Safety and efficacy of low-power pure-cut hot snare polypectomy for small nonpedunculated colorectal polyps compared with conventional resection methods: A propensity score matching analysis.

Objectives: Cold snare polypectomy (CSP) is widely performed for small colorectal polyps. However, small colorectal polyps sometimes include high-grade adenomas or carcinomas that require endoscopic resection with electrocautery. This study aimed to evaluate the efficacy and safety of a novel resection technique, hot snare polypectomy with low-power pure-cut current (LPPC-HSP) for small colorectal polyps, compared with CSP and conventional endoscopic mucosal resection (EMR). Methods: Records of patients who underwent CSP, EMR, or LPPC-HSP for nonpedunculated colorectal polyps less than 10 mm between April 2021 and March 2022 were retrospectively evaluated. We analyzed and compared the treatment outcomes of CSP and EMR with those of LPPC-HSP using propensity score matching. Results: After propensity score matching of 396 pairs, an analysis of CSP and LPPC-HSP indicated that LPPC-HSP had a significantly higher R0 resection rate (84% vs. 68%; p < 0.01). Delayed bleeding was observed in only two cases treated with CSP before matching. Perforation was not observed with either treatment. After propensity score matching of 176 pairs, an analysis of EMR and LPPC-HSP indicated that their en bloc and R0 resection rates were not significantly different (99.4% vs. 100%, p = 1.00; 79% vs. 81%, p = 0.79). Delayed bleeding and perforation were not observed with either treatment. Conclusions: The safety of LPPC-HSP was comparable to that of CSP. The treatment outcomes of LPPC-HSP were comparable to those of conventional EMR for small polyps. These results suggest that this technique is a safe and effective treatment for nonpedunculated polyps less than 10 mm.

Wearable heart rate sensing and critical power-based whole-body fatigue monitoring in the field.

Whole-body fatigue (WBF) presents a concerning risk to construction workers, which can impact function and ultimately lead to accidents and diminished productivity. This study proposes a new WBF monitoring technique by applying the Critical Power (CP) model, a bioenergetic model, with a wrist-worn heart rate sensor. The authors modified the CP model to calculate WBF from the percentage of heart rate reserve (%HRR) and generated a personalized model via WBF perception surveys. Data were collected for two days from 33 workers at four construction sites. The results showed that the proposed technique can monitor field workers' perceived WBF with a mean absolute error of 12.8% and Spearman correlation coefficient of 0.83. This study, therefore, demonstrates the viability of wearable WBF monitoring on construction sites to support programs aimed at improving workplace safety and productivity.

Cellulose binary coatings with spherical envelope structure via structure rearrangement in ball milling for integrated radiative cooling-electricity generation.

Passive daytime radiative cooling is a zero-energy consumption cooling technology, which can dissipate heat to outer space via infrared radiation. Recently, coupling radiative cooling technology and thermoelectric devices to generate electricity has attracted much attention. However, existing radiative cooling integrated thermoelectric devices still suffer from low-temperature gradient and output voltage. Here, based on the Mie scattering and internal reflection enhancing principle, an impact-inducing geometry reconstruction approach was proposed to fabricate hierarchical nanostructured cellulosic coatings with good daytime cooling performance to achieve stable electricity generation function, which can be realized by using a scalable and facile wet ball milling technology. Guided by the theoretical simulations of the finite difference time domain method (FDTD), the cellulose and TiO2 nanoparticles can assemble into spherical envelope structured coatings drying by the shear, impact, and friction interaction in the ball milling process, dramatically enhancing the Mie scattering and internal reflection of coatings. The cellulosic coatings exhibit sunlight reflectivity of 0.962 and infrared emissivity of 0.94, resulting in a daytime radiative cooling efficiency of 5.9 °C under direct sunlight. Energy Plus stimulation demonstrated 35 % cooling energy and 468.9 kWh of cooling energy can be saved annually in China. Meanwhile, this cellulosic coating-based thermoelectric device can deliver a high voltage output of 150 mV under 1 Sun due to the strong bonding and high-temperature gradient formation (30 °C), which is higher than previous reports. This study will facilitate the development of sustainable power generation device for the goal of green future.

Exponential PID controller for effective load frequency regulation of electric power systems.

Load frequency regulation (LFR) is an indispensable scheme in planning electrical power production to provide consumers with stable, reliable and uninterrupted power. In the face of complicated power system (PS) structures with increasing and intricate power demand, new controllers that offer not only good performance, but also easy commissioning in practice are required. To this end, this research introduces an exponential PID (EXP-PID) controller as a new control scheme to ameliorate the LFR performance of PSs. This controller is simple to design and has a nonlinear feature inherited from two tunable exponential functions, which are placed in front of the PID controller and act on the error signal and its time derivative individually. To achieve the utmost performance, the EXP-PID controller's parameters are procured by a corrected variant of the snake optimizer (co-SO). To validate the proposed control scheme, various single-/multi-area single-/multi-source PSs favored in the area are considered as test benches. A thorough comparison with the state-of-the-art approaches is performed to disclose the true efficacy of our proposal. Among the rivals, co-SO tuned EXP-PID controller, despite its simplicity, is found to render credible and promising performance in mitigating frequency and tie-line power deviations effectively.

Investigation of low-GWP working fluids as substitutes for R245fa in organic Rankine cycle application.

This study presents a thermo-economic assessment of three low-global-warming-potential (GWP) substitutes, R1233zd(E), R1234ze(Z) and R1234ze(E), for R245fa used in organic Rankine cycle (ORC) systems, considering two models with different heat sources. The exhaust heat from a diesel generator is served as heat source of Model I, while the waste heat of exhaust and jacket cooling water are used as heat source of Model II. It is noted that the working pressure of R1234ze(E) is much higher than that of R1233zd(E), R1234ze(Z) and R245fa in a fixed evaporation-temperature range. Furthermore, the system using R1234ze(E) has the minimum net power output for Model I, while it turns into the maximum net power output for Model II. In addition, both R1234ze(Z) and R1233zd(E) can be used as good alternative working fluids for R245fa because R1234ze(Z), R1233zd(E) and R245fa have close working pressures, maximum net power outputs, and minimum levelized energy costs. Compared to Model I, LEC min of R1233ed(E) and R1234ze(Z) are reduced by 10.8 % and 9.9 % and PB min of R1233ed(E) and R1234ze(Z) are reduced by 11.5 % and 10.1 %, respectively, in Model II. However, R1233zd(E) has the highest minimum payback period for both Model I and Model II among the four working fluids investigated.

Assessing muscle quality as a key predictor to differentiate fallers from non-fallers in older adults.

BACKGROUND: Falling is an important public health issue because of its prevalence and severe consequences. Evaluating muscle performance is important when assessing fall risk. The study aimed to identify factors [namely muscle capacity (strength, quality, and power) and spatio-temporal gait attributes] that best discriminate between fallers and non-fallers in older adults. The hypothesis is that muscle quality, defined as the ratio of muscle strength to muscle mass, is the best predictor of fall risk. METHODS: 184 patients were included, 81% (n = 150) were women and the mean age was 73.6 ± 6.83 years. We compared body composition, mean grip strength, spatio-temporal parameters, and muscle capacity of fallers and non-fallers. Muscle quality was calculated as the ratio of maximum strength to fat-free mass. Mean handgrip and power were also controlled by fat-free mass. We performed univariate analysis, logistic regression, and ROC curves. RESULTS: The falling patients had lower muscle quality, muscle mass-controlled power, and mean weighted handgrip than the non-faller. Results showing that lower muscle quality increases fall risk (effect size = 0.891). Logistic regression confirmed muscle quality as a significant predictor (p < .001, OR = 0.82, CI [0.74; 0.89]). ROC curves demonstrated muscle quality as the most predictive factor of falling (AUC = 0.794). CONCLUSION: This retrospective study showed that muscle quality is the best predictor of fall risk, above spatial and temporal gait parameters. Our results underscore muscle quality as a clinically meaningful assessment and may be a useful complement to other assessments for fall prevention in the aging population.

Impact of cap-and-trade mechanism on investment decision of new electric power system.

Under the background of cap-and-trade mechanisms, this article constructs a game model of the electricity supply chain, which is dominated by electricity generators and followed by electricity sellers, taking into account the situation of electricity generators investing in renewable energy and energy storage under the grandfathering mechanism (GM) and benchmarking mechanism (BM). By comparing the equilibrium solutions in different cases, the research finds that (1) compared with the grandfathering mechanism, the benchmarking mechanism has more investment in renewable energy and higher energy storage quality; (2) in the consumer market, compared with GM, the electricity price and the electricity demand are higher under BM; (3) an increase in the renewable energy preference coefficient or carbon price will lead to an increase in the electricity wholesale price, renewable energy investment, energy storage quality, electricity price, and electricity demand. Further, an increase in the energy storage cost coefficient or renewable energy investment cost coefficient will result in lower electricity wholesale price, renewable energy investment, energy storage quality, electricity price, and electricity demand; and (4) the profit of the generator under GM is higher than that under BM when the total carbon quota is larger, while the profit of the generator under BM is higher than that under GM when the unit carbon quota is larger.

Cancer Incidence Among Residents Near Coal-Fired Power Plants Based on the Korean National Health Insurance System Data.

BACKGROUND: Cancer is a leading cause of death worldwide, posing a significant threat to human health and life expectancy. Numerous existing studies explored the correlation between coal-fired power plants and cancer development. Currently, Chungcheongnam-do Province hosts 29 coal-fired power plants, constituting half of the total 58 plants across South Korea. METHODS: This study assessed the cancer incidence by proximity to coal-fired power plants in Chungcheongnam-do Province, Korea. In this study, the exposed group comprised individuals residing within a 2-km radius of the coal-fired power plants, whereas the control group comprised individuals who had no prior residency within the 2-km radius of such plants or elsewhere in the province. Standardized incidence ratios were calculated using the cancer incidence cases retrieved from the National Health Insurance System data from 2007 to 2017. RESULTS: The study found that exposed men had a 1.11 (95% confidence interval [CI], 1.09-1.21) times higher risk of developing all cancer types and a 1.15 (95% CI, 1.09-1.22) times higher risk of developing cancers excluding thyroid cancer compared with control men. Exposed women had a 1.05 (95% CI, 1.00-1.14) times higher risk of developing all cancer types and a 1.06 (95% CI, 0.98-1.13) times higher risk of developing cancers excluding thyroid cancer than did control women. The colorectal, liver, prostate, and bladder cancer incidence rates were significantly higher in exposed men than that in all control groups. The incidence of esophageal, stomach, liver, and lung cancers were significantly higher in exposed women compared with all control groups. CONCLUSION: The residents near coal-fired power plants had a higher risk of developing cancer than did those living in other areas. In the future, long-term follow-up investigations in residents living in the vicinity of power plants are warranted.

Clinical trials with mechanism evaluation of intervention(s): mind the power and sample size calculation.

BACKGROUND: Mediation analysis, often completed as secondary analysis to estimating the main treatment effect, investigates situations where an exposure may affect an outcome both directly and indirectly through intervening mediator variables. Although there has been much research on power in mediation analyses, most of this has focused on the power to detect indirect effects. Little consideration has been given to the extent to which the strength of the mediation pathways, i.e., the intervention-mediator path and the mediator-outcome path respectively, may affect the power to detect the total effect, which would correspond to the intention-to-treat effect in a randomized trial. METHODS: We conduct a simulation study to evaluate the relation between the mediation pathways and the power of testing the total treatment effect, i.e., the intention-to-treat effect. Consider a sample size that is computed based on the usual formula for testing the total effect in a two-arm trial. We generate data for a continuous mediator and a normal outcome using the conventional mediation models. We estimate the total effect using simple linear regression and evaluate the power of a two-sided test. We explore multiple data generating scenarios by varying the magnitude of the mediation paths whilst keeping the total effect constant. RESULTS: Simulations show the estimated total effect is unbiased across the considered scenarios as expected, but the mean of its standard error increases with the magnitude of the mediator-outcome path and the variability in the residual error of the mediator, respectively. Consequently, this affects the power of testing the total effect, which is always lower than planned when the mediator-outcome path is non-trivial and a naive sample size was employed. Analytical explanation confirms that the intervention-mediator path does not affect the power of testing the total effect but the mediator-outcome path. The usual effect size consideration can be adjusted to account for the magnitude of the mediator-outcome path and its residual error. CONCLUSIONS: The sample size calculation for studies with efficacy and mechanism evaluation should account for the mediator-outcome association or risk the power to detect the total effect/intention-to-treat effect being lower than planned.

Role of impedance drop and lesion size index (LSI) to guide catheter ablation for atrial fibrillation.

BACKGROUND: When using lesion size index (LSI) to guide catheter ablation, it is unclear what combination of power, contact force and time would be preferable to use and what LSI target value to aim for. This study aimed at identifying desirable ablation settings and LSI targets by using tissue impedance drop as indicator of lesion formation. METHODS: Consecutive patients, undergoing their first left atrial (LA) catheter ablation for atrial fibrillation, with radiofrequency energy (RF) powers of 20, 30 and 40 W were enrolled. Tissue impedance, contact force (CF), Force Time Integral (FTI) and LSI values were continuously recorded during ablation and sampled at 100 Hz. Mean CF and Contact Force Variability (CFV) were calculated for every lesion. The effect of RF power, ablation time, CF and CFV on impedance drop and LSI were assessed. RESULTS: A total of 3258 lesions were included in the analysis. For any target LSI value, use of higher RF powers translated into progressively higher impedance drops. The impact of lower CF and higher CFV on impedance drop was more relevant when using lower powers. Target LSI values corresponding to maximum impedance drop were identified depending on RF power, mean CF and CFV used. CONCLUSIONS: Even in the context of an LSI-guided ablation strategy, use of lower or higher powers might lead to different lesion sizes. Different LSI targets might be needed depending on the combination of RF power, CF and CFV used for ablation. Incorporating indicators of catheter stability, like CFV, in the LSI formula could improve the predictive value of LSI for lesion size. Studies with clinical outcomes are required to confirm the clinical relevance of these findings.

Application of the Marshall-Olkin-Weibull logarithmic distribution to complete and censored data.

In contemporary statistical research, there has been a notable surge of interest surrounding a suggested extension of the Marshall-Olkin-G distributions. The present extension exhibits a higher degree of flexibility in comparison to its parent distributions. In a similar manner, we present in this context an expansion of the Marshall-Olkin-G distributions proposed by statistical scholars. This study utilizes a specific variant of the extension known as the Marshall-Olkin-Weibull Logarithmic model, which is applied to both complete and censored data sets. It is evident that the aforementioned model has strong competitiveness in accurately characterizing both complete and censored observations in lifetime reliability issues, when compared to other comparative models discussed in this research work.

Enhanced power grid performance through Gorilla Troops Algorithm-guided thyristor controlled series capacitors allocation.

This article introduces an innovative application of the Enhanced Gorilla Troops Algorithm (EGTA) in addressing engineering challenges related to the allocation of Thyristor Controlled Series Capacitors (TCSC) in power grids. Drawing inspiration from gorilla group behaviors, EGTA incorporates various methods, such as relocation to new areas, movement towards other gorillas, migration to specific locations, following the silverback, and engaging in competitive interactions for adult females. Enhancements to EGTA involve support for the exploitation and the exploration, respectively, through two additional strategies of periodic Tangent Flight Operator (TFO), and Fitness-based Crossover Strategy (FCS). The paper initially evaluates the effectiveness of EGTA by comparing it to the original GTA using numerical CEC 2017 single-objective benchmarks. Additionally, various recent optimizers are scrutinized. Subsequently, the suitability of the proposed EGTA for the allocation of TCSC apparatuses in transmission power systems is assessed through simulations on two IEEE power grids of 30 and 57 buses, employing various TCSC apparatus quantities. A comprehensive comparison is conducted between EGTA, GTA, and several other prevalent techniques in the literature for all applications. According to the average attained losses, the presented EGTA displays notable reductions in power losses for both the first and second systems when compared to the original GTA. Specifically, for the first system, the proposed EGTA achieves reductions of 1.659 %, 2.545 %, and 4.6 % when optimizing one, two, and three TCSC apparatuses, respectively. Similarly, in the second system, the suggested EGTA achieves reductions of 6.096 %, 7.107 %, and 4.62 %, respectively, when compared to the original GTA's findings considering one, two, and three TCSC apparatuses. The findings underscore the superior effectiveness and efficiency of the proposed EGTA over both the original GTA and several other contemporary systems.

Improving the Long-Term Stability of PbTe-Based Thermoelectric Modules: From Nanostructures to Packaged Module Architecture.

Nanostructured lead telluride PbTe is among the best-performing thermoelectric materials, for both p- and n-types, for intermediate temperature applications. However, the fabrication of power-generating modules based on nanostructured PbTe still faces challenges related to the stability of the materials, especially nanoprecipitates, and the bonding of electric contacts. In this study, in situ high-temperature transmission electron microscopy observation confirmed the stability of nanoprecipitates in p-type Pb0.973Na0.02Ge0.007Te up to at least ∼786 K. Then, a new architecture for a packaged module was developed for improving durability, preventing unwanted interaction between thermoelectric materials and electrodes, and for reducing thermal stress-induced crack formation. Finite element method simulations of thermal stresses and power generation characteristics were utilized to optimize the new module architecture. Legs of nanostructured p-type Pb0.973Na0.02Ge0.007Te (maximum zT ∼ 2.2 at 795 K) and nanostructured n-type Pb0.98Ga0.02Te (maximum zT ∼ 1.5 at 748 K) were stacked with flexible Fe-foil diffusion barrier layers and Ag-foil-interconnecting electrodes forming stable interfaces between electrodes and PbTe in the packaged module. For the bare module, a maximum conversion efficiency of ∼6.8% was obtained for a temperature difference of ∼480 K. Only ∼3% reduction in output power and efficiency was found after long-term operation of the bare module for ∼740 h (∼31 days) at a hot-side temperature of ∼673 K, demonstrating good long-term stability.

Correlation analysis of occupational stress and metabolic syndrome among employees of a power grid enterprise in China.

BACKGROUND: Being in a state of high occupational stress may disrupt the metabolic balance of the body, thus increasing the risk of metabolic diseases. However, the evidence about the relationship between occupational stress and metabolic syndrome was limited. OBJECTIVES: To explore the association between occupational stress and metabolic syndrome (MetS) in employees of a power grid enterprise. METHODS: A total of 1091 employees were recruited from a power grid enterprise in China. Excluding those who failed to complete the questionnaire and those who had incomplete health check-ups, 945 subjects were included in the study. Assessment of occupational stress was used by job demand-control (JDC) and effort-reward imbalance (ERI) questionnaires, respectively. The information on body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were collected. The levels of high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), and fasting blood glucose (FBG) in the fasting venous blood samples were measured. Logistic regression analysis and multiple linear regression methods were used to analyze the correlation between JDC and ERI models of occupational stress, metabolic syndrome, and its components, respectively. RESULTS: The prevalence of MetS was 8.4% and 9.9% in JDC and ERI model high occupational stress employees, respectively. ERI model occupational stress and smoking are significantly associated with the risk of MetS. ERI ratio was significantly associated with lower HDL-C levels. Gender, age, marital status, smoking, high-temperature and high-altitude work were significantly associated with metabolic component levels. CONCLUSION: Our study revealed a high detection rate of occupational stress in both JDC and ERI models among employees of a power grid enterprise. ERI model occupational stress, demanding more attention, was associated with the risk of MetS as well as its components such as HDL-C.

Regional wood chip quality parameters decomposition and price linkage with impact on Polish energy sustainability: Time frequency analysis between 2013 and 2019.

The study aims to analyze and decompose the qualitative parameters of wood chips in Poland. The European Green Deal brings the new framework to support sustainability and elimination of emissions. The Wavelet coherence and Wavelet Discrete Decomposition are used for determination of relations among significant qualitative parameters. Thus, the possible uses are discussed. For the obvious relationship between moisture and calorific value there is evidence of strong correlation. The behaviour of these interrelations are different at frequencies in the long and short time. The wood chip price is inter-transmitter from moisture parameter to calorific value in a positive (in-phase) relationship. At both low and high frequencies there is evidence that the variables of moisture and calorific value are highly correlated. The transient effect of linkage is presented at values between 0.1 and 0.3 in coherence map. The empirical findings provide implication for local producers and policymakers.

Short-term wind farm cluster power point-interval prediction based on graph spatio-temporal features and S-Stacking combined reconstruction.

Wind energy is becoming increasingly competitive, Accurate and reliable multi-engine wind power forecasts can reduce power system operating costs and improve wind power consumption capacity. Existing research on wind power forecasting has neglected the importance of interval forecasting using clusters of wind farms to capture spatial characteristics and the objective selection of forecasting sub-learners, leading to increased uncertainty and risk in system operation. This paper proposes a new "decomposition-aggregation-multi-model parallel prediction" method. The data set is pre-processed by a decomposition-aggregation strategy and spatial feature extraction, and then a Stacking model with multiple parallel sub-learners selected by bootstrap method is used for point and interval forecasting. Experiments and discussions are conducted based on 15-min resolution wind power data from a cluster dataset of a wind farm in northwest China. The experimental results indicate that the method achieves higher accuracy and reliability in both point prediction and interval prediction than other comparative models, with a root mean square error value of 7.47 and an average F value of 1.572, which can provide a reliable reference for power generation planning from wind farm clusters.

Interindividual differences in physical function and their impact on regular player selection among junior high school soccer athletes.

[Purpose] Unlike professional teams that use comprehensive evaluations, player selection in local and school-level soccer teams relies on the coaches' practical experience. This study investigated the differences in physical function between regular and non-regular male junior high school soccer players to provide valuable insights into player selection. [Participants and Methods] We assessed grip strength, rebound jumps, muscle strength, agility, short-distance running, anaerobic power, and countermovement jumps in 55 Japanese junior high school boys, who were divided into regular (R) and non-regular (NR) groups. Moreover, the age, height, and weight of the groups were compared. [Results] The analysis revealed significant differences in countermovement jumps and anaerobic power, while accounting for age and physique. [Conclusion] These results suggest that countermovement jumps and anaerobic power may constitute determining factors for regular and non-regular players, even when age and physical characteristics are considered.

The impact of frequency and power on the ultrasonic purification of aluminum alloy.

In this study, the variations in hydrogen content and oxide content in alloys under 0 W, 500 W, 1000 W, 1500 W, 2000 W, 2500 W, 3000 W, and at 20 kHz, 30 kHz, 40 kHz were investigated. Hydrogen content was assessed using porosity and computed tomography, while oxygen content in the alloy was measured using element analyzer and elemental scanning. Compared to other conditions, the melt had the lowest hydrogen and oxide contents at a frequency of 20 kHz and an ultrasonic power of 2500 W, with values of 0.099 cm3/100 g and 0.0015 %, respectively. Experimental observations also indicate that the variations in hydrogen content and oxide content in the alloy during ultrasonic treatment are almost similar. In most cases, lower hydrogen content corresponds to lower oxide content in the same alloy. This is because hydrogen bubbles and oxides become a single entity. At the same time, ultrasonic purification increases the tensile strength of the alloy to 200.1 MPa and the elongation rate to 0.72 %. This study primarily investigates the relationship between hydrogen bubbles and oxides in aluminum melt under different ultrasonic frequencies and power levels, providing significant reference for the purification of various fluids under ultrasonic fields.

Study on different brain activation rearrangement during cognitive workload from ERD/ERS and coherence analysis.

The functional activities of the brain during any task like imaginary, motor, or cognitive are different in pattern as well as their area of activation in the brain is also different. This variation in pattern is also found in the brain's electrical variations that can be measured from the scalp of the brain using an electroencephalogram (EEG). This work exclusively studied a group of subjects' EEG data (available at: https://archive.physionet.org/physiobank/database/eegmat/) to unravel the activation pattern of the human brain during a mental arithmetic task. Since any cognitive task creates variations in EEG signal pattern, the relative changes in the signal power also occur which is also known as event-related desynchronization/synchronization (ERD/ERS). In this work, ERD/ERS have calculated the band-wise power spectral density (PSD) using Welch's method from the EEG signals. Besides, the coherence analysis was also performed to verify the results of ERD/ERS analysis from several randomly chosen subjects' EEG data. Here, subjects performing mental arithmetic tasks were grouped based on their performances: good (subtraction solved > 10 on average) and bad (subtraction solved ≤ 10 on average) to conduct group-specific ERD/ERS analysis regarding their performance in cognitive tasks. It was found that when the brain is on count condition, the variations found in the band power of theta and beta. The amounts of ERS in the left hemisphere are increased. When the task complexity increases, it contributes to an increase in relative ERD/ERS amounts and durations. The left and right hemispheres were asymmetrically distributed by both the pre-stimulus stages of the corresponding band power and relative ERD/ERS.

Initial treatment for surgery-naïve desmoid tumors by high intensity focused ultrasound.

Introduction: Desmoid tumor (DT) is a rare proliferative disease occurring in connective tissues, characterized by high infiltration and recurrence rates. While surgery remains the primary treatment, its recurrence risk is high, and some extra-abdominal desmoid tumors are inoperable due to their locations. Despite attempts with radiotherapy and systemic therapy, the efficacy remains limited. Methods: We used low-power cumulative high-intensity focused ultrasound (HIFU) therapy as an initial treatment for desmoid tumor patients either ineligible or unwilling for surgery. Low-power cumulative HIFU employs slower heat accumulation and diffusion, minimizing damage to surrounding tissues while enhancing efficacy. Results: Fifty-seven non-FAP desmoid tumor patients, previously untreated surgically, underwent low-power cumulative HIFU therapy. Among them, 35 had abdominal wall DT, 20 had extra-abdominal DT, and 2 had intra- abdominal DT, with an 85% median ablation ratio. Abdominal wall DT patients showed significantly better response rates (91.4% vs. 86%) and disease control rates (100% vs. 32%) than that of non-abdominal wall DT patients. Median event- free survival time was not reached after a median follow-up duration of 34 months. Discussion: With its high response rate, durable efficacy, and mild adverse effects, our findings suggest that low-power cumulative HIFU presents a promising novel treatment for desmoid tumors, particularly abdominal wall DT patients.