Optimal ultrasonic treatment frequency and duration parameters were used to detect the pathogenic bacteria of orthopedic implant-associated infection by ultrasonic oscillation.

INTRUDUCTON: The most accurate method for detecting the pathogen of orthopedic implant-associated infections (OIAIs) is sonication fluid (SF). However, the frequency and duration of ultrasound significantly influence the number and activity of microorganisms. Currently, there is no consensus on the selection of these two parameters. Through this study, the choice of these two parameters is clarified. METHODS: We established five ultrasonic groups (40kHz/10min, 40kHz/5min, 40 kHz/1min, 20kHz/5min, and 10kHz/5min) based on previous literature. OIAIs models were then developed and applied to ultrasound group treatment. Subsequently, we evaluated the efficiency of bacteria removal by conducting SEM and crystal violet staining. The number of live bacteria in the SF was determined using plate colony count and live/dead bacteria staining. RESULTS: The results of crystal violet staining revealed that both the 40kHz/5min group and the 40kHz/10min group exhibited a significantly higher bacterial clearance rate compared to the other groups. However, there was no significant difference between the two groups. Additionally, the results of plate colony count and fluorescence staining of live and dead bacteria indicated that the number of live bacteria in the 40kHz/5min SF group was significantly higher than in the other groups. CONCLUSION: 40kHz/5min ultrasound is the most beneficial for the detection of pathogenic bacteria on the surface of orthopedic implants.

Impact of Nonthermal Plasma on Lipid Oxidation from the Perspective of Plasma Treatment Parameters and Plasma Species: Identification of Key Reactive Species.

Nonthermal plasma is a mild processing technology for food preservation. Its impact on lipid oxidation was investigated in this study. Stripped methylesters were considered as a basic lipid model system and were treated by a multihollow surface dielectric barrier discharge. In dry air plasma, O3, ·NO2, ·NO3, and 1O2 were identified as the main reactive species reaching the sample surface. Treatment time was the most prominent parameter affecting lipid oxidation, followed by the (specific) power input and the plasma-sample distance. In humid air plasma, less O3 was detected, but ONOOH and O2NOOH were generated and presumed to play a role in lipid oxidation. Ozone mainly resulted in the formation of carbonyl substances via the trioxolane pathway, while reactive nitrogen species (i.e., ·NO2, ·NO3, ONOOH, and O2NOOH) led to the formation of hydroperoxides. The impact of short-living radicals (e.g., ·O, ·N, ·OH, and ·OOH) was restricted in general, since they dissipated too fast to reach the sample.·NO, HNO3, H2O2, and UV radiation did not induce lipid oxidation. All the reactive species identified in this study were associated with the presence of O2 in the input gas.

Efficacy of Using Intermittent Theta Burst Stimulation to Treat Negative Symptoms in Patients with Schizophrenia-A Systematic Review and Meta-Analysis.

Negative symptoms in schizophrenia impose a significant burden with limited effective pharmacological treatment options. Recent trials have shown preliminary evidence for the efficacy of using intermittent theta burst stimulation (iTBS) in treating negative symptoms in schizophrenia. We aim to systematically review the current evidence of iTBS in the treatment of the negative symptoms of schizophrenia as an augmentation therapy. The study protocol was developed and registered on Prospero (registration ID: 323381). MEDLINE, EMBASE, Web of Science (Scopus), PsycINFO and Wan Fang databases were searched for sham-controlled, randomized trials of iTBS among patients with schizophrenia. The mean difference in major outcome assessments for negative symptoms was calculated. The quality of evidence was assessed using the Cochrane Risk of Bias Tool (version 1) and the GRADE system. Moreover, 12 studies including a total of 637 participants were included. Compared to sham treatment, the pooled analysis was in favor of iTBS treatment for negative symptoms (mean weight effect size: 0.59, p = 0.03) but not for positive symptoms (mean weight effect size: 0.01, p = 0.91) and depressive symptoms (mean weight effect size: 0.35, p = 0.16). A significant treatment effect was also observed on the iTBS target site left dorsal prefrontal cortex (mean weight effect size: 0.86, p = 0.007) and for stimulation with 80% motor threshold (mean weight effect size: 0.86, p = 0.02). Thus, our synthesized data support iTBS as a potential treatment for negative symptoms among patients with schizophrenia. However, the long-term efficacy and safety issues of iTBS in a larger population have yet to be examined.

Research progress on negative pressure wound therapy with instillation in the treatment of orthopaedic wounds.

Negative pressure wound therapy with instillation (NPWTi) has the dual function of negative pressure sealing drainage and irrigation, which overcomes the disadvantages of NPWT, such as tube obstruction, inability to apply topical medicine, and poor anti-infection ability. NPWTi has been researched extensively and widely used in various types of wounds, and certain effects have been achieved. A series of parameters for NPWTi have not been unified at present, including the flushing fluid option, flushing mode, and treatment period. This paper reviews the research progress of these parameters for NPWTi and their application in the treatment of orthopaedic wounds.

Impact of Treatment Parameters on Racial Survival Differences in Oropharyngeal Cancer: National Cancer Database Study.

OBJECTIVE: To investigate how differences in treatment parameters account for survival differences between races of patients with oropharyngeal squamous cell carcinoma (OPSCC). STUDY DESIGN: Retrospective cohort study. SETTING: National Cancer Database. METHODS: Data of patients with OPSCC undergoing radiation therapy (RT) or concurrent chemoradiation therapy as primary treatment were obtained from the National Cancer Database from 2004 to 2016. We analyzed 4 treatment-related time intervals to determine their impact on survival between races when controlling for human papilloma virus (HPV) status. Cox proportional hazards models, stepwise logistic regressions, covariate adjustments, and propensity score matching were performed. RESULTS: A total of 3152 patients were identified (2877 White, 275 Black). In HPV- cases, Black patients with prolonged radiation duration had a significantly worse overall survival as compared with White patients (hazard ratio, 1.77; 95% CI, 1.03-3.05; P = .039). In a logistic regression model, the only covariate that was significantly associated with prolonged RT was facility type. When further adjusted for facility type, the survival difference between Black and White patients with HPV- status and prolonged RT times was no longer significant (hazard ratio, 1.55; 95% CI, 0.90-2.69; P = .116). CONCLUSIONS: There is a significant disparity in overall survival between Black and White patients with HPV- OPSCC when RT duration is prolonged. Clinicians should be aware of the negative impact of prolonged RT, especially in Black patients, so that they can attempt to decrease treatment-related time intervals. Facility type was also found to affect the outcomes of patients with OPSCC, and efforts should be made to improve patient access to well-equipped, high-volume facilities.

Can Pre-Treatment Inflammatory Parameters Predict the Probability of Sphincter-Preserving Surgery in Patients with Locally Advanced Low-Lying Rectal Cancer?

There is evidence suggesting that pre-treatment clinical parameters can predict the probability of sphincter-preserving surgery in rectal cancer; however, to date, data on the predictive role of inflammatory parameters on the sphincter-preservation rate are not available. The aim of the present cohort study was to investigate the association between inflammation-based parameters and the sphincter-preserving surgery rate in patients with low-lying locally advanced rectal cancer (LARC). A total of 848 patients with LARC undergoing radiotherapy from 2004 to 2019 were retrospectively reviewed in order to identify patients with rectal cancer localized ≤6 cm from the anal verge, treated with neo-adjuvant radiochemotherapy (nRCT) and subsequent surgery. Univariable and multivariable analyses were used to investigate the role of pre-treatment inflammatory parameters, including the C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) for the prediction of sphincter preservation. A total of 363 patients met the inclusion criteria; among them, 210 patients (57.9%) underwent sphincter-preserving surgery, and in 153 patients (42.1%), an abdominoperineal rectum resection was performed. Univariable analysis showed a significant association of the pre-treatment CRP value (OR = 2.548, 95% CI: 1.584-4.097, p < 0.001) with sphincter preservation, whereas the pre-treatment NLR (OR = 1.098, 95% CI: 0.976-1.235, p = 0.120) and PLR (OR = 1.002, 95% CI: 1.000-1.005, p = 0.062) were not significantly associated with the type of surgery. In multivariable analysis, the pre-treatment CRP value (OR = 2.544; 95% CI: 1.314-4.926; p = 0.006) was identified as an independent predictive factor for sphincter-preserving surgery. The findings of the present study suggest that the pre-treatment CRP value represents an independent parameter predicting the probability of sphincter-preserving surgery in patients with low-lying LARC.

Subthreshold stimulation intensity is associated with greater clinical efficacy of intermittent theta-burst stimulation priming for Major Depressive Disorder.

BACKGROUND: Intermittent theta-burst stimulation priming (iTBS-P) can improve clinical outcome of patients with Major Depressive Disorder (MDD) who do not show early benefit from 10 Hz stimulation of left dorsolateral prefrontal cortex (DLPFC), also known as high-frequency left-sided (HFL) stimulation. The intensity and pulse number for iTBS-P needed to induce clinical benefit have not been systematically examined. OBJECTIVE: To study the effect of intensity and pulse number on the clinical efficacy of iTBS-P. METHODS: We conducted a retrospective review of 71 participants who received at least five sessions of HFL with limited clinical benefit and received iTBS-P augmentation for between 5 and 25 sessions. Intensity of iTBS-P priming stimuli ranged from 75 to 120% of motor threshold (MT) and pulse number ranged from 600 to 1800. Associations among intensity, pulse number, and clinical outcome were analyzed using a mixed methods linear model with change in IDS-SR as the primary outcome variable, priming stimulation intensity (subthreshold or suprathreshold), pulse number (<1200 or >1200 pulses), and gender as fixed factors, and number of iTBS-P treatments and age as continuous covariates. RESULTS: Subjects who received subthreshold intensity iTBS-P experienced greater reduction in depressive symptoms than those who received suprathreshold iTBS-P (p = 0.011) with no effect of pulse number after controlling for stimulus intensity. CONCLUSIONS: Subthreshold intensity iTBS-P was associated with greater clinical improvement than suprathreshold stimulation. This finding is consistent with iTBS-P acting through homeostatic plasticity mechanisms.

The impact of treatment parameter variation on secondary neutron spectra in high-energy electron beam radiotherapy.

High-energy electron treatment procedures in radiotherapy pose a potential iatrogenic cancer risk as well as a critical health risk to patients with cardiac implantable electronic devices due to the generation of secondary neutrons in the linac head, the treatment room, and the patient. It may be argued that the neutron production from photons is well characterized, but the same is not true for electrons. Therefore, to assess the risk involved in an electron treatment, one must determine the neutron flux spectrum generated by the treatment procedure. The neutron spectrum depends on the treatment parameters used and therefore it is crucial to study its dependence on these parameters. In this work, eight experiments were devised to analyze how eight electron treatment parameters impacted the neutron spectrum. The parameters we considered were the electron beam energy, location of measurement, cutout size, collimator size, applicator size, collimator angle, choice of treatment room, and the presence or absence of a solid water phantom. For each experiment, we used a Nested Neutron Spectrometer™ (NNS) to measure the neutron flux spectra for multiple settings of the treatment parameter of interest. The resulting spectra were plotted and compared. We found that the electron beam energy and the location of measurement had the most impact on the neutron flux spectra, while the other parameters had a smaller or insignificant impact. This report may serve as a reference tool for medical physicists to help estimate the risk associated with a particular high-energy electron treatment procedure.

One hertz versus ten hertz repetitive TMS treatment of PTSD: A randomized clinical trial.

The purpose of this trial was to test whether right prefrontal cortex 1 Hz versus 10 Hz rTMS provides a significantly greater improvement in PTSD symptoms and/or function. Veterans 18 to 50 years of age suffering from PTSD were randomized to right prefrontal 1 Hz rTMS [2400 pulses/session] versus right prefrontal 10 Hz rTMS [2400 pulses/session]. The treatments were performed 5 days a week for 6 weeks with a 3-week taper using the NeuroStar system. There were one month and three months post treatment follow-up evaluations. Forty-four participants were enrolled with 17 being randomized to 1 Hz rTMS and 18 to 10 Hz rTMS. Both groups had significant improvement in PTSD and depression scores from baseline to the end of acute treatment. The 10 Hz group but not the 1 Hz group demonstrated significant improvement in function. Although both groups demonstrated significant improvement in PTSD and depression symptoms, a significant advantage for either the 1 Hz or 10 Hz frequency group on any of the scales acquired was not demonstrated. Further work is required with larger samples sizes to test whether low or high frequency is superior or if individual differences would indicate the more effective frequency.

Enhancing the Photocurrent of Top-Cell by Ellipsoidal Silver Nanoparticles: Towards Current-Matched GaInP/GaInAs/Ge Triple-Junction Solar Cells.

A way to increase the photocurrent of top-cell is crucial for current-matched and highly-efficient GaInP/GaInAs/Ge triple-junction solar cells. Herein, we demonstrate that ellipsoidal silver nanoparticles (Ag NPs) with better extinction performance and lower fabrication temperature can enhance the light harvest of GaInP/GaInAs/Ge solar cells compared with that of spherical Ag NPs. In this method, appropriate thermal treatment parameters for Ag NPs without inducing the dopant diffusion of the tunnel-junction plays a decisive role. Our experimental and theoretical results confirm the ellipsoidal Ag NPs annealed at 350 °C show a better extinction performance than the spherical Ag NPs annealed at 400 °C. The photovoltaic conversion efficiency of the device with ellipsoidal Ag NPs reaches 31.02%, with a nearly 5% relative improvement in comparison with the device without Ag NPs (29.54%). This function of plasmonic NPs has the potential to solve the conflict of sufficient light absorption and efficient carrier collection in GaInP top-cell devices.

Effect of ammonia plasma treatment on the properties and cytocompatibility of a poly(L-lactic acid) film surface.

Ammonia plasma treatment is an efficient method to modify the surface of polymeric biomaterials to improve their hydrophilicity and biocompatibility. In this study, poly(L-lactic acid) (PLLA) films were treated with ammonia plasma to investigate the effects on the surface properties and cytocompatibility. Surface morphologies of the films were observed with atomic force microscopy (AFM) and the surface roughness was analyzed with the software attached to the AFM. Mass loss density and contact angles associated to plasma treatment power and time were also studied. The stability of the treated films was evaluated by testing the contact angle change. The cytocompatibiliy was evaluated by cell adhesion, proliferation and cell cycle. The results showed that the surface morphology and roughness of the treated PLLA surfaces increased with treatment power. The mass loss density increased with plasma treatment power and time. With increasing treatment power and time, the resulting amino group density on treated PLLA film surface increased first and decreased later, while the contact angle showed an opposite trend. The contact angle of the treated films increased with storage time and returned to its original value after about 2 weeks. The cell experiments indicated that promotion of cell adhesion and proliferation were significantly improved on the treated PLLA surfaces.