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Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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BACKGROUND: The principle of respect for autonomy (PRA) is a central tenet of bioethics. In the quest for a global bioethics, it is pertinent to ask whether this principle can be applied as it is to cultures and societies that are devoid of the Western sociopolitical historical pressures that led to its emergence. Relational autonomists have argued for a more inclusive approach to patient autonomy which takes into account factors such as interdependency and social relations. However, at the outset of any relational approach, it is necessary to identify underlying factors that influence patient autonomy in non-Western cultures. OBJECTIVE: To conduct a review of the literature to uncover the mechanisms through which social, cultural, and religious factors influence and impact the application of the PRA in healthcare decision-making in non-Western cultures and societies. METHODS: We conducted a systematic review through a comprehensive search of three major electronic databases of biomedical sciences. Returned citations were imported to Covidence, full texts were assessed for eligibility, included articles were thoroughly reviewed and data was synthesized. PRISMA guidelines were followed. RESULTS: Our search retrieved 590 non-duplicate results, 50 of which were included after screening and full-text eligibility checks. The included studies were predominantly qualitative in nature, with few quantitative, mixed-methods, and review studies included. Our synthesis of data identified nine key factors that influenced patients' autonomous decision-making through cultural, social, religious, or intersectional pathways. CONCLUSION: Two main conclusions emerge from this review. Firstly, there is a notable dearth of bioethical research examining the influence of diverse factors on patients' inclination towards different conceptions of autonomy. Secondly, the analysis of prevalent collectivist cultures and deference of autonomy adds value to the solution-oriented relational autonomy debate. This raises questions regarding how decision-making can be truly autonomous in the presence of such large-scale factors, warranting further attention.
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This paper proposes measurement and reduction of eye dose in real time for the physician and the assistant performing fluoroscopy guided arterial puncture. Eye dose rates were measured for 30 fluoroscopy-guided punctures of bilateral femoral arteries in pigs. Fifteen fluoroscopy-guided punctures were performed using real time radiation dosimeter without auditory and visual feedback and other fifteen punctures were done using real time radiation dosimeter with visual and auditory feedback worn on forehead by an interventional cardiologist having experience of more than 10 years. The mean radiation dose rate for eyes of physician during arterial puncturing with real time radiation dosimeter with auditory feedback was 0.07 mSv/h (n = 15) whereas it was 0.18 mSv/h (n = 15) without visual and auditory feedback. The percentage of reduction with the device was 61% for eyes. In case of assistant the reduction was 33% for eyes (n = 15). The real time visual and auditory feedback dosimeter has reduced the eye dose rate of the physician and assistant and also helped him staying away from the X-ray source. Real time radiation dosimeters can be an effective tool to measure and reduce the dose to the eyes. The radiation eye dose rate for physician and assistant was significantly reduced by using real time radiation dosimeter with visual and auditory feedback. The real time radiation dosimeter not only helps in measuring but also help in minimizing the radiation dose rate for the physician and assistant in real time.
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Ojo , Dosis de Radiación , Animales , Fluoroscopía/métodos , Porcinos , Ojo/efectos de la radiación , Dosímetros de Radiación , Retroalimentación Sensorial , Radiometría/métodos , Arteria Femoral , Modelos AnimalesRESUMEN
The reliable operation of electrical power transmission systems is crucial for ensuring consumer's stable and uninterrupted electricity supply. Faults in electrical power transmission systems can lead to significant disruptions, economic losses, and potential safety hazards. A protective approach is essential for transmission lines to guard against faults caused by natural disturbances, short circuits, and open circuit issues. This study employs an advanced artificial neural network methodology for fault detection and classification, specifically distinguishing between single-phase fault and fault between all three phases and three-phase symmetrical fault. For fault data creation and analysis, we utilized a collection of line currents and voltages for different fault conditions, modelled in the MATLAB environment. Different fault scenarios with varied parameters are simulated to assess the applied method's detection ability. We analyzed the signal data time series analysis based on phase line current and phase line voltage. We employed SMOTE-based data oversampling to balance the dataset. Subsequently, we developed four advanced machine-learning models and one deep-learning model using signal data from line currents and voltage faults. We have proposed an optimized novel glassbox Explainable Boosting (EB) approach for fault detection. The proposed EB method incorporates the strengths of boosting and interpretable tree models. Simulation results affirm the high-efficiency scores of 99% in detecting and categorizing faults on transmission lines compared to traditional fault detection state-of-the-art methods. We conducted hyperparameter optimization and k-fold validations to enhance fault detection performance and validate our approach. We evaluated the computational complexity of fault detection models and augmented it with eXplainable Artificial Intelligence (XAI) analysis to illuminate the decision-making process of the proposed model for fault detection. Our proposed research presents a scalable and adaptable method for advancing smart grid technology, paving the way for more secure and efficient electrical power transmission systems.
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Suministros de Energía Eléctrica , Redes Neurales de la Computación , Aprendizaje Automático , Electricidad , Algoritmos , Falla de EquipoRESUMEN
Current medical treatments for diastasis recti often involve exercises to strengthen the core muscles, along with abdominal binders or supports. However, there is limited evidence comparing the effectiveness of surface electromyography (SEMG) biofeedback-assisted core strengthening exercises combined with kinesiotaping to other approaches. This study aimed to assess the impact of three interventions on core strength, inter-rectus distance, and quality of life in postpartum women with diastasis recti. The interventions included core strengthening exercises with kinesiotaping and SEMG biofeedback-assisted core strengthening with kinesiotaping. This randomized controlled trial (NCT05897255) included 24 postpartum women divided into three groups. We measured inter-rectus distance, quality of life using the Short Form Health Survey 36, and core strength using the McGill torso battery test. The SEMG biofeedback provided auditory and visual cues. We used one-way analysis of variance to compare outcomes between groups, while a t-test for within-group analysis. Both the SEMG biofeedback-assisted and non-assisted core strengthening exercises with kinesiotaping groups showed significantly greater improvements in energy, bodily pain, general health, physical functioning, and limitations due to physical problems than the core strengthening group. Additionally, the SEMG biofeedback-assisted group demonstrated a greater reduction in inter-rectus distance. There were no statistically significant differences in core strength improvement among the three groups. Core strengthening exercises with SEMG-assisted kinesiotaping were superior to core strengthening alone in reducing inter-rectus distance, enhancing physical function, energy levels, and general health, and decreasing bodily pain and limitations due to physical problems. Core strength improvements were similar across all groups.
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The lipopolyplex, a multicomponent nonviral gene carrier, generally demonstrates superior colloidal stability, reduced cytotoxicity, and high transfection efficiency. In this study, a new concept, photochemical reaction-induced transfection, using photosensitizer (PS)-loaded lipopolyplexes was applied, which led to enhanced transfection and cytotoxic effects by photoexcitation of the photosensitizer. Hypericin, a hydrophobic photosensitizer, was encapsulated in the lipid bilayer of liposomes. The preformed nanosized hypericin liposomes enclosed the linear polyethylenimine (lPEI)/pDNA polyplexes, resulting in the formation of hypericin lipopolyplexes (Hy-LPP). The diameters of Hy-LPP containing 50 nM hypericin and 0.25 µg of pDNA were 185.6 ± 7.74 nm and 230.2 ± 4.60 nm, respectively, measured by dynamic light scattering (DLS) and atomic force microscopy (AFM). Gel electrophoresis confirmed the encapsulation of hypericin and pDNA in lipopolyplexes. Furthermore, in vitro irradiation of intracellular Hy-LPP at radiant exposures of 200, 600, and 1000 mJ/cm2 was evaluated. It demonstrated 60- to 75-fold higher in vitro luciferase expression than that in nonirradiated cells. The lactate dehydrogenase (LDH) assay supported that reduced transfection was a consequence of photocytotoxicity. The developed photosensitizer-loaded lipopolyplexes improved the transfection efficiency of an exogenous gene or induced photocytotoxicity; however, the frontier lies in the applied photochemical dose. The light-triggered photoexcitation of intracellular hypericin resulted in the generation of reactive oxygen species (ROS), leading to photoselective transfection in HepG2 cells. It was concluded that the two codelivered therapeutics resulted in enhanced transfection and a photodynamic effect by tuning the applied photochemical dose.
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Antracenos , Carcinoma Hepatocelular , Liposomas , Neoplasias Hepáticas , Perileno , Fármacos Fotosensibilizantes , Transfección , Perileno/química , Perileno/análogos & derivados , Perileno/farmacología , Antracenos/química , Humanos , Fármacos Fotosensibilizantes/química , Fármacos Fotosensibilizantes/farmacología , Transfección/métodos , Liposomas/química , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/patología , Células Hep G2 , ADN/química , Polietileneimina/química , Polietileneimina/farmacología , Plásmidos/química , Supervivencia Celular/efectos de los fármacosRESUMEN
BACKGROUND: Crop diversification is considered as an imperative approach for synchronizing the plant nutrient demands and soil nutrient availability. Taking two or more crops from the same field in one year is considered as multiple cropping. It improves the diversity and abundance of soil microbes, thereby improving the growth and yield of crops. Therefore, the present study was conducted to explore the effects of different multiple winter cropping on soil microbial communities in paddy fields. In this study, eight rice cropping patterns from two multiple cropping systems with three different winter crops, including Chinese milk vetch (CMV), rape, and wheat were selected. The effects of different multiple winter cropping on soil microbial abundance, community structure, and diversity in paddy fields were studied by 16 S rRNA high-throughput sequencing and real-time fluorescence quantitative polymerase chain reaction (PCR). RESULTS: The results showed that different multiple winter cropping increased the operational taxonomic units (OTUs), species richness, and community richness index of the bacterial community in 0 ~ 20 cm soil layer. Moreover, soil physical and chemical properties of different multiple cropping patterns also affected the diversity and abundance of microbial bacterial communities. The multiple cropping increased soil potassium and nitrogen content, which significantly affected the diversity and abundance of bacterial communities, and it also increased the overall paddy yield. Moreover, different winter cropping changed the population distribution of microorganisms, and Proteobacteria, Acidobacteria, Nitrospira, and Chloroflexi were identified as the most dominant groups. Multiple winter cropping, especially rape-early rice-late rice (TR) andChinese milk vetch- early rice-late rice (TC) enhanced the abundance of Proteobacteria, Acidobacteria, and Actinobacteria and decreased the relative abundance of Verrucomicrobia and Euryarchaeota. CONCLUSION: In conclusion, winter cropping of Chinese milk vetch and rape were beneficial to improve the soil fertility, bacteria diversity, abundance and rice yield.
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Bacterias , Oryza , Microbiología del Suelo , Suelo , Oryza/crecimiento & desarrollo , Oryza/microbiología , Suelo/química , Bacterias/genética , Bacterias/clasificación , Bacterias/aislamiento & purificación , Productos Agrícolas/crecimiento & desarrollo , Biodiversidad , ARN Ribosómico 16S/genética , Microbiota , Estaciones del Año , Agricultura/métodos , Producción de Cultivos/métodosRESUMEN
Microgrids (MGs) and energy communities have been widely implemented, leading to the participation of multiple stakeholders in distribution networks. Insufficient information infrastructure, particularly in rural distribution networks, is leading to a growing number of operational blind areas in distribution networks. An optimization challenge is addressed in multi-feeder microgrid systems to handle load sharing and voltage management by implementing a backward neural network (BNN) as a robust control approach. The control technique consists of a neural network that optimizes the control strategy to calculate the operating directions for each distributed generating point. Neural networks improve control during communication connectivity issues to ensure the computation of operational directions. Traditional control of DC microgrids is susceptible to communication link delays. The proposed BNN technique can be expanded to encompass the entire multi-feeder network for precise load distribution and voltage management. The BNN results are achieved through mathematical analysis of different load conditions and uncertain line characteristics in a radial network of a multi-feeder microgrid, demonstrating the effectiveness of the proposed approach. The proposed BNN technique is more effective than conventional control in accurately distributing the load and regulating the feeder voltage, especially during communication failure.
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This study addresses the pervasive and debilitating impact of Alzheimer's disease (AD) on individuals and society, emphasizing the crucial need for timely diagnosis. We present a multistage convolutional neural network (CNN)-based framework for AD detection and sub-classification using brain magnetic resonance imaging (MRI). After preprocessing, a 26-layer CNN model was designed to differentiate between healthy individuals and patients with dementia. After detecting dementia, the 26-layer CNN model was reutilized using the concept of transfer learning to further subclassify dementia into mild, moderate, and severe dementia. Leveraging the frozen weights of the developed CNN on correlated medical images facilitated the transfer learning process for sub-classifying dementia classes. An online AD dataset is used to verify the performance of the proposed multistage CNN-based framework. The proposed approach yielded a noteworthy accuracy of 98.24% in identifying dementia classes, whereas it achieved 99.70% accuracy in dementia subclassification. Another dataset was used to further validate the proposed framework, resulting in 100% performance. Comparative evaluations against pre-trained models and the current literature were also conducted, highlighting the usefulness and superiority of the proposed framework and presenting it as a robust and effective AD detection and subclassification method.
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Soil salinization is a serious concern across the globe that is negatively affecting crop productivity. Recently, biochar received attention for mitigating the adverse impacts of salinity. Salinity stress induces osmotic, ionic, and oxidative damages that disturb physiological and biochemical functioning and nutrient and water uptake, leading to a reduction in plant growth and development. Biochar maintains the plant function by increasing nutrient and water uptake and reducing electrolyte leakage and lipid peroxidation. Biochar also protects the photosynthetic apparatus and improves antioxidant activity, gene expression, and synthesis of protein osmolytes and hormones that counter the toxic effect of salinity. Additionally, biochar also improves soil organic matter, microbial and enzymatic activities, and nutrient and water uptake and reduces the accumulation of toxic ions (Na+ and Cl), mitigating the toxic effects of salinity on plants. Thus, it is interesting to understand the role of biochar against salinity, and in the present Review we have discussed the various mechanisms through which biochar can mitigate the adverse impacts of salinity. We have also identified the various research gaps that must be addressed in future study programs. Thus, we believe that this work will provide new suggestions on the use of biochar to mitigate salinity stress.
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Given the significance of nitrogen (N) as the most constraining nutrient in agro-ecosystems, it is crucial to develop an updated model for N fertilizers management to achieve higher crop yields while minimizing the negative impacts on the environment. Coated urea is touted as one of the most important controlled-release N fertilizers used in agriculture to reduce cropland emissions and improve nitrogen use efficiency (NUE) for optimal crop yields. The sustainability of coated urea depends on the trade-offs between crop productivity, NUE and greenhouse gas emissions (CO2, CH4 and N2O); however, role of various agro-edaphic factors in influencing these trade-offs remains unclear. To determine the effects of soil properties, climatic conditions, experimental conditions, and type of coated urea on greenhouse gas emissions, NH3 losses, crop productivity, and NUE, we conducted a meta-analysis using data from 76 peer-reviewed studies. Our results showed that the application of coated urea under field conditions contributed to a greater reduction in N2O emissions (-48.67%) and higher NUE (58.72%), but crop yields were not significant. Across different climate regions, subtropical monsoon climate showed a perceptible mitigation for CO2, CH4 and NH3 (-78.38%; -83.33%; -27.46%), while temperate climate reduced N2O emissions by -70.36%. For different crops, only rice demonstrated reduction in CO2, CH4, N2O and NH3 losses. On the other hand, our findings revealed a mitigating trade-off between CO2 and CH4 emissions on medium-textured soils and N2O emissions on fine-textured soils. A significant reduction in N2O and NH3 losses was evident when coated urea was applied to soils with a pH > 5.5. Interestingly, application of coated urea to soils with higher C/N ratios increased NH3 losses but showed a noticeable N2O reduction. We found that polymer-coated urea reduced CH4 and N2O emissions and NH3 losses at the expense of higher CO2 emissions. Moreover, application of a lower dose of coated urea (0-100 kg N ha-1) enhanced CO2 and CH4 mitigation, while N2O mitigation increased linearly with increasing dose of coated urea. Most importantly, our results showed that the application of coated urea leads to a large mismatch between NUE, crop yields and greenhouse gas mitigation. By and large, the application of coated urea did not correspond with higher crop yields despite significant reduction in the emissions and improved NUE. Overall, these results suggest that site-specific agro-edaphic conditions should be considered when applying coated urea to reduce these emissions and N volatilization losses for increasing NUE and crop yields.
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Agricultura , Productos Agrícolas , Fertilizantes , Gases de Efecto Invernadero , Urea , Agricultura/métodos , Productos Agrícolas/crecimiento & desarrollo , Suelo/química , Metano , Dióxido de Carbono/análisis , Nitrógeno , Óxido Nitroso/análisisRESUMEN
[This corrects the article DOI: 10.1021/acsomega.3c09495.].
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In cancer research, circulating tumor cells (CTCs) were identified as the main drivers of metastasis. They are vital for early detection and prevention of metastasis during cancer treatment. Even though continuous progress in research offers more and more tools to combat cancer, we still lack a proper arsenal of therapeutics. Especially in tumors with close to no targeting options, like triple-negative breast cancer, early detection is often the main difference between successful and failed therapy. When such tumors are detected too late, they may have already produced plenty of CTCs, likely causing metastasis, which is the primary reason for tumor-associated deaths. Detecting those CTCs early on could substantially impact therapy outcomes and the 5-year survival rate. In our study, we developed and evaluated a reliable and affordable CTC screening method based on flow cytometry and 5-aminolevulinic acid (5-ALA) staining. We successfully established a circulation model for 5-ALA and CTCs research and demonstrated that the method can detect an average of 11⯱â¯3.3 CTCs out of 10,000 peripheral blood mononuclear cells, representing as low as approximately 0.1â¯% with a reasonable number of false positive events. Additionally, we present initial results on a theranostic approach using 5-ALA converted to protoporphyrin IX. The outcomes of this study might contribute significantly to the further development of CTC detection and the overall detection and treatment of cancer.
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Citometría de Flujo , Células Neoplásicas Circulantes , Células Neoplásicas Circulantes/patología , Células Neoplásicas Circulantes/metabolismo , Humanos , Ácido Aminolevulínico , Línea Celular Tumoral , Animales , Femenino , Leucocitos MononuclearesRESUMEN
INTRODUCTION: Existing literature suggests that women are significantly underrepresented in the field of hematology-oncology. Women make up 35.6% of hematologists and data on females as site investigators for pivotal trials and authors in publications of pivotal trials in hematologic malignancies, specifically in the novel niche of Chimeric antigen receptor T cell (CAR-T), is sparse. METHODS: We examined the proportion of women in pivotal trials, screening a total of 2180 studies from PubMed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. 2180 initially searched records were filtered by date (2017-2023) and clinical trial status, yielding 149 records. Following a manual review, we included 15 studies that led to the approval of or anticipated approval of CD19 and BCMA CAR-T therapies in lymphoid and plasma cell malignancies. We examined overall number of female authors, number of lead female authors, and ratio of all authors to female authors in the 15 trials, which were all high impact, cited on average 1314 times. RESULTS: Of the 436 authors assessed, 132 were female, correlating to 29.5% female authorship. The only study with female authorship >50% was ELIANA, a 2017 pediatric study. 7 of the 15 studies had female lead authors; notably, 6 out of 7 of these studies were published in 2021 or later. CONCLUSION: In conclusion, our data suggests gender iniquities for female investigators exist in the field of immune effector cell therapy. We suggest further investigation and strategies to decrease gendered authorship disparities.
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INTRODUCTION: This systematic review and meta-analysis assessed the characteristics, types, and impact of interventions to improve adherence to attention-deficit hyperactivity disorder (ADHD) medications within the context of the three phases of adherence, namely, initiation, implementation, and discontinuation. METHODS: PubMed, Psychological Information Database, Embase, International Pharmaceutical Abstracts, and Google Scholar were systematically searched for relevant trials using appropriate search terms. Interventions were classified as educational, behavioural, affective, and multifaceted. Data was pooled using odds ratios and proportions. RESULTS: Seventeen studies were included in this review. In a pooled analysis of four RCTs, interventions did not significantly improve medication adherence (OR = 2.32; 95%-Confidence Interval=CI = 0.91-5.90; p = 0.08). In seven non-randomized trials, a pooled proportion of people who adhered to ADHD medication was considerably higher in the intervention group (85%, 95%CI = 78%-91%) than in the control group (47%, 95%CI = 33%-61%). Interventions varied in terms of study design, methods and their impact on different phases of adherence. CONCLUSIONS: Despite some promising results, the lack of consideration of phase-specific adherence factors may limit the effectiveness and sustainability of interventions to improve adherence in clinical practice. Future interventions should be phase-specific, guided by factors which are pertinent to each phase. Meanwhile, clinicians should choose or tailor interventions based on individual needs and preferences.
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Trastorno por Déficit de Atención con Hiperactividad , Cumplimiento de la Medicación , Trastorno por Déficit de Atención con Hiperactividad/tratamiento farmacológico , Humanos , Estimulantes del Sistema Nervioso Central/uso terapéuticoRESUMEN
Medium and long-chain triacylglycerol (MLCT) rich in n-3 polyunsaturated fatty acids (PUFAs) were obtained in three-hour interesterification of fish oil with medium-chain triacylglycerol (MCTs), using lipase bio-imprinted with surfactant as a catalyst. Initially, for bio-imprinted lipase preparation, the interesterification reaction conditions were optimized, resulting in a lipase with 1.47 times higher catalytic activity compared to control (non-bio-imprinted). Afterwards, the reaction conditions for MLCT synthesis were optimized, using bio-imprinted lipase as a catalyst. The reaction reached equilibrium within first three hours at 70 °C temperature, 4 wt% lipase load, and molar ratio of substrate 1:1.5. Under these conditions, final product contained 18.52% MCT, 56.65% MLCT, and 24.83% long-chain triacylglycerol (LCT). To reduce the MCT content, a solvent extraction process was performed, yielding 2.42% MCT, 56.19% MLCT, and 41.39% LCT. The obtained structured lipids (SLs), enriched in n-3 PUFAs, offer significant health benefits, enhanced bioavailability, with potential applications in functional foods and nutraceuticals.
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Ácidos Grasos Omega-3 , Aceites de Pescado , Lipasa , Triglicéridos , Lipasa/química , Lipasa/metabolismo , Triglicéridos/química , Ácidos Grasos Omega-3/química , Esterificación , Aceites de Pescado/química , Biocatálisis , Enzimas Inmovilizadas/química , Proteínas Fúngicas/químicaRESUMEN
BCMA-directed chimeric antigen receptor T-cell (CAR T) therapies, including idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel), have transformed the treatment landscape for relapsed-refractory multiple myeloma (RRMM), offering remarkable efficacy with hallmark toxicity risks of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS). The FDA mandates a 4-week monitoring period at the treatment center as part of a Risk Evaluation and Mitigation Strategy (REMS) to monitor and manage these toxicities, which, while prudent, may add unnecessary challenges related to access and socioeconomic disparities. We sought to assess CRS and ICANS onset and duration, as well as causes of non-relapse mortality (NRM) in real-world BCMA CAR T recipients in order to better inform future changes to the monitoring guidelines for CAR T recipients. This is a retrospective study across four academic centers that examined 129 ide-cel and cilta-cel recipients that received CAR T cell infusions from May 2021 to June 2023. Infusion and toxicities were managed per institutional guidelines in accordance with previously published guidelines. While differences were noted in the incidence and duration of CRS/ ICANS between ide-cel and cilta-cel, late-onset CRS and ICANS were rare after 2 weeks following infusion (0% and 1.6%, respectively). NRM was driven by hemophagocytic lymphohistiocytosis and infections in the early follow-up period (1.1% until Day 29), then by infections through three months post-infusion (1.2%). Our findings suggest that 25% of patients had to relocate for 4 weeks due to distance from the treatment center. With the low risk of CRS and ICANS after 2 weeks, a flexible shorter monitoring period may be reasonable, emphasizing collaboration with referring oncologists to improve NRM.
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Síndrome de Liberación de Citoquinas , Inmunoterapia Adoptiva , Mieloma Múltiple , Humanos , Mieloma Múltiple/mortalidad , Mieloma Múltiple/terapia , Inmunoterapia Adoptiva/efectos adversos , Femenino , Persona de Mediana Edad , Masculino , Anciano , Síndrome de Liberación de Citoquinas/etiología , Síndrome de Liberación de Citoquinas/mortalidad , Estudios Retrospectivos , Antígeno de Maduración de Linfocitos B/inmunología , Adulto , Receptores Quiméricos de Antígenos/uso terapéutico , Receptores Quiméricos de Antígenos/inmunología , Síndromes de Neurotoxicidad/etiología , Síndromes de Neurotoxicidad/mortalidad , Factores de TiempoRESUMEN
BACKGROUND: Nivestym, a biosimilar granulocyte colony-stimulating factor (G-CSF) to the originator filgrastim (Neupogen), is now being used for the mobilization of peripheral blood stem cells (PBSC) in allogeneic hematopoietic stem cell transplantation (allo-HSCT). We aim to compare the efficacy of Nivestym and Neupogen for PBSC mobilization in healthy allogeneic donors. METHODS: We conducted a retrospective single-center study including 541 adult allo-HSCT donors receiving Nivestym (January 2013-July 2020), or Neupogen (July 2020-June 2023) for donor PBSC mobilization. Bivariate analysis was conducted using SPSS version 28. Statistical significance was determined at a p-value <.05. RESULTS: Our study included 541 allo-HSCT donors who received Neupogen (n = 345, 64%) or Nivestym (n = 196, 36%) for PBSC mobilization. The median age was 47 years (range 17-76). The median donor weight was 86 kg (95% confidence interval [CI]: 87-91). Donors receiving Neupogen had similar pre-G-CSF white blood cell count, CD34+ percentages, and circulating CD34+ count compared with donors receiving Nivestym. The Neupogen group had similar median PBSC product total neutrophil count, CD34+ percentage, absolute CD34+ count, and infused CD34+ dose compared with the Nivestym group. For donors aged 35 years or younger, the median CD34+ dose was higher in donors who received Neupogen compared with Nivestym (6.9 vs. 6.3 million cells/kg, p = .044). CONCLUSIONS: Nivestym demonstrated similar efficacy for PBSC mobilization compared with Neupogen among allo-HSCT donors. In donors aged 35 years or younger, a slightly lower PBSC product CD34+ count was noted with Nivestym compared with Neupogen.
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Biosimilares Farmacéuticos , Filgrastim , Movilización de Célula Madre Hematopoyética , Trasplante de Células Madre Hematopoyéticas , Células Madre de Sangre Periférica , Humanos , Filgrastim/uso terapéutico , Filgrastim/administración & dosificación , Filgrastim/farmacología , Adulto , Persona de Mediana Edad , Movilización de Célula Madre Hematopoyética/métodos , Masculino , Femenino , Estudios Retrospectivos , Anciano , Adolescente , Adulto Joven , Células Madre de Sangre Periférica/efectos de los fármacos , Trasplante Homólogo , Trasplante de Células Madre de Sangre PeriféricaRESUMEN
Soil salinity poses a substantial threat to agricultural productivity, resulting in far-reaching consequences. Green-synthesized lignin nanoparticles (LNPs) have emerged as significant biopolymers which effectively promote sustainable crop production and enhance abiotic stress tolerance. However, the defensive role and underlying mechanisms of LNPs against salt stress in Zea mays remain unexplored. The present study aims to elucidate two aspects: firstly, the synthesis of lignin nanoparticles from alkali lignin, which were characterized using Field Emission Scanning Electron Microscopy (FE-SEM), Transmission Electron Microscopy (TEM), Fourier Infrared Spectroscopy (FT-IR) and Energy Dispersive X-Ray Spectroscopy (EDX). The results confirmed the purity and morphology of LNPs. Secondly, the utilization of LNPs (200 mg/L) in nano priming to alleviate the adverse effects of NaCl (150 mM) on Zea mays seedlings. LNPs significantly reduced the accumulation of Na+ (17/21%) and MDA levels (21/28%) in shoots/roots while increased lignin absorption (30/31%), resulting in improved photosynthetic performance and plant growth. Moreover, LNPs substantially improved plant biomass, antioxidant enzymatic activities and upregulated the expression of salt-tolerant genes (ZmNHX3 (1.52 & 2.81 FC), CBL (2.83 & 3.28 FC), ZmHKT1 (2.09 & 4.87 FC) and MAPK1 (3.50 & 2.39 FC) in both shoot and root tissues. Additionally, SEM and TEM observations of plant tissues confirmed the pivotal role of LNPs in mitigating NaCl-induced stress by reducing damages to guard cells, stomata and ultra-cellular structures. Overall, our findings highlight the efficacy of LNPs as a practical and cost-effective approach to alleviate NaCl-induced stress in Zea mays plants. These results offer a sustainable agri-environmental strategy for mitigating salt toxicity and enhancing crop production in saline environments.