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1.
Sci Rep ; 14(1): 18032, 2024 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-39098938

RESUMO

Bael is a fruit crop that is extensively distributed throughout South-East Asia and is underutilized in medicine. The potential applications of bael's therapeutic and nutritional qualities in diverse ethnic communities are enormous. This study focuses on evaluating the morpho-pomological and molecular characteristics, utilizing SSR markers, of 80 wild bael genotypes alongside the NB-5 and NB-9 cultivars, derived from the North Western plains of India. Based on the evaluated morpho-pomological features, substantial variations were found between all genotypes. The fruit's inner diameter and pulp weight varied from 4.41 to 11.54 cm and 34.63 to 786.41 g, respectively. Numerous variations in the genotypes were observed in the shell weight/fruit, fruit skull thickness and fruit yield/plant. The bael fruit mucilage's total soluble solids (TSS) and total sugar content varied from 40.10 to 49.60 obrix and 8.11 to 21.17%, respectively. Using ward cluster analysis, the genotypes were divided into two primary clusters. Among the bael genotypes, the population structure analysis identified three subpopulations. SSR markers are used to measure genetic variety; of the 27 polymorphic markers, 17 show allelic diversity between genotypes. Molecular genetic diversity analysis, on the other hand, highlighted the genotypes genetic distinctiveness by classifying them into three major clusters. These findings offer valuable insights into the rich diversity and intricate interactions among the bael genotypes under investigation, paving the way for more strategic future breeding and selection efforts to elevate the quality of this remarkable fruit.


Assuntos
Aegle , Frutas , Variação Genética , Genótipo , Repetições de Microssatélites , Índia , Repetições de Microssatélites/genética , Aegle/genética , Frutas/genética , Marcadores Genéticos , Genética Populacional , Filogenia
2.
Cancers (Basel) ; 16(15)2024 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-39123477

RESUMO

The National Comprehensive Cancer Network guidelines provide evidence-based consensus for optimal individual site- and stage-specific treatments. This is a cohort study of 11,121 late-stage oral cancer patients in the National Cancer Database from 2010 to 2016. We hypothesized that patient travel distance may affect treatment choices and impact outcome. We split travel distance (miles) into quartiles (D1-4) and assessed treatment choices, type of facility, and survival outcome in relation to distance traveled. Univariate and multivariate analyses addressed contributions of specific variables. White patients were most likely to travel farthest (D4) for treatment compared to Black patients (D1). Urban area patients traveled shorter distances than those from rural areas. Greater travel distance was associated with patients undergoing surgical-based therapies and treatment at academic centers. Patients in D1 had the lowest median survival of all distance quartiles. Surgery-based multimodality treatment (surgery and radiation) had a median survival significantly greater than for non-surgical therapy. Several factors including travel distance and treatment facility were associated with survival outcomes for late-stage oral cavity cancers. Consideration of these factors may help improve the outcome for this patient population.

5.
Blood Adv ; 2024 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-39093952

RESUMO

The effect of prior inotuzumab ozogamicin (InO) treatment on brexucabtagene autoleucel (brexu-cel) outcomes remains unclear in adults with acute lymphoblastic leukemia (ALL), particularly the influence off previous InO response and the timing of administration. We conducted a retrospective multicenter analysis of 189 patients with relapsed/refractory (r/r) ALL treated with brexu-cel. Over half of the patients received InO before brexu-cel (InO-exposed). InO-exposed patients were more heavily pretreated (p= 0.02) and frequently had active marrow disease pre-apheresis (p= 0.03). Response rate and toxicity profile following brexu-cel were comparable for InO-exposed and InO-naïve; however, consolidation therapy post brexu-cel response was utilized at a higher rate in InO-naïve patients (p= 0.005). With a median follow up of 11.4 months, InO-exposed patients had inferior progression-free survival (PFS) (p=0.013) and overall survival (OS) (p=0.006) in univariate analyses; however, prior InO exposure did not influence PFS (HR 1.20, 95%CI, 0.71-2.03) in multivariate models. When InO-exposed patients were stratified according to prior InO response, InO responders had superior PFS (p=0.002) and OS (p<0.0001) relative to InO-refractory. The timing of administering InO did not affect brexu-cel outcomes, with comparable PFS (p=0.51) and OS (p=0.86) for patients receiving InO as bridging therapy or pre-apheresis. In conclusion, while InO exposure was associated with inferior survival outcomes following brexu-cel in unadjusted analyses, these associations were no longer significant in multivariate analyses, suggesting it is unlikely that InO negatively impacts brexu-cel efficacy. Our data instead imply that InO-exposed recipients of brexu-cel tend to be higher-risk patients with intrinsic adverse leukemia biology.

6.
BMC Cancer ; 24(1): 838, 2024 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-39003442

RESUMO

BACKGROUND: The National Comprehensive Cancer Network (NCCN) guideline recommends consideration of weekly cisplatin as an alternative option for patients with head and neck cancer undergoing definitive chemoradiation. However, in a recent phase III trial (ConCERT), 20% of patients treated with weekly cisplatin could not receive a total of 200 mg/m2, and the association of low adherence to weekly cisplatin and cancer control outcomes remains unclear. To fill this knowledge gap, we performed an observational cohort study of patients with head and neck cancer undergoing definitive chemoradiation with weekly cisplatin. METHODS: Our institutional database was queried for patients with non-metastatic head and neck cancer who underwent definitive chemoradiation with weekly cisplatin (40 mg/m2) between November 2007 and April 2023. Adherence to weekly cisplatin was defined as receiving at least 5 cycles with a total cumulative dose of 200 mg/m2. Survival outcomes were evaluated using Kaplan-Meier method, log-rank tests, Cox proportional hazard multivariable (MVA) analyses. Logistic MVA was performed to identify variables associated with low adherence to weekly cisplatin. Fine-Gray MVA was performed to analyze failure outcomes with death as a competing event. RESULTS: Among 119 patients who met our criteria, 51 patients (42.9%) had low adherence to weekly cisplatin. Median follow up was 19.8 months (interquartile range 8.8-65.6). Low adherence to weekly cisplatin was associated with worse overall survival (adjusted hazards ratio [aHR] 2.94, 95% confidence interval [CI] 1.58-5.47, p < 0.001) and progression-free survival (aHR 2.32, 95% CI 1.29-4.17, p = 0.005). It was also associated with worse distant failure (aHR 4.55, 95% CI 1.19-17.3, p = 0.03), but not locoregional failure (aHR 1.61, 95% CI 0.46-5.58, p = 0.46). KPS < 90 was the only variable associated with low adherence to weekly cisplatin (adjusted odds ratio [aOR] 2.67, 95% CI 1.10-6.65, p = 0.03). CONCLUSION: Our study suggested that over 40% of patients underwent fewer than 5 weekly cisplatin cycles and that low adherence to weekly cisplatin was an independent, adverse prognostic factor for worse survival and distant failure outcomes. Those with reduced adherence to weekly cisplatin were more likely to have poor performance status. Further studies are warranted to improve the adherence to chemotherapy and outcomes.


Assuntos
Quimiorradioterapia , Cisplatino , Neoplasias de Cabeça e Pescoço , Carcinoma de Células Escamosas de Cabeça e Pescoço , Humanos , Cisplatino/administração & dosagem , Cisplatino/uso terapêutico , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Idoso , Carcinoma de Células Escamosas de Cabeça e Pescoço/tratamento farmacológico , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/mortalidade , Neoplasias de Cabeça e Pescoço/patologia , Quimiorradioterapia/métodos , Adesão à Medicação/estatística & dados numéricos , Antineoplásicos/uso terapêutico , Antineoplásicos/administração & dosagem , Resultado do Tratamento , Esquema de Medicação , Adulto , Estimativa de Kaplan-Meier
9.
Adv Radiat Oncol ; 9(4): 101418, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38778826

RESUMO

Purpose: For patients with head and neck squamous cell carcinoma (HNSCC), locoregional failure and second primary tumors are common indications for adjuvant reirradiation (re-RT). Given an absence of clear consensus on the role of adjuvant re-RT, we sought to assess histopathologic risk factors of patients with HNSCC and their resulting outcomes after adjuvant re-RT with proton therapy. Methods and Materials: We conducted a retrospective analysis of patients with HNSCC who underwent salvage surgery at our institution followed by adjuvant re-RT with proton therapy over 1.5 years. All included patients received prior radiation therapy. The Kaplan-Meier method was used to evaluate locoregional recurrence-free survival and overall survival. Results: The cohort included 22 patients, with disease subsites, including oropharynx, oral cavity, hypopharynx, larynx, and nasopharynx. Depending on adverse pathologic features, adjuvant re-RT to 66 Gy (32% of cohort) or 60 Gy (68%), with (59%) or without (41%) concurrent systemic therapy was administered. The majority (86%) completed re-RT with no reported treatment delay; 3 patients experienced grade ≥3 acute Common Terminology Criteria for Adverse Events toxicity and no patient required enteral feeding tube placement during re-RT. Median follow-up was 21.0 months (IQR, 11.7-25.2 months). Five patients had biopsy-proven disease recurrences a median of 5.9 months (IQR, 3.8-9.7 months) after re-RT. Locoregional recurrence-free survival was 95.2%, 70.2%, 64.8% at 6, 12, and 24 months, respectively. OS was 100%, 79.2%, and 79.2% at 6, 12, and 24 months, respectively. Four patients had osteoradionecrosis on imaging a median of 13.2 months (IQR, 8.7-17.4 months) after re-RT, with 2 requiring surgical intervention. Conclusions: Adjuvant re-RT for patients with HNSCC was well-tolerated and offered reasonable local control in this high-risk cohort but appears to be associated with a risk of osteoradionecrosis. Additional study and longer follow-up could help define optimal patient management in this patient population.

10.
Biopolymers ; : e23600, 2024 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-38808736

RESUMO

Distal ulna locking bone plates (DLBPs) are commonly employed in the treatment of distal ulna fractures. However, commercially available metallic bone plates experience stress shielding and lack corrosion resistance. Poly lactic acid (PLA) is highly favored biopolymer due to its biocompatible and bioabsorbable nature with human tissues. The use of additive layer manufacturing (ALM) is gaining attention for creating customized implants with intricate structures tailored to patient autonomy. ALM-based PLA bone plates must provide high resistance against impact and torsional forces, necessitating the adjustment of printing process parameters. This study focuses on examining the influence of key printing parameters, on the impact strength and torque-withstanding capability of DLBPs. Experimental results, along with microscopic images, reveal that an increase in infill density (IF) and wall thickness imparts strong resistance to layers against crack propagation under impact and torsional loads. On the contrary, an increase in layer height and printing speed leads to delamination and early fracture of layers during impact and torsional testing. IF significantly contributes to improving the impact strength and torque-withstanding capability of DLBPs by 70.53% and 80.65%, respectively. The study highlights the potential of the ALM technique in developing DLBPs with sufficient mechanical strength for biomedical applications.

11.
Med Eng Phys ; 126: 104129, 2024 04.
Artigo em Inglês | MEDLINE | ID: mdl-38621834

RESUMO

3D printed Poly Lactic Acid (PLA) bone plates exhibit limited three-point bending strength, restricting their viability in biomedical applications. The application of polydopamine (PDM) enhances the three-point bending strength by undergoing covalent interactions with PLA molecular structure. However, the heavy nature of PDM particles leads to settling at the container base at higher coating solution concentrations. This study investigates the impact of ultrasonic-assisted coating parameters on the three-point bending strength. Utilizing Response Surface Methodology (RSM) for statistical modeling, the study examines the influence of ultrasonic vibration power (UP), coating solution concentration (CC), and submersion time (TIME). RSM optimization recommended 100 % UP, 6 mg/ml CC, and 150 min TIME, resulting in maximum three-point bending strength of 83.295 MPa. Microscopic images from the comparative analysis revealed non-uniform coating deposition with mean thickness of 6.153 µm under normal coating. In contrast, ultrasonic-assisted coating promoted uniform deposition with mean thickness of 18.05 µm. The results demonstrate that ultrasonic-assisted coating induces PDM particle collision, preventing settling at the container base, and enhances three-point bending strength by 7.27 % to 23.24 % compared to the normal coating condition. This study emphasizes on the potential of ultrasonic-assisted coating to overcome the limitations of direct immersion coating technique.


Assuntos
Placas Ósseas , Ultrassom , Poliésteres/química , Ondas Ultrassônicas , Impressão Tridimensional
12.
Proc Inst Mech Eng H ; 238(5): 550-561, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38627994

RESUMO

The designed biomedical implants require excellent shear strength primarily for mechanical stability against forces in human body. However, metallic implants undergo stress shielding with release of toxic ions in the body. Thus, Fused Deposition Modeling (FDM) has made significant progress in the biomedical field through the production of customized implants. The mechanical behavior is highly dependent on printing parameters, however, the effect of these parameters on punch shear strength of ASTM D732-02 standard specimens has not been explored. Thus, in the current study, the effect of infill density (IFD), printing speed (PTS), wall thickness (WLT), and layer thickness (LYT) has been investigated on the punch shear strength using Response Surface Methodology. The Analysis of Variance (ANOVA) has been performed for predicting statistical model with 95% confidence interval. During the statistical analysis, the terms with p-value lower than 0.05 were considered significant and the influence of process parameters has been examined using microscopic images. The surface plots have been used for discussing the effect of interactions between printing parameters. The statistical results revealed IFD as the most significant contributing factor, followed by PTS, LYT, and WLT. The study concluded by optimization of printing parameters for obtaining the highest punch shear strength.


Assuntos
Teste de Materiais , Poliésteres , Resistência ao Cisalhamento , Poliésteres/química , Próteses e Implantes , Estresse Mecânico , Impressão Tridimensional
13.
Adv Healthc Mater ; : e2304299, 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38655817

RESUMO

The mortality caused by tuberculosis (TB) infections is a global concern, and there is a need to improve understanding of the disease. Current in vitro infection models to study the disease have limitations such as short investigation durations and divergent transcriptional signatures. This study aims to overcome these limitations by developing a 3D collagen culture system that mimics the biomechanical and extracellular matrix (ECM) of lung microenvironment (collagen fibers, stiffness comparable to in vivo conditions) as the infection primarily manifests in the lungs. The system incorporates Mycobacterium tuberculosis (Mtb) infected human THP-1 or primary monocytes/macrophages. Dual RNA sequencing reveals higher mammalian gene expression similarity with patient samples than 2D macrophage infections. Similarly, bacterial gene expression more accurately recapitulates in vivo gene expression patterns compared to bacteria in 2D infection models. Key phenotypes observed in humans, such as foamy macrophages and mycobacterial cords, are reproduced in the model. This biomaterial system overcomes challenges associated with traditional platforms by modulating immune cells and closely mimicking in vivo infection conditions, including showing efficacy with clinically relevant concentrations of anti-TB drug pyrazinamide, not seen in any other in vitro infection model, making it reliable and readily adoptable for tuberculosis studies and drug screening.

14.
Artigo em Inglês | MEDLINE | ID: mdl-38595008

RESUMO

Background Paradoxical flare of pemphigus following rituximab infusion has been reported previously, however, its incidence or risk factors have not been studied in detail. Objectives To evaluate the clinical and immunological predictors associated with post-rituximab paradoxical pemphigus flare. Materials and Methods This was a prospective cohort study including adult patients with pemphigus vulgaris or foliaceus who were treated with rituximab. Patients were administered 1000 mg of intravenous rituximab on days 0 and 14 (Rheumatoid arthritis (RA) protocol), with or without oral prednisolone and/or conventional immunosuppressive agents. Baseline clinical and immunological predictors of post-rituximab pemphigus flares were assessed. Results Fifty patients (mean age 40.44 ± 12.36 years) with a mean pemphigus disease area index (PDAI) score of 27.8 ± 15.48 were administered rituximab. Post-rituximab flare occurred in 10 (20%) patients after a mean of 14.1 ± 4.33 days after the first rituximab infusion. The mean baseline PDAI score (36.4 ± 11.7 vs. 25.6 ± 15.7, P = 0.02) and serum anti-Dsg1 levels (1216.8 ± 850.1 vs. 592 ± 562.12 RU/mL, P = 0.03) were statistically significantly higher in patients experiencing a flare. Using ROC-curve analysis, a PDAI score of 328 (OR 8.3, 95% CI 1.5-44.7) was 80% sensitive and 67.5% specific in predicting post-rituximab flare, while serum anti-Dsg1 level of 31137.78 RU/ml had a sensitivity of 60% and specificity of 85%. There was no significant difference in terms of affected body surface area, type of pemphigus, starting prednisolone dose, oral immunosuppressive adjuvant, serum anti-Dsg3, serum anti-AchRM3, and peripheral CD19+ B cell population. Limitations Our study is limited by a relatively small sample size. Immunological factors were not evaluated at the time of pemphigus flare. Though these unexpected pemphigus flares are likely to be associated with rituximab infusion, the possibility of spontaneous disease exacerbation cannot be entirely excluded. Conclusions Patients with more severe pemphigus or high serum anti-Dsg1 are at risk of post-rituximab paradoxical flare, and may benefit from rituximab administration under close monitoring.

15.
Cancers (Basel) ; 16(7)2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38611024

RESUMO

Endometrial cancer is the most common gynecologic cancer in the United States and it contributes to the second most gynecologic cancer-related deaths. With upfront surgery, the specific characteristics of both the patient and tumor allow for risk-tailored treatment algorithms including adjuvant radiotherapy and systemic therapy. In this narrative review, we discuss the current radiation treatment paradigm for endometrial cancer with an emphasis on various radiotherapy modalities, techniques, and dosing regimens. We then elaborate on how to tailor radiotherapy treatment courses in combination with other cancer-directed treatments, including chemotherapy and immunotherapy. In conclusion, this review summarizes ongoing research that aims to further individualize radiotherapy regimens for individuals in an attempt to improve patient outcomes.

17.
Indian J Med Microbiol ; 48: 100561, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38458336

RESUMO

Reactive arthritis is included in the spectrum of seronegative spondyloarthritides, occurring secondary to triggers of genitourinary and gastrointestinal tract infections. We describe two cases of sexually acquired reactive arthritis secondary to genital infection by Chlamydia trachomatis, diagnosed by in-house polymerase chain reaction performed on the first void urine. Both patients were managed with a combined approach of short course antibiotics, immunosuppressive agents, biologicals and surgical intervention.


Assuntos
Antibacterianos , Artrite Reativa , Infecções por Chlamydia , Chlamydia trachomatis , Humanos , Antibacterianos/uso terapêutico , Artrite Reativa/microbiologia , Artrite Reativa/etiologia , Artrite Reativa/diagnóstico , Artrite Reativa/tratamento farmacológico , Infecções por Chlamydia/microbiologia , Infecções por Chlamydia/diagnóstico , Infecções por Chlamydia/complicações , Chlamydia trachomatis/isolamento & purificação , Imunossupressores/uso terapêutico , Reação em Cadeia da Polimerase , Urina/microbiologia
18.
Heliyon ; 10(4): e26525, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38404771

RESUMO

Bael is a medicinal cum fruit tree with multipurpose utility and propagated mostly through seeds. The present study aimed to assess and analyse the morpho-pomological and biochemical traits of eighty seedlings grown bael genotypes comparison with two commercial cultivars (NB-5 and NB-9) of bael. The significant differences were detected among the genotypes based on the measured morpho-pomological and biochemical traits. The morpho-pomological and biochemical traits of bael exhibited variation ranging from 6.17% to 133.65%. Trunk girth ranged from 29.50 to 63.40 cm and tree spread (N-S) varied 1.00-6.30 m. Fruit length ranged from 4.60 to 12.05 cm and fruit width ranged from 4.64 to 11.72 cm. Moreover, fruit weight ranged from 56.33 to 917.65 g and pulp percentage varied from 58.64 to 81.38%. Soluble Solid Content ranged from 25.90 to 36.77 0brix and ascorbic acid varied from 14.38 to 25.45 mg/100 g. Fruit length was positively correlated with fruit width, fruit weight, pulp percentage, seed length, seed diameter and number of seeds per fruit, while it was negatively correlated with fruit surface and total number of fruit per plant. Principal component analysis showed that 76.66% of the variability observed was explained by the 13 components. Ward cluster analysis using Euclidean distance classified the genotypes into two main clusters. These findings contribute to a better understanding of the diversity and relationships among the studied genotypes, aiding future breeding and selection programs for improved bael cultivation.

19.
Food Chem ; 443: 138502, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38306909

RESUMO

The present investigation explored the antifungal effectiveness of Trachyspermum ammi essential oil (TAEO) against Aspergillus flavus, aflatoxin B1 (AFB1) contamination, and its mechanism of action using biochemical and computational approaches. The GC-MS result revealed the chemical diversity of TAEO with the highest percentage of γ-terpinene (39 %). The TAEO exhibited minimum inhibitory concentration against A. flavus growth (0.5 µL/mL) and AFB1 (0.4 µL/mL) with radical scavenging activity (IC50 = 2.13 µL/mL). The mechanism of action of TAEO was associated with the alteration in plasma membrane functioning, antioxidative defense, and carbon source catabolism. The molecular dynamic result shows the multi-regime binding of γ-terpinene with the target proteins (Nor1, Omt1, and Vbs) of AFB1 biosynthesis. Furthermore, TAEO exhibited remarkable in-situ protection of Sorghum bicolor seed samples against A. flavus and AFB1 contamination and protected the nutritional deterioration. Hence, the study recommends TAEO as a natural antifungal agent for food protection against A. flavus mediated biodeterioration.


Assuntos
Ammi , Apiaceae , Monoterpenos Cicloexânicos , Óleos Voláteis , Sorghum , Aspergillus flavus/metabolismo , Óleos Voláteis/química , Aflatoxina B1/metabolismo , Sorghum/metabolismo , Ammi/metabolismo , Antifúngicos/química , Apiaceae/metabolismo
20.
Curr Oncol ; 31(1): 436-446, 2024 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-38248114

RESUMO

The COVID-19 pandemic precipitated drastic changes in cancer care. Its impact on the U.S. head and neck cancer population has yet to be fully understood. This study aims to understand the impact of pandemic-related changes on the head and neck cancer population. An observational study of head and neck cancer patients at a single institution during the spring of 2020 and 2019 was performed. Clinical characteristics and survival outcomes were analyzed. In 2020, 54 head and neck cancer patients were evaluated in the department of radiation oncology vs. 74 patients seen in 2019; 42% of the patients were female in 2019 versus 24% in 2020 (p = 0.036). The median follow-up time was 19.4 and 31 months for 2020 and 2019, respectively. After adjusting for stage, the relapse-free survival probability at 6 and 12 months was 79% and 69% in 2020 vs. 96% and 89% in 2019, respectively (p = 0.036). There was no significant difference in the overall survival, with 94% and 89% in 2020 and 2019, respectively (p = 0.61). Twenty-one percent of patients received induction chemotherapy in 2020 versus 5% in 2019 (p = 0.011); significantly more treatment incompletions occurred in 2020, 9% vs. 0% in 2019 (p = 0.012). Moreover, the stage-adjusted RFS differed between cohorts, suggesting head and neck cancer patients seen during the initial wave of COVID-19 may experience worse oncologic outcomes.


Assuntos
COVID-19 , Neoplasias de Cabeça e Pescoço , Radioterapia (Especialidade) , Humanos , Feminino , Masculino , COVID-19/epidemiologia , Pandemias , Oncologia , Neoplasias de Cabeça e Pescoço/terapia
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