Deviation parameters of intraoral scanning with and without artificial markers versus conventional impression of total, partial and congenital nasal defects: A pilot non-randomized clinical trial.

PURPOSE: This pilot clinical trial aimed to investigate accuracy of intra-oral scanning (IOS) with and without artificial reference markers in capturing total, subtotal and congenital nasal defects. BASIC PROCEDURES: Thirteen patients with 3 types of nasal defects were selected and digitally scanned using an IOS with (ScM) and without artificial markers (Sc). Patients were grouped as follows; Group T (total nasal defect), Group P (partial/subtotal nasal defect), Group C (congenital defect). Silicone impressions of the defects were made and poured to get a model that was scanned using a Desktop scanner (Imp). The standard tessellation language (STL) files obtained from IOS were registered and compared to each other using a processing software. RMS, positive and negative average values were used to report deviations between the scans. Kruskal Wallis test was used to study the effect of defect type, while Friedmann was used to study the effect of impression technique. Results were considered significant at P≤.05. MAIN FINDINGS: All deviation values showed statistically significant differences among the 3 studied nasal defects and among the 3 investigated impression techniques. The smallest deviation values were recorded in Sc-ScM of congenital defects (RMS= 0.13±0.04, +average=0.08±0.01, -average=-0.09±0.02), while the largest deviation values were recorded in IMP-Sc in the total defects (RMS= 0.38±0.05, +average=0.29±0.04, -average=-0.29±0.04). CONCLUSIONS: Within the limitations of this study, it was concluded that the nasal defect type and the use of artificial markers during scanning affect the deviation parameters of the obtained scan. The combined effect of the studied parameters calls for the use of markers in when scanning total nasal defects.

Clinical Outcomes in Relation to Total Hospital Surgical and Transcatheter Aortic Valve Replacement Volumes.

BACKGROUND: There is a paucity of data regarding the relationship between overall hospital volumes for total aortic valve replacement (AVR; transcatheter AVR [TAVR] or surgical AVR [SAVR]) and patient outcomes. METHODS AND RESULTS: We queried the 2019 Nationwide Readmission Database for patients undergoing AVR. Based on procedural volumes of TAVR or SAVR, we classified hospitals as high (≥50th percentile) or low (<50th percentile) volume centers and categorized hospitals as high TAVR/high SAVR, high TAVR/low SAVR, high SAVR/low TAVR, and low TAVR/low SAVR. Multivariable regression models were employed. The main study outcomes were in-hospital mortality and 30-day readmission after total AVR. Our final analysis included 72 123 patients undergoing AVR at 400 hospitals across the United States. The median (interquartile range) hospital procedural volumes for total AVR, TAVR, and SAVR were 137 (86-210), 82 (50-127), and 56 (31-87) procedures, respectively. There was an inverse correlation between hospital procedural volumes of AVR, TAVR, or SAVR and in-hospital mortality after total AVR but not with 30-day readmission. Using high TAVR/high SAVR hospitals as reference, there was higher in-hospital mortality after total AVR among low TAVR/low SAVR hospitals (adjusted odds ratio [OR], 1.29 [95% CI, 1.07-1.56]) but similar in-hospital mortality among high TAVR/low SAVR hospitals and low TAVR/high SAVR volumes. There was no difference in 30-day readmission rates after total AVR among the 4 hospital categories. CONCLUSIONS: Nationwide data revealed that in-hospital mortality after total AVR (SAVR or TAVR) is inversely related to hospital total volumes of AVR. Patients with aortic stenosis have better outcomes if they are managed among experienced centers with high case volumes of both TAVR and SAVR.

Anti-Inflammatory and Antimicrobial Activity of Silver Nanoparticles Green-Synthesized Using Extracts of Different Plants.

In this study, an easy, efficient, economical, and eco-friendly green bio-synthesis method was utilized to synthesize silver nanoparticles (AgNPs) using the extracts of four plants: Ginkgo biloba, Cichorium Intybus, Adiantum Capillus-Veneris, and Rosmarinus Officinalis. The synthesis of AgNPs was confirmed by using a uv-vis spectrometer, which showed distinct surface plasmon resonance (SPR) bands. The surface of AgNPs was characterized using scanning electron microscopy and Fourier-transform infrared spectroscopy. The anti-inflammatory activity of Tenoxicam/Meloxicam-loaded AgNPs has been studied using the inhibition of albumin denaturation method. Tenoxicam-loaded AgNPs showed higher % Inhibition, but Meloxicam-loaded AgNPs showed lower % Inhibition. Furthermore, the AgNPs showed excellent antimicrobial activity on both Gram-negative and Gram-positive bacteria.

Exploring the role of RNASET2 in the immune response of black soldier fly larvae.

T2 RNases are transferase-type enzymes distributed across phyla, crucial for breaking down single-stranded RNA molecules. In addition to their canonical function, several T2 enzymes exhibit pleiotropic roles, contributing to various biological processes, such as the immune response in invertebrates and vertebrates. This study aims at characterizing RNASET2 in the larvae of black soldier fly (BSF), Hermetia illucens, which are used for organic waste reduction and the production of valuable insect biomolecules for feed formulation and other applications. Given the exposure of BSF larvae to pathogens present in the feeding substrate, it is likely that the mechanisms of their immune response have undergone significant evolution and increased complexity. After in silico characterization of HiRNASET2, demonstrating the high conservation of this T2 homolog, we investigated the expression pattern of the enzyme in the fat body and hemocytes, two districts mainly involved in the insect immune response, in larvae challenged with bacterial infection. While no variation in HiRNASET2 expression was observed in the fat body following infection, a significant upregulation of HiRNASET2 synthesis occurred in hemocytes shortly after the injection of bacteria in the larva. The intracellular localization of HiRNASET2 in lysosomes of plasmatocytes, its extracellular association with bacteria, and the presence of a putative antimicrobial domain in the molecule, suggest its potential role in RNA clean-up and as an alarm molecule promoting phagocytosis activation by hemocytes. These insights contribute to the characterization of the immune response of Hermetia illucens larvae and may facilitate the development of animal feedstuff enriched with highly valuable BSF bioactive compounds.

Pancreatic and Ileal Neuroendocrine Tumors: Metastatic Disease or a Novel MEN Syndrome?

Multiple endocrine neoplasms are a feature of multiple endocrine neoplasia (MEN) syndromes types 1, 2, 4, and 5. However, the ileum is not usually involved in these disorders. We report a series of patients with neuroendocrine tumors (NETs) involving both the pancreas and the ileum. We searched the laboratory information system and personal consultation records of the authors from 2019 to 2023 for patients who had neuroendocrine tumors (NETs) involving both the pancreas and ileum. In a series of 846 patients, we identified 4 patients with pancreatic and ileal NETs, 2 female and 2 male, ages 52 to 75. Two female patients had primary EC cell tumors of the ileum with metastasis to the pancreas that showed expression of CDX2 and serotonin similar to the ileal primary tumors. Two males had primary lesions in the 2 sites with different immunoprofiles; the ileal tumors expressed CDX2 and serotonin and were negative for ARX, whereas the pancreatic tumors expressed ARX, glucagon, and pancreatic polypeptide and were negative for CDX2 and serotonin. In both male patients, the nontumorous pancreas showed preneoplastic changes in the endocrine elements, suggesting germline predisposition to endocrine neoplasia. Testing for known genetic alterations underlying MEN syndromes has not identified a genetic alteration that can be implicated in the development of NETs in both pancreas and ileum. Our series indicates the rare occurrence of NETs in both the pancreas and ileum and emphasizes the importance of using the correct biomarkers to distinguish metastasis from primary neoplasms at the different sites. The rare occurrence of primary ileal and pancreatic NETs may represent a novel MEN syndrome with as yet unknown germline predisposition.

EFL Special Education Teachers' Perspectives: Evaluating Game-Based Learning for ADHD Behavioral Disorders.

OBJECTIVE: The purpose of this study was to examine the perspectives of English as a Foreign Language Special Education teachers (EFLSE) regarding game-based learning approaches for addressing behavioral disorders in ADHD patients. METHOD: The study involved a sample (n = 131) of EFLSE teachers who completed a questionnaire to determine how feasible, acceptable, and helpful they found game-based learning. RESULTS: The study revealed that EFLSE teachers perceive game-based learning to be a feasible and acceptable method for engaging ADHD students and helping to maintain their attention during game-based learning activities. Nevertheless, implementation and individualized approaches are cited as challenges. Additionally, EFLSE teachers emphasized the benefits of game-based learning, including improved problem-solving, assessment methods, collaboration, and the acquisition of academic skills. CONCLUSIONS: The study contributes insights for educators, policymakers, and researchers that can support the development of evidence-based interventions offering game-based learning for students with ADHD.

Cavity preparation and cementation of indirect adhesive posterior restorations using three different composite resins with a one-year follow-up: A clinical report.

Adhesive cementation of contemporary indirect restorations can be achieved using a composite resin. An established protocol with preheated composite resin was used, along with 2 recently introduced types of composite resin. All 3 are evaluated for clinical performance.

Exploring the risk of microplastics to pollinators: focusing on honey bees.

The rapid increase in global plastic production and usage has led to global environmental contamination, with microplastics (MPs) emerging as a significant concern. Pollinators provide a crucial ecological service, while bee populations have been declining in recent years, and MPs have been recognized as a new risk factor contributing to their losses. Despite the pervasive distribution and persistence of MPs, understanding their risks to honey bees remains a critical knowledge gap. This review summarizes recent studies that investigate the toxicity of MPs on honey bee health from different perspectives. The findings revealed diverse and material-/size-/dosage-dependent outcomes, emphasizing the need for comprehensive assessments in the follow-up studies. MPs have been detected in honey and in bees' organs (e.g., gut and brain), posing potential threats to bee fitness, including altered behavior, cognitive abilities, compromised immunity, and dysfunction of the gut microbiota. It should be noticed that despite several laboratory studies suggesting the aforementioned adverse effects of MPs, field/semi-field experiments are still warranted. The synergistic toxicity of MPs with other environmental contaminants (pesticides, antibiotics, fungicides, heavy metals, etc.) still requires further investigation. Our review highlights the critical need to understand the relationships between MPs, pollinators, and the ecosystem to mitigate potential risks and ensure the sustainability of vital services provided by honey bees.

Impact of Exposure to Leaves From Metal-Polluted Sites on the Developmental Parameters of Larvae of the Dark Sword-Grass, Agrotis ipsilon (Lepidoptera: Noctuidae).

Insects are impacted by pollutants in their environments and food sources. Herein, we set out a semi-field study to assess the impact of environmental heavy metal contamination on developmental parameters, energy reserves, and acidic and alkaline phosphatases in the larval Agrotis ipsilon (Lepidoptera: Noctuidae). Castor leaves from contaminated and uncontaminated (reference site) areas were fed to A. ipsilon larvae in all treatments. The heavy metal concentrations in the plant from different areas (contaminated and reference sites) and in the larvae were analyzed. Toxic effects were observed in the larvae feeding on the leaves from the metal contaminated areas. Larval and pupal weights, growth indices, and larval fitness were all significantly lower than in the reference group. Likewise, in the third and fourth instars, there was a significant decrease in both the survival and moth emergence rates. In contrast, the pupation duration was significantly longer. Total protein, lipid, and glycogen content showed significant reductions in treated larvae. Larval homogenate samples contaminated with heavy metals showed a significant increase in acid- and alkaline- phosphatase levels. The results obtained could provide a basis for a long-term evaluation of the risk associated with heavy metals and their impact on plant populations and important agricultural pests.

Rates and Predictors of Structural Valve Degeneration and Failure of Trifecta Bioprosthetic Valve Over a 5-year Follow-up Period: A Single-center Experience.

Introduction: The Trifecta bioprosthetic valve has been commonly used for surgical aortic valve replacement (SAVR). Multiple studies have been done to define the rate of structural valve degeneration (SVD) and failure (SVF), but the outcomes are still debatable. Therefore, we aim to conduct this single-center study to estimate the rate and predictors of SVD/SVF. Methodology: This retrospective observational cohort single-center study was conducted between 2014 and 2019 among Trifecta SAVR patients. Data were patient's characteristics collected from electronic medical records at baseline and follow-up (3-5 years). Statistical analysis was performed with a significance level of P ≤ 0.05. Results: A total of 271 eligible patients were identified. Most of our sample were males (57.9%), with a mean age of 71.1 ± 10.6 years. The mean baseline preoperative ejection fraction (EF) was 53.0%, with no change (P = 0.88) in the immediate postoperative EF (53.6%). A most recent follow-up EF revealed a significant increase of EF (55.2%), P = 0.01. Furthermore, there was a significant increase from peak velocity to PVMRE (mean difference [MD] ± standard error of mean (SEM) [0.15 ± 0.04], P < 0.01), an increase in pressure gradient (PGIPE) to PGMRE (MD ± SEM [1.70 ± 0.49], P < 0.01), and a decrease in Doppler velocity index (DVIIPE) to DVIMRE (MD ± SEM [-0.037 ± 0.01], P = 0.01). Regarding the SVF rate, 13 (4.8%) patients had failed valves requiring replacement throughout the study period. Conclusions: Over a 5-year follow-up period, 4.8% had SVF with an SVD of 23.2%, with the majority of SVD not being clinically significant except in six patients. These results corroborate with a previously published study suggesting a bad clinical outcome of Trifecta valve placement.

Impacts of preoperative anxiety and depression on pain and range of motion after arthroscopic frozen shoulder release: a cohort study.

PURPOSE: We aimed to evaluate the impact of preoperative anxiety and depression levels on baseline and postoperative pain in patients who underwent arthroscopic frozen shoulder release. METHODS: The study included 59 patients with more than three months of idiopathic frozen shoulder. All patients had arthroscopic frozen shoulder release. Two patients were excluded from statistical analysis. Therefore, the statistical analysis was performed on the remaining 57 patients. The patients were divided into two groups according to HADS scores: group 1 which included 28 patients with a healthy psychological status (anxiety ≤ 7 and depression ≤ 7), and Group 2, which included 29 patients with psychological distress ( anxiety ≥ 8 or depression ≥ 8). RESULTS: The hallmark finding of this study is that patients complaining of frozen shoulder symptoms and having psychological distress (HADS ≥ 8) experienced higher pain scores preoperatively and at one-year follow-up after arthroscopic release. All patients showed significant improvement between the preoperative period and the one year follow-up regarding the abduction, forward flexion, external rotation at the side and the VAS pain score with a P value of 0.001. CONCLUSIONS: Arthroscopic frozen shoulder release significantly lowers the VAS pain score over the 12-month.

Active Dual Line-Laser Scanning for Depth Imaging of Piled Agricultural Commodities for Itemized Processing Lines.

The accurate depth imaging of piled products provides essential perception for the automated selection of individual objects that require itemized food processing, such as fish, crabs, or fruit. Traditional depth imaging techniques, such as Time-of-Flight and stereoscopy, lack the necessary depth resolution for imaging small items, such as food commodities. Although structured light methods such as laser triangulation have high depth resolution, they depend on conveyor motion for depth scanning. This manuscript introduces an active dual line-laser scanning system for depth imaging static piled items, such as a pile of crabs on a table, eliminating the need for conveyor motion to generate high-resolution 3D images. This advancement benefits robotic perception for loading individual items from a pile for itemized food processing. Leveraging a unique geometrical configuration and laser redundancy, the dual-laser strategy overcomes occlusions while reconstructing a large field of view (FOV) from a long working distance. We achieved a depth reconstruction MSE of 0.3 mm and an STD of 0.5 mm on a symmetrical pyramid stage. The proposed system demonstrates that laser scanners can produce depth maps of complex items, such as piled Chesapeake Blue Crab and White Button mushrooms. This technology enables 3D perception for automated processing lines and offers broad applicability for quality inspection, sorting, and handling of piled products.

Outcomes of Hepatic Artery-Based Therapies and Systemic Multiagent Chemotherapy in Unresectable Colorectal Liver Metastases: A Systematic Review and Meta-analysis.

BACKGROUND: Treatment of unresectable colorectal liver metastases (UCRLM) includes locoregional and systemic therapy. A comprehensive analysis capturing long-term outcomes of these treatment options has not been performed. OBJECTIVE: A systematic review and meta-analysis was performed to calculate pooled outcomes of hepatic artery infusion with systemic chemotherapy (HAI-S), transarterial chemoembolization with systemic chemotherapy (TACE-S), transarterial radioembolization with systemic chemotherapy (TARE-S), doublet (FOLFOX, FOLFIRI), and triplet chemotherapy (FOLFOXIRI). METHODS: Outcomes included overall survival (OS), progression-free survival (PFS), rate of conversion to resection (CTR), and response rate (RR). RESULTS: A total of 32, 7, 9, and 14 publications were included in the HAI-S, TACE-S, and TARE-S chemotherapy arms. The 6/12/24/36-month OS estimates for HAI-S, TACE-S, TARE-S, FOLFOX, FOLFIRI, and FOLFOXIRI were 97%/80%/54%/35%, 100%/83%/40%/14%, 82%/61%/34%/21%, 96%/83%/53%/36%, and 96%/93%/72%/55%. Similarly, the 6/12/24/36-month PFS estimates were 74%/44%/19%/14%, 66%/20%/9%/3%, 57%/23%/10%/3%, 69%/30%/12%/7%, and 88%/55%/18%/11%. The corresponding CTR and RR rates were 31, 20%, unmeasurable (TARE-S), 35, 53; and 49, 45, 45, 50, 80%, respectively. The majority of chemotherapy studies included first-line therapy and liver-only metastases, whereas most HAI-S studies were pretreated. On subgroup analysis in first-line setting with liver-only metastases, the HAI-S arm had comparable outcomes to FOLFOXIRI and outperformed doublet chemotherapy regimens. Although triplet chemotherapy appeared to outperform other arms, high toxicity and inclusion of potentially resectable patients must be considered while interpreting results. CONCLUSIONS: HAI-S and multiagent chemotherapy are effective therapies for UCRLM. To make definitive conclusions, a randomized trial with comparable patient characteristics and line of therapy will be required. The upcoming EA2222 PUMP trial may help to address this question.

Limited genetic variability and spatial population structure in grasshoppers between natural and metal-contaminated areas in Egypt.

Pollutants in an environment can have long-term implications for the species living there, resulting in local adaptations with implications for their genetic structure. Heavy metal pollutants infiltrate soils and groundwater, bioaccumulate in food webs, and negatively impact biota. In this study, we investigated the degree to which the genetic structure and variability of the slender green-winged grasshopper (Aiolopus thalassinus (Fabricius) (Orthoptera: Acrididae)) were impacted by heavy metal pollution and distance. We used the random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR) method to examine the genetic variability of populations in 3 heavy metal-polluted and 3 unpolluted locations across varying geographical distances in Egypt. The heavy metal concentrations of cadmium, copper, lead, and zinc were measured from the grasshopper tissue and soils. Sixty-nine unique and polymorphic bands were produced by 4 primers. Cluster and principal component analyses separated the populations inside and outside Cairo into 2 main branches, which were further divided into smaller branches corresponding to their geographical regions. We found no differences in the Shannon genetic diversity index between populations or with increasing heavy metal concentrations in either the soil or the grasshopper tissue. Our results showed a greater genetic variation among populations than between populations within the same location, indicating populations within locations were less differentiated than those between locations. The moderate correlation between genetic similarity and spatial distance suggests geographical isolation influenced grasshopper population differentiation. Based on the RAPD analysis, environmental pollutants and geographical distances impact the A. thalassinus population structure, potentially restricting gene flow between sites even at small spatial scales.

Chitosan-Supported ZnO Nanoparticles: Their Green Synthesis, Characterization, and Application for the Removal of Pyridoxine HCl (Vitamin B6) from Aqueous Media.

A composite of chitosan-supported ZnO nanoparticles (ZnO/CS) was green-synthesized via an easy and cost-effective method using Chicory (Cichorium intybus) plant extract. The synthesis was confirmed using uv-vis spectrometry at a λmax of 380 nm, and the surface of the material was characterized via FT-IR spectroscopy, and finally via SEM, which confirmed the distribution of ZnO nanoparticles on the surface of chitosan biopolymer (CS). The synthesized material was applied in the adsorptive removal of residues of the pyridoxine hydrochloride (vitamin B6) pharmaceutical drug from aqueous media using the batch technique. The material's removal capacity was studied through several adjustable parameters including pH, contact time, the dose of the adsorbent, and the capacity for drug adsorption under the optimal conditions. Langmuir and Freundlich isotherms were applied to describe the adsorption process. The removal was found to obey the Freundlich model, which refers to a chemisorption process. Different kinetic models were also studied for the removal process and showed that the pseudo-second-order model was more fitted, which indicates that the removal was a chemisorption process. Thermodynamic studies were also carried out. The maximum removal of vitamin B6 by the nano-ZnO/CS composite was found to be 75% at optimal conditions. The results were compared to other reported adsorbents. Reusability tests showed that the nano-ZnO/CS composite can be efficiently reused up to seven times for the removal of PDX drugs from aqueous media.

Individual ingredients of NP-101 (Thymoquinone formula) inhibit SARS-CoV-2 pseudovirus infection.

Thymoquinone TQ, an active ingredient of Nigella Sativa, has been shown to inhibit COVID-19 symptoms in clinical trials. Thymoquinone Formulation (TQF or NP-101) is developed as a novel enteric-coated medication derivative from Nigella Sativa. TQF consists of TQ with a favorable concentration and fatty acids, including palmitic, oleic, and linoleic acids. In this study, we aimed to investigate the roles of individual ingredients of TQF on infection of SARS-CoV-2 variants in-vitro, by utilizing Murine Leukemia Virus (MLV) based pseudovirus particles. We demonstrated that NP-101, TQ, and other individual ingredients, including oleic, linoleic, and palmitic acids inhibited SARS-CoV-2 infection in the MLV-based pseudovirus model. A large, randomized phase 2 study of NP-101 is planned in outpatient COVID-19 patients.

Cross-talk between immunity and behavior: insights from entomopathogenic fungi and their insect hosts.

Insects are one of the most successful animals in nature, and entomopathogenic fungi play a significant role in the natural epizootic control of insect populations in many ecosystems. The interaction between insects and entomopathogenic fungi has continuously coevolved over hundreds of millions of years. Many components of the insect innate immune responses against fungal infection are conserved across phyla. Additionally, behavioral responses, which include avoidance, grooming, and/or modulation of body temperature, have been recognized as important mechanisms for opposing fungal pathogens. In an effort to investigate possible cross-talk and mediating mechanisms between these fundamental biological processes, recent studies have integrated and/or explored immune and behavioral responses. Current information indicates that during discrete stages of fungal infection, several insect behavioral and immune responses are altered simultaneously, suggesting important connections between the two systems. This review synthesizes recent advances in our understanding of the physiological and molecular aspects influencing cross-talk between behavioral and innate immune antifungal reactions, including chemical perception and olfactory pathways.

Neutrophil extracellular traps induced by chemotherapy inhibit tumor growth in murine models of colorectal cancer.

Neutrophil extracellular traps (NETs), a web-like structure of cytosolic and granule proteins assembled on decondensed chromatin, kill pathogens and cause tissue damage in diseases. Whether NETs can kill cancer cells is unexplored. Here, we report that a combination of glutaminase inhibitor CB-839 and 5-FU inhibited the growth of PIK3CA-mutant colorectal cancers (CRCs) in xenograft, syngeneic, and genetically engineered mouse models in part through NETs. Disruption of NETs by either DNase I treatment or depletion of neutrophils in CRCs attenuated the efficacy of the drug combination. Moreover, NETs were present in tumor biopsies from patients treated with the drug combination in a phase II clinical trial. Increased NET levels in tumors were associated with longer progression-free survival. Mechanistically, the drug combination induced the expression of IL-8 preferentially in PIK3CA-mutant CRCs to attract neutrophils into the tumors. Further, the drug combination increased the levels of ROS in neutrophils, thereby inducing NETs. Cathepsin G (CTSG), a serine protease localized in NETs, entered CRC cells through the RAGE cell surface protein. The internalized CTSG cleaved 14-3-3 proteins, released BAX, and triggered apoptosis in CRC cells. Thus, our studies illuminate a previously unrecognized mechanism by which chemotherapy-induced NETs kill cancer cells.

Surgical management of 1- to 2-cm neuroendocrine tumors of the appendix: Appendectomy or right hemicolectomy?

BACKGROUND: The surgical management of 1- to 2-cm neuroendocrine tumors of the appendix is an area of debate. We analyzed the clinical outcomes of appendectomy and compared them to right hemicolectomy. METHODS: We queried the National Cancer Database to identify patients treated for 1- to 2-cm ANETs from 2004 to 2018. Patients were stratified by surgical approach (appendectomy vs. hemicolectomy). Multivariable models were used to identify factors associated with the choice of surgical approach and the association between surgical approach and overall survival. RESULTS: Of the 3,189 patients we included, 1,573 (49.3%) underwent right hemicolectomy and 1,616 (50.7%) appendectomy. The appendectomy rate increased from 37.7% in 2004 to 58.9% in 2018. On multivariable analysis, patients with grade 2 and 3 tumors were less likely to undergo appendectomy alone (odds ratio = 0.41, 95% confidence interval = 0.26-0.66). Longer travel distance was associated with a higher likelihood of undergoing appendectomy (odds ratio = 2.52, 95% confidence interval = 1.15-5.51). After adjusting for tumor grade, appendectomy alone had similar survival to hemicolectomy (hazard ratio = 1.03, 95% confidence interval = 0.67-1.59). CONCLUSION: In this updated analysis of the National Cancer Database, right hemicolectomy was not associated with improved overall survival compared to appendectomy alone for 1- to 2-cm neuroendocrine tumors of the appendix. Although patients with grade 2 or 3 tumors are more likely to undergo right hemicolectomy, this procedure may not improve their treatment or overall outcome.