models (GAMs) across three modelling scenarios, ALS + site type + climate (sa), ALS only (sb), and ALS + site type (sc), and also performed internal and external validation to assess temporal transferability. Among the three modelling approaches, GAMs outperformed the MLR and RF models in internal validation, improving the R² by 6%–8% and reducing the rRMSE by 6%–12%. We found that climate was significant in GSV prediction when integrated with ALS and site conditions, with a permutation test (p ≤ 0.023) based on the rRMSE confirming climate significance. The direct contribution of climate to model performance was marginal on a broad scale. However, its influence on GSV and temporal transferability seem stronger in homogenous sites. In general, RF was the most stable in both the forward (t₁→t₂) and backward (t₂→t₁) directions in the sa scenario unlike the GAM, which was more stable in the backward direction. This study provides a framework for assessing the reliability of GSV models and addresses a critical gap in forest monitoring. Full article

Arboviruses transmitted by Aedes aegypti pose a significant challenge in Ecuador, as they are persistent, emerging, and re-emerging. During the SARS-CoV-2 pandemic, these diseases were temporarily overshadowed. This study aimed to detect and identify arbovirus species in mosquitoes collected from two communities in Manabí province—Caja Fuego (rural) and San Gregorio (marginal urban). A total of 468 mosquitoes were collected—385 from Caja Fuego and 83 from San Gregorio—and grouped into 72 pools. Samples were transported to CISeAL under proper biosafety protocols, homogenized, and analyzed using End-Point PCR, RT-PCR, and Sanger sequencing. The results revealed the presence of Flaviviruses and Alphaviruses. Of the 22 Flavivirus pools tested, 18 were positive, with PCR analysis specifically identifying dengue and Zika. Although no arbovirus was identified via RT-PCR, Sanger sequencing detected two Zika-positive samples. Notably, no official Zika cases were reported in 2023, suggesting a potential undetected risk of infection in human populations of Caja Fuego and San Gregorio. This study recommends the implementation of a surveillance campaign in collaboration with the Ecuadorian Ministry of Public Health to mitigate the risk. Full article

A 78-year-old woman was referred to our hospital for close examination of an extramural submucosal tumor in the gastroesophageal region, suspected based on an imaging test performed for a chief complaint of epicardial pain while eating. Contrast-enhanced computed tomography revealed a 3 cm sized mass with well-defined margins and a homogeneous interior near the gastroesophageal junction. Endoscopic ultrasonography (EUS) revealed a large (28 mm) unilocular cystic lesion with a heterogeneous hypoechoic internal structure. The cyst wall was layered with a hypoechoic layer that appeared to be muscular and continuous with the external longitudinal muscle of the esophagus. Based on the EUS findings, an esophageal duplication cyst was diagnosed. Cystectomy was performed because the patient was symptomatic. Pathological examination revealed that the specimen was covered with columnar and pseudostratified ciliated epithelium without atypia and that the cyst wall comprised two layers of smooth muscle. No cartilaginous tissue was present, which is consistent with esophageal duplication cysts. Retrospectively, the EUS findings were consistent with the pathological findings. Full article

Background and Objectives: Static Computer-Assisted Implant Surgery (sCAIS) can be performed with different drill guiding systems. This study aimed to compare the accuracy of two guiding concepts of sCAIS in partially edentulous cases. Materials and Methods: Forty polyamide models of partially edentulous maxillae with seven implantation sites were fabricated. In total, 140 replica implants were placed with keyless (KL) and drill-key (DK) guiding systems using static, full-arch, tooth-supported surgical guides. Three-dimensional crestal and apical, angular and vertical deviations from the planned implant positions were compared using Mann–Whitney U and Kruskal–Wallis H tests. Intergroup homogeneity of variance homogeneity was examined using Levene’s test to assess the precision. Results: Overall median 3D crestal and apical deviations of implants placed in the KL group were significantly higher compared to the DK group (0.86 mm [0.63–0.98] vs. 0.72 mm [0.52–0.89], p = 0.006 and 1.26 [0.98–1.52] vs. 1.13 [0.70–1.45], p = 0.012). In the subgroup analysis, implants placed with a KL system showed higher 3D crestal (p = 0.029), 3D apical (p < 0.001) and angular (p < 0.001) deviations in the extended anterior area, higher 3D crestal (p < 0.001) deviations in the proximal posterior single-tooth gap and higher vertical (p < 0.001) deviations in the distal site of free-end situation. Contrarily, the KL group showed lower 3D crestal (p = 0.007), 3D apical (p < 0.001), angular (p < 0.001) and vertical (p = 0.003) deviations in the distal posterior single-tooth gap, lower 3D apical (p = 0.007) and angular (p = 0.007) deviations in the distal site of free-end situation and lower vertical (p = 0.019) deviations in the proximal site of free-end situation. Conclusions: The deviations of both guiding concepts did not exceed the recommended safety margins. Statistically significant differences in deviations were found between two guiding concepts. Guiding concepts with superior accuracy varied across different sites of implantation. Full article

The vulva is a complex anatomical organ that may present with a wide range of pathologies. Even if it can be easily investigated, correctly interpreting vulvar appearance is often challenging. Vulvar ultrasound is an emerging diagnostic technique that may be helpful in different aspects of vulvar pathology. We aimed to summarize the state of the art of vulvar ultrasound, provide the necessary theoretical bases of embryology and anatomy, describe the normal and pathological vulvar sonographic characteristics, and propose a feasible and reproducible methodology for vulvar ultrasound. Vulvar sonographic scan should be performed with a linear probe, preferably > 15 mHz, following a standardized methodology. The sonographic appearance of the normal vulva reflects the different histology of its structures and, thus, their embryogenetic origin. The description of a suspected vulvar lesion should include localization, dimensions, volume, type of growth, shape, appearance of the edges, depth of invasion, echogenicity, and identification of vascularization. Cystic dilatation of obstructed Bartolini ducts is the most common benign finding in the vulva (fluctuant structures in the posterior third of the labia majora containing clear mucous fluid). Malignant vulvar lesions appear as hypoechogenic or heterogeneous solid lesions with irregular margins and a high degree of vascularization. Extramammary Paget Disease presents a homogeneous hypoechogenic creeping area in the epidermis due to neoplastic cells typical of this disease. The potential applications of vulvar ultrasound are examining the content of a vulvar swelling to guide its management and assessing the response to medical treatment in the case of lichen sclerosus. In managing patients affected by vulvar malignancies, it may play a critical role in local staging, stromal invasion determination, measuring the distance from the midline, and assessing the eligibility for sentinel lymph node procedure. Vulvar ultrasound is a minimally invasive and economical test that can be performed with minimal equipment. Further studies will be necessary to validate the clinical applications, quantify the diagnostic performance, and evaluate the agreement between operators. Full article

Background and objective: Staging Parkinson’s disease (PD) with a novel simple classification called MNCD, based on four axes (Motor; Non-motor; Cognition; Dependency) and five stages, correlated with disease severity, patients’ quality of life and caregivers’ strain and burden. Our aim was to apply the MNCD classification in advanced PD patients treated with device-aided therapy (DAT). Patients and Methods: A multicenter observational retrospective study of the first patients to start the levodopa-entacapone-carbidopa intestinal gel (LECIG) in Spain was performed (LECIPARK study). The MNCD total score (from 0 to 12) and MNCD stages (from 1 to 5) were collected by the neurologist at V0 (before starting LECIG) and V2 (follow-up visit). Wilcoxon’s signed rank and Marginal Homogeneity tests were applied to compare changes from V0 to V2. Results: Sixty-seven PD patients (58.2% males; 69.9 ± 9.3 years old) with a mean disease duration of 14.4 ± 6.5 years were included. The mean treatment duration (V2) was 172.9 ± 105.2 days. At V0, patients were classified as in stage 2 (35.8%), 3 (46.3%) or 4 (17.9%). The frequency of patients in stage 4 decreased to 9% at V2 (p = 0.001). The MNCD total score decreased from 6.27 ± 1.94 at V0 to 5.21 ± 2.23 (p < 0.0001). From V0 to V2, the motor (M; p < 0.0001) and non-motor symptom (N; p < 0.0001) burden decreased, and autonomy for the activities of daily living (D; p = 0.005) improved. Conclusions: The MNCD classification could be useful to classify advanced PD patients and to monitor the response to a DAT. Full article

This study aimed to evaluate the scanning time and marginal fit of CAD/CAM crowns fabricated using different intraoral scanning systems (IOS) (O1—Omnicam 1.0, O2—Omnicam 2.0, PS—Primescan). A standardized, 3D-printed composite resin die with a full-crown tooth preparation was scanned ten times with each IOS, and the scanning time was recorded. Subsequently, lithium disilicate ceramic crowns were designed and milled. The crowns were seated in the die and scanned using micro-computed tomography to assess the marginal fit. Fifty-two measurements were performed for each crown. Data were assessed for homogeneity, and one-way analysis of variance and the Tukey HSD test were performed (α = 0.05). For the analysis of vertical fit categories, the chi-square (Fisher’s exact) test (α = 0.05) was used. The mean vertical fit values were: O1—46.7 ± 16.4 μm, O2—33.8 ± 21.4 μm (p = 0.041), and PS—12.3 ± 6.6 μm (p < 0.001). The vertical fit values were further categorized by percentage and representative specimens were scanned with electron microscopy to evaluate adaptation. The mean scanning times were: O1—37.4 ± 3.1 s; O2—34.8 ± 2.7 s; and PS—27.8 ± 1.9 s. Significant differences were observed in the scanning times and marginal fit values of the CAD/CAM ceramic crowns across the different IOS systems, with PS demonstrating the best results. Improvements in IOS hardware and software significantly influence these outcomes. Full article

Head and neck squamous cell carcinoma (HNSCC) is the sixth most prevalent type of cancer worldwide. Not all mechanisms associated with cell cycle disturbances have been recognized in HNSCC. The aim of this study was to examine the concentration of CDKN2A and Ki-67 proteins in 54 tumor and margin samples of HNSCC and to evaluate their association with the clinical and demographic variables. The ELISA method was used to measure concentrations of CDKN2A and Ki-67 in the tissue homogenates. A significantly higher CDKN2A concentration was found in OSCC tumor samples as compared with OPSCC+HPSCC+LSCC. An inverse correlation was observed for Ki-67. We showed an association between the CDKN2A level and the clinical parameters N in tumors. The patients with concomitant diseases had significantly higher levels of Ki-67 as compared with patients with no concomitant diseases. An analysis of the effect of drinking habits on Ki-67 level demonstrated a statistical difference between regular or occasional users of stimulants and patients who do not use any stimulants in the tumor and margin samples. Moreover, we found an association between CDKN2A and Ki-67 concentrations and the HPV status in tumor and margin samples. The levels of the proteins tested may be dependent on environmental factors. Our results showed that changes in protein levels in HNSCC subtypes may reflect different molecular pathways of tumor development or may also be responsible for the involvement of CDKN2A and Ki-67 in the carcinogenesis process. Full article

Background: The advantage of a robotic-assisted (RARP) over a laparoscopic (LRP) approach in radical prostatectomy (RP) remains to be demonstrated. Aim: The aim of the study is to use a homogeneous population in real life and single primary surgeon surgery to analyze the oncological and functional results based on the type of surgical approach and pathological features. Methods: This is a prospective trial on non-metastatic prostate cancer (PCa) patients considered after a multidisciplinary decision to conduct a RP, using a RARP or LRP approach. A real-life setting was analyzed at our Urological Departments using homogeneous criteria for the management of PCa cases and a single surgeon experience on 444 cases (284 LRP and 160 RARP). Results: Mean operating time was significantly lower in RARP (153.21 ± 25.1 min) than in LRP (173.33 ± 44.3 min) (p < 0.001). In cases submitted to an extended lymph node dissection (eLND), the mean number of lymph nodes removed was 15.16 ± 7.83 and 19.83 ± 4.78, respectively, in LRP and RARP procedures (p < 0.001), but positive lymph nodes (pN1) were similarly found in 15.8% of LRP patients and 13.6% of RARP patients (p = 0.430). Surgical margins (SM) positivity was not significantly higher in the RARP group (20.0%) when compared to the LRP group (15.9%) (p = 0.145). During the postoperative follow-up, a biochemical recurrence (BCR) was detected in 14.4% and 7.5% of cases in the LRP and RARP group, respectively, (p = 0.014). Better results of PAD tests at 3-month intervals using the RARP approach (mean pad weight 75.57 ± 122 g and 14 ± 42 g, respectively, in LRP and RARP (p < 0.01)) were described. Conclusions: In the comparison between the RARP and LRP approach, a clear advantage of the robotic approach is a significant reduction in operating times, days of hospitalization, and postoperative catheterization compared to laparoscopic surgery. It is not possible to describe any certain oncological advantage both in terms of surgical margins and pathological lymph nodes removed. In RARP cases a reduction to the limit of significance is described in terms of biochemical recurrence. RARP produces a more rapid recovery of urinary continence at 3 months postoperatively without significant advantages in terms of erective potency recovery. Full article

Open-ended steel piles are commonly used as the foundation for offshore structures. Numerous model and field tests have demonstrated a time-dependent increase in the resistance of these piles, a phenomenon referred to as pile ageing or pile setup. Additionally, for open-ended steel piles with comparably small diameters, soil plugging enhances the resistance against axial compressive loads. Realistically predicting these effects is necessary for their reliable incorporation into design practice. This contribution presents static compression and tension pile load testing conducted in an experimental pit filled with wet, uniformly graded silica sand. In total, twelve piles ($L=$ 5.5 m, $D_o=$ 325 mm) were driven into homogeneously compacted sand using a pneumatic impact hammer. Firstly, static compression pile load testing was executed at various times after installation. Subsequently, static tension pile load tests were carried out. The results of the static compression pile load tests indicate that the compressive resistance doubles over an ageing period of 64 weeks. The experimental investigations of the effect of soil plugging showed marginal soil plugging during pile installation, but a significant influence of the soil plug on the compressive resistance. Full article