The Effect of Low Temperature Storage on the Lipid Quality of Fish, Either Alone or Combined with Alternative Preservation Technologies.

Marine foods are highly perishable products due to their high content of polyunsaturated fatty acids, which can be readily oxidized to form peroxides and secondary oxidation products, thus conferring such foods undesirable organoleptic characteristics and generating harmful compounds that are detrimental to the health of consumers. The use of preservation methods that minimize lipid oxidation is required in the fishing and aquaculture industries. Low temperature storage (chilling or freezing) is one of the most commonly used preservation methods for fish and seafood, although it has been shown that the oxidation of the lipid fraction of such products is partially but not completely inhibited at low temperatures. The extent of lipid oxidation depends on the species and the storage temperature and time, among other factors. This paper reviews the effect of low temperature storage on the lipid quality of fish, either alone or in combination with other preservation techniques. The use of antioxidant additives, high hydrostatic pressure, irradiation, ozonation, ultrasounds, pulsed electric fields, and the design of novel packaging can help preserve chilled or frozen fish products, although further research is needed to develop more efficient fish preservation processes from an economic, nutritional, sensory, and sustainable standpoint.

COVID-19 Outcomes in Patients with Hematologic Malignancies in the Era of COVID-19 Vaccination and the Omicron Variant.

A greater understanding of clinical trends in COVID-19 outcomes among patients with hematologic malignancies (HM) over the course of the pandemic, particularly the Omicron era, is needed. This ongoing, observational, and registry-based study with prospective data collection evaluated COVID-19 clinical severity and mortality in 1818 adult HM patients diagnosed with COVID-19 between 27 February 2020 and 1 October 2022, at 31 centers in the Madrid region of Spain. Of these, 1281 (70.5%) and 537 (29.5%) were reported in the pre-Omicron and Omicron periods, respectively. Overall, patients aged ≥70 years (odds ratio 2.16, 95% CI 1.64-2.87), with >1 comorbidity (2.44, 1.85-3.21), or with an underlying HM of chronic lymphocytic leukemia (1.64, 1.19-2.27), had greater odds of severe/critical COVID-19; odds were lower during the Omicron BA.1/BA.2 (0.28, 0.2-0.37) or BA.4/BA.5 (0.13, 0.08-0.19) periods and among patients vaccinated with one or two (0.51, 0.34-0.75) or three or four (0.22, 0.16-0.29) doses. The hospitalization rate (75.3% [963/1279], 35.7% [191/535]), rate of intensive care admission (30.0% [289/963], 14.7% [28/191]), and mortality rate overall (31.9% [409/1281], 9.9% [53/536]) and in hospitalized patients (41.3% [398/963], 22.0% [42/191]) decreased from the pre-Omicron to Omicron period. Age ≥70 years was the only factor associated with higher mortality risk in both the pre-Omicron (hazard ratio 2.57, 95% CI 2.03-3.25) and Omicron (3.19, 95% CI 1.59-6.42) periods. Receipt of prior stem cell transplantation, COVID-19 vaccination(s), and treatment with nirmatrelvir/ritonavir or remdesivir were associated with greater survival rates. In conclusion, COVID-19 mortality in HM patients has decreased considerably in the Omicron period; however, mortality in hospitalized HM patients remains high. Specific studies should be undertaken to test new treatments and preventive interventions in HM patients.

Chroma-dependence of CIEDE2000 acceptability thresholds for dentistry.

OBJECTIVES: Determine visual 50:50% color difference acceptability thresholds (AT) for regions of the dental color space with varying chromaticity. METHODS: A 40-observer panel belonging to two different groups (dentists and laypersons) evaluated 144 dental resin composites pairs (divided in three different sets of 48 pairs according to chroma value: Low Chroma (LC), Medium Chroma (MC) and High Chroma (HC) placed 40 cm away and inside of a viewing cabinet (D65 Standard light source; diffuse/0° geometry). A Takagi-Sugeno-Kang (TSK) fuzzy approximation was used for fitting the data points and calculate the 50:50% acceptability thresholds in CIEDE2000. A paired t-test was used to evaluate the statistical significance between thresholds differences and Bonferroni correction was applied. RESULTS: The CIEDE2000 50:50% AT were ∆E00 = 2.84, ∆E00 = 2.31 and ∆E00 = 1.80 for LC, MC and HC sets of sample pairs, respectively. The 50:50% AT values were statistically significant between the different sets of sample pairs, as well as the 50:50% AT values obtained for different observer groups. CONCLUSIONS: 50:50% CIEDE2000 acceptability thresholds for dentistry are significantly different depending on the chromaticity of the samples. Observers show higher acceptability for more achromatic samples (low chroma value) than for more chromatic samples. CLINICAL SIGNIFICANCE: The difference in the AT for distinct regions of the dental color space can assist professionals as a quality control tool to assess clinical performance and interpret visual and instrumental findings in clinical dentistry, dental research, and subsequent standardization processes.

Optical properties of dental zirconia, bovine dentin, and enamel-dentin structures.

OBJECTIVE: To evaluate the optical properties and the relative translucency parameter of Ceramill ZI White (3Y-TZP) and Ceramill Zolid FX White (5Y-PSZ) zirconia ceramic systems and compare them with those of the bovine dentin and enamel/dentin structures. MATERIALS AND METHODS: 3Y-TZP and 5Y-PSZ zirconia ceramic systems were evaluated. A 0.5-mm-thick 3Y-TZP (3Y-NC.5), 0.5-mm-thick (5Y-NC.5), and 1.4-mm-thick (5Y-C.14) were used. A 0.5-mm-thick dentin specimens and 1.4-mm-thick enamel/dentin specimens (n = 5) were obtained from anterior bovine maxillary teeth. Scattering, absorption, transmittance, and albedo coefficient were calculated using Kubelka-Munk's model. Data were statistically analyzed using Kruskal-Wallis and Mann-Whitney tests (p < 0.001), and goodness-of-fit coefficient (GFC). Relative translucency parameter differences were evaluated using translucency thresholds. RESULTS: Reflectance, scattering, absorption, and transmittance properties were wavelength dependent. Good matches (GFC ≥ 0.999) in spectral reflectance were observed between 0.5-mm-thick dentin and 1.4-mm-thick enamel/dentin, and 3Y-NC.5 and 5Y-NC.5. Scattering was the main optical extinction process during light interaction with zirconia and dental structures, as indicated by albedo coefficient. Translucency differences were acceptable only for 3Y-NC.5 and the dentin structure, and 5Y-C.14 and the enamel/dentin structure. CONCLUSIONS: Optical properties of 3Y-TZP and 5Y-PSZ dental zirconia differed from each other and from bovine dental structures. Nevertheless, 3Y-TZP showed similar relative translucency parameter to bovine dentin. CLINICAL SIGNIFICANCE: To achieve the best esthetic results in restorative dentistry, it is crucial for clinicians to know about the optical properties of 3Y-TZP and 5Y-PSZ and to be able to compare these properties with those of dental structures.

Impact of Interfractional Bladder and Trigone Displacement and Deformation on Radiation Exposure and Subsequent Acute Genitourinary Toxicity: A Post Hoc Analysis of Patients Treated with Magnetic Resonance Imaging-Guided Prostate Stereotactic Body Radiation Therapy in a Phase 3 Randomized Trial.

PURPOSE: Emerging data suggest that trigone dosimetry may be more associated with poststereotactic body radiation therapy (SBRT) urinary toxicity than whole bladder dosimetry. We quantify the dosimetric effect of interfractional displacement and deformation of the whole bladder and trigone during prostate SBRT using on-board, pretreatment 0.35T magnetic resonance images (MRI). METHODS AND MATERIALS: Seventy-seven patients treated with MRI-guided prostate SBRT (40 Gy/5 fractions) on the MRI arm of a phase 3 single-center randomized trial were included. Bladder and trigone structures were contoured on images obtained from a 0.35T simulation MRI and 5 on-board pretreatment MRIs. Dice similarity coefficient (DSC) scores and changes in volume between simulation and daily treatments were calculated. Dosimetric parameters including Dmax, D0.03 cc, Dmean, V40 Gy, V39 Gy, V38 Gy, and V20 Gy for the bladder and trigone for the simulation and daily treatments were collected. Both physician-scored (Common Terminology Criteria for Adverse Events, version 4.03 scale) as well as patient-reported (International Prostate Symptom Scores and the Expanded Prostate Cancer Index Composite-26 scores) acute genitourinary (GU) toxicity outcomes were collected and analyzed. RESULTS: The average treatment bladder volume was about 30% smaller than the simulation bladder volume; however, the trigone volume remained fairly consistent despite being positively correlated with total bladder volume. Overall, the trigone accounted for <2% of the bladder volume. Median DSC for the bladder was 0.79, whereas the median DSC of the trigone was only 0.33. No statistically significant associations between our selected bladder and trigonal dosimetric parameters and grade ≥2 GU toxicity were identified, although numerically, patients with GU toxicity (grade ≥2) had higher intermediate doses to the bladder (V20 Gy and Dmean) and larger volumes exposed to higher doses in the trigone (V40 Gy, V39 Gy, and V38 Gy). CONCLUSIONS: The trigone exhibits little volume change, but considerable interfractional displacement/deformation. As a result, the relative volume of the trigone receiving high doses during prostate SBRT varies substantially between fractions, which could influence GU toxicity and may not be predicted by radiation planning dosimetry.

Optical behavior of 3D-printed dental restorative resins: Influence of thickness and printing angle.

OBJECTIVES: To evaluate the influence of thickness and printing angle on the optical properties of 3D-printed dental restorative resins. METHODS: Four 3D printing resin systems were evaluated: DFT-Detax Freeprint Temp; FP- Formlabs Permanent Crown; FP- Formlabs Temporary CB; and GCT- GC Temporary-. Samples from each material were printed at 0° and 90°, and polished up to 0.5, 1.0, 1.5 and 2.0 mm thickness. Scattering (S), absorption (K) and albedo (a) coefficients, transmittance (T%), light reflectivity (RI) and infinite optical thickness (X∞) were calculated using Kubelka-Munk's model. Data were statistically analyzed using Kruskal-Wallis¸ Mann-Whitney tests, and VAF coefficient. RESULTS: The spectral distribution on S, K, T%, RI,X∞ were wavelength dependent. Although the spectral behaviors were similar for all the specimens evaluated, the values of S, K, T% andX∞ presented significant differences between specimen thicknesses for all the materials used and for both printing orientations. Values for S and K increased, and T% and X∞ decreased. Significant differences between 0° and 90° were found for RI values at 0.5 and 1.0 mm thick samples, for S and K at 2.0 mm, for X∞ at 0.5 and 1.0 mm for DFT, and at 0.5 mm for FT. CONCLUSIONS: Optical properties of 3D-printed restorative resins vary between thicknesses, and could be affected by the building orientation. Therefore, these factors should be considered in order to improve the biomimetic potential of 3D-printed dental restorative resins. CLINICAL SIGNIFICANCE: Understanding the optical behavior of the 3D-printed restorative resins is essential to optimize their clinical performance.

Color stability and degree of conversion of gingiva-colored resin-based composites.

OBJECTIVES: To evaluate gingiva-colored resin-based composites' (GCRBC) color stability and degree of conversion (DC%). METHODS: Eight discs (8 × 1 mm) of 20 shades of GCRBC were prepared. Color coordinates were measured against a gray background with a calibrated spectroradiometer, CIE D65 illuminant and the CIE 45°/0° geometry at baseline and after 30 days of storage in distilled water, coffee, and red wine. Color differences ( ∆ E 00 ) between final and baseline conditions were calculated. An ATR-FTIR spectrometer with a diamond tip was used to calculate DC%. The results were analyzed statistically using ANOVA and Tukey post-hoc test. The level of significance was p < 0.05. RESULTS: DC% and color stability correlated with each other and with the GCRBC brand. DC% ranged between 43% and 96%, highest values correspond to flowable composites. All composites have experienced color changes after immersion in water, wine and coffee. However, the magnitude of the color change has varied widely depending on the immersion medium and the GCRBC. Color changes generated by the wine were, globally, greater than those induced by coffee (p < 0.001) and above the acceptability thresholds. CONCLUSIONS: The DC% of GCRBCs is sufficient to achieve adequate biocompatibility and physicomechanical properties, but the high susceptibility to staining could compromise aesthetic long-term results. CLINICAL SIGNIFICANCE: The degree of conversion and the color stability of gingiva-colored resin-based composites correlated with each other. All composites have experienced color changes after immersion in water, wine and coffee. Color changes generated by wine were, globally, greater than those induced by coffee and above the acceptability thresholds that could compromise aesthetic long-term results.

Persistent olfactory dysfunction in mild COVID-19 patients: A descriptive study of the characteristics and association with other symptoms.

Introduction: Post-COVID olfactory dysfunction continues to be studied due to the controversy of the mechanisms involved. The aim was to investigate the olfactory dysfunctions in association with other post-COVID symptoms. Material and methods: Observational, descriptive and single-center study. The patients had confirmed mild COVID-19 and subjective olfactory dysfunction of more than a month of evolution, which was assessed by Sniffin' Sticks Olfactory Test. Results: A total of 86 patients participated. The mean age was 37.2 years (SD 9.82). 70.9% reported parosmia and 46.5% symptoms of brain fog. A pathological test result was obtained in 72.1% of the participants. The most failed pen was 11 (apple) in 76.7%. Anosmia of pen 15 (anise) was reported more frequently in 24.4% and cacosmia of pen 9 (garlic) in 27.9%. We observed a significant association between patients who reported parosmias and brain fog (RR 2.18; p = 0.018), also between parosmia and phantosmia (RR 6.042; p < 0.001). Conclusion: There is some pathological selectivity for certain test pens, a higher prevalence of cognitive symptoms and many patients with combined parosmia and brain fog.

Introducción: La alteración olfatoria post-COVID continúa en estudio por la controversia sobre los mecanismos implicados. El objetivo de este estudio es caracterizar las alteraciones olfatorias y su relación con otros síntomas post-COVID. Material y métodos: Estudio unicéntrico, observacional y descriptivo. Los pacientes tuvieron infección por COVID-19 leve confirmada y disfunción olfatoria subjetiva de más de un mes de evolución, evaluada con el Sniffin' Sticks Olfatory Test. Resultados: Se seleccionaron 86 pacientes. La edad media fue de 37,2 años (DE 9,82). El 70,9% refirieron parosmia y el 46,5% niebla mental. Se obtuvo un test patológico en el 72,1% de los participantes. El lápiz más fallado fue el número 11 (manzana), en el 76,7%. La anosmia fue reportada más frecuentemente con el lápiz 15 (anís) y la cacosmia con el lápiz 9 (ajo) en el 27,9%. Observamos una asociación significativa entre pacientes que refieren parosmias y niebla mental (RR 2,18; p = 0,018) y entre parosmia y fantosmia (RR 6,042; p < 0,001). Conclusión: Se observa anosmia y cacosmia selectiva para algunos olores testados. Hay una alta prevalencia de síntomas cognitivos, más frecuentes en pacientes con parosmia.

Changes in Lipid Metabolism Enzymes in Rat Epididymal Fat after Chronic Central Leptin Infusion Are Related to Alterations in Inflammation and Insulin Signaling.

Leptin inhibits food intake and reduces the size of body fat depots, changing adipocyte sensitivity to insulin to restrain lipid accrual. This adipokine may modulate the production of cytokines that could diminish insulin sensitivity, particularly in visceral adipose tissue. To explore this possibility, we examined the effects of chronic central administration of leptin on the expression of key markers of lipid metabolism and its possible relationship with changes in inflammatory- and insulin-signaling pathways in epididymal adipose tissue. Circulating non-esterified fatty acids and pro- and anti-inflammatory cytokines were also measured. Fifteen male rats were divided into control (C), leptin (L, icv, 12 µg/day for 14 days), and pair-fed (PF) groups. We found a decrease in the activity of glucose-6-phosphate dehydrogenase and malic enzyme in the L group, with no changes in the expression of lipogenic enzymes. A reduction in the expression of lipoprotein lipase and carnitine palmitoyl-transferase-1A, together with a decrease in the phosphorylation of insulin-signaling targets and a low-grade inflammatory pattern, were detected in the epididymal fat of L rats. In conclusion, the decrease in insulin sensitivity and increased pro-inflammatory environment could regulate lipid metabolism, reducing epididymal fat stores in response to central leptin infusion.

Persistent olfactory dysfunction in mild COVID-19 patients: A descriptive study of the characteristics and association with other symptoms / Alteración olfatoria persistente en pacientes con infección leve por COVID-19: estudio descriptivo de las características y su asociación con otros síntomas

Introduction: Post-COVID olfactory dysfunction continues to be studied due to the controversy of the mechanisms involved. The aim was to investigate the olfactory dysfunctions in association with other post-COVID symptoms.Material and methodsObservational, descriptive and single-center study. The patients had confirmed mild COVID-19 and subjective olfactory dysfunction of more than a month of evolution, which was assessed by Sniffin’ Sticks Olfactory Test.ResultsA total of 86 patients participated. The mean age was 37.2 years (SD 9.82). 70.9% reported parosmia and 46.5% symptoms of brain fog. A pathological test result was obtained in 72.1% of the participants. The most failed pen was 11 (apple) in 76.7%. Anosmia of pen 15 (anise) was reported more frequently in 24.4% and cacosmia of pen 9 (garlic) in 27.9%. We observed a significant association between patients who reported parosmias and brain fog (RR 2.18; p=0.018), also between parosmia and phantosmia (RR 6.042; p<0.001).ConclusionThere is some pathological selectivity for certain test pens, a higher prevalence of cognitive symptoms and many patients with combined parosmia and brain fog. (AU)

Introducción: La alteración olfatoria post-COVID continúa en estudio por la controversia sobre los mecanismos implicados. El objetivo de este estudio es caracterizar las alteraciones olfatorias y su relación con otros síntomas post-COVID.Material y métodosEstudio unicéntrico, observacional y descriptivo. Los pacientes tuvieron infección por COVID-19 leve confirmada y disfunción olfatoria subjetiva de más de un mes de evolución, evaluada con el Sniffin’ Sticks Olfatory Test.ResultadosSe seleccionaron 86 pacientes. La edad media fue de 37,2 años (DE 9,82). El 70,9% refirieron parosmia y el 46,5% niebla mental. Se obtuvo un test patológico en el 72,1% de los participantes. El lápiz más fallado fue el número 11 (manzana), en el 76,7%. La anosmia fue reportada más frecuentemente con el lápiz 15 (anís) y la cacosmia con el lápiz 9 (ajo) en el 27,9%. Observamos una asociación significativa entre pacientes que refieren parosmias y niebla mental (RR 2,18; p=0,018) y entre parosmia y fantosmia (RR 6,042; p<0,001).ConclusiónSe observa anosmia y cacosmia selectiva para algunos olores testados. Hay una alta prevalencia de síntomas cognitivos, más frecuentes en pacientes con parosmia. (AU)

The influence of printing angle on color and translucency of 3D printed resins for dental restorations.

OBJECTIVES: To evaluate the influence of printing orientation on color and translucency of 3D printing restorative resins. METHODS: Four 3D printing resin systems in the available shades (DFT-Detax Freeprint Temp- A1, A2,A3; FP-Formlabs Permanent Crown- A2,A3,B1,C2; FT- Formlabs Temporary CB- A2,A3,B1,C2; GCT-GC Temporary- Light, Medium) were evaluated. Three samples (10×10×1.2 mm) from each material were printed at two different printing orientations (0° and 90°) and polished to 1.00 ± 0,01 mm of thickness. Spectral reflectance was measured against black background using a calibrated spectroradiometer, CIE D65 standard illuminant and the 45°/0°geometry. Color and translucency differences were evaluated using CIEDE2000 metric (ΔE00) and 50:50% perceptibility (PT00 and TPT00) and acceptability (AT00 and TAT00) thresholds. RESULTS: In general, color changes due to printing orientation at (0° and 90°) were mainly produced by ΔL* or ΔC* . ΔE00 were above PT00 for all DFT shades, FP-B1, FP-C2, FT-A2 and FT-B1. Only for DFT-1, ΔE00 was above AT00. ΔRTP00 values were above TPT00 for DFT-A1, DFT-A3, FP-B1 and FT-B1, but lower than TAT00. The direction of the changes in translucency (ΔRTP00) depends on the material and shade. SIGNIFICANCE: The selection of building orientation (0° and 90°) for the 3D printed resins influence the visual color and translucency and therefore their esthetic appearance. These aspects should be considered when printing dental restorations using the evaluated materials.

Chondroid Tumors: Review of Salient Imaging Features and Update on the WHO Classification.

Chondrogenic tumors are typically well recognized on radiographs, but differentiation between benign and malignant cartilaginous lesions can be difficult both for the radiologist and for the pathologist. Diagnosis is based on a combination of clinical, radiological and histological findings. While treatment of benign lesions does not require surgery, the only curative treatment for chondrosarcoma is resection. This article (1) emphasizes the update of the WHO classification and its diagnostic and clinical effects; (2) describes the imaging features of the various types of cartilaginous tumors, highlighting findings that can help differentiate benign from malignant lesions; (3) presents differential diagnoses; and (4) provides pathologic correlation. We attempt to offer valuable clues in the approach to this vast entity.

Persistent olfactory dysfunction in mild COVID-19 patients: A descriptive study of the characteristics and association with other symptoms.

INTRODUCTION: Post-COVID olfactory dysfunction continues to be studied due to the controversy of the mechanisms involved. The aim was to investigate the olfactory dysfunctions in association with other post-COVID symptoms. MATERIAL AND METHODS: Observational, descriptive and single-center study. The patients had confirmed mild COVID-19 and subjective olfactory dysfunction of more than a month of evolution, which was assessed by Sniffin' Sticks Olfactory Test. RESULTS: A total of 86 patients participated. The mean age was 37.2 years (SD 9.82). 70.9% reported parosmia and 46.5% symptoms of brain fog. A pathological test result was obtained in 72.1% of the participants. The most failed pen was 11 (apple) in 76.7%. Anosmia of pen 15 (anise) was reported more frequently in 24.4% and cacosmia of pen 9 (garlic) in 27.9%. We observed a significant association between patients who reported parosmias and brain fog (RR 2.18; p=0.018), also between parosmia and phantosmia (RR 6.042; p<0.001). CONCLUSION: There is some pathological selectivity for certain test pens, a higher prevalence of cognitive symptoms and many patients with combined parosmia and brain fog.

Magnetic Resonance Imaging-Guided vs Computed Tomography-Guided Stereotactic Body Radiotherapy for Prostate Cancer: The MIRAGE Randomized Clinical Trial.

Importance: Magnetic resonance imaging (MRI) guidance offers multiple theoretical advantages in the context of stereotactic body radiotherapy (SBRT) for prostate cancer. However, to our knowledge, these advantages have yet to be demonstrated in a randomized clinical trial. Objective: To determine whether aggressive margin reduction with MRI guidance significantly reduces acute grade 2 or greater genitourinary (GU) toxic effects after prostate SBRT compared with computed tomography (CT) guidance. Design, Setting, and Participants: This phase 3 randomized clinical trial (MRI-Guided Stereotactic Body Radiotherapy for Prostate Cancer [MIRAGE]) enrolled men aged 18 years or older who were receiving SBRT for clinically localized prostate adenocarcinoma at a single center between May 5, 2020, and October 1, 2021. Data were analyzed from January 15, 2021, through May 15, 2022. All patients had 3 months or more of follow-up. Interventions: Patients were randomized 1:1 to SBRT with CT guidance (control arm) or MRI guidance. Planning margins of 4 mm (CT arm) and 2 mm (MRI arm) were used to deliver 40 Gy in 5 fractions. Main Outcomes and Measures: The primary end point was the incidence of acute (≤90 days after SBRT) grade 2 or greater GU toxic effects (using Common Terminology Criteria for Adverse Events, version 4.03 [CTCAE v4.03]). Secondary outcomes included CTCAE v4.03-based gastrointestinal toxic effects and International Prostate Symptom Score (IPSS)-based and Expanded Prostate Cancer Index Composite-26 (EPIC-26)-based outcomes. Results: Between May 2020 and October 2021, 156 patients were randomized: 77 to CT (median age, 71 years [IQR, 67-77 years]) and 79 to MRI (median age, 71 years [IQR, 68-75 years]). A prespecified interim futility analysis conducted after 100 patients reached 90 or more days after SBRT was performed October 1, 2021, with the sample size reestimated to 154 patients. Thus, the trial was closed to accrual early. The incidence of acute grade 2 or greater GU toxic effects was significantly lower with MRI vs CT guidance (24.4% [95% CI, 15.4%-35.4%] vs 43.4% [95% CI, 32.1%-55.3%]; P = .01), as was the incidence of acute grade 2 or greater gastrointestinal toxic effects (0.0% [95% CI, 0.0%-4.6%] vs 10.5% [95% CI, 4.7%-19.7%]; P = .003). Magnetic resonance imaging guidance was associated with a significantly smaller percentage of patients with a 15-point or greater increase in IPSS at 1 month (6.8% [5 of 72] vs 19.4% [14 of 74]; P = .01) and a significantly reduced percentage of patients with a clinically significant (≥12-point) decrease in EPIC-26 bowel scores (25.0% [17 of 68] vs 50.0% [34 of 68]; P = .001) at 1 month. Conclusions and Relevance: In this randomized clinical trial, compared with CT-guidance, MRI-guided SBRT significantly reduced both moderate acute physician-scored toxic effects and decrements in patient-reported quality of life. Longer-term follow-up will confirm whether these notable benefits persist. Trial Registration: ClinicalTrials.gov Identifier: NCT04384770.

Recent Advances in the Knowledge of the Mechanisms of Leptin Physiology and Actions in Neurological and Metabolic Pathologies.

Excess body weight is frequently associated with low-grade inflammation. Evidence indicates a relationship between obesity and cancer, as well as with other diseases, such as diabetes and non-alcoholic fatty liver disease, in which inflammation and the actions of various adipokines play a role in the pathological mechanisms involved in these disorders. Leptin is mainly produced by adipose tissue in proportion to fat stores, but it is also synthesized in other organs, where leptin receptors are expressed. This hormone performs numerous actions in the brain, mainly related to the control of energy homeostasis. It is also involved in neurogenesis and neuroprotection, and central leptin resistance is related to some neurological disorders, e.g., Parkinson's and Alzheimer's diseases. In peripheral tissues, leptin is implicated in the regulation of metabolism, as well as of bone density and muscle mass. All these actions can be affected by changes in leptin levels and the mechanisms associated with resistance to this hormone. This review will present recent advances in the molecular mechanisms of leptin action and their underlying roles in pathological situations, which may be of interest for revealing new approaches for the treatment of diseases where the actions of this adipokine might be compromised.

Development of Thickness-Dependent Predictive Methods for the Estimation of the CIEL*a*b* Color Coordinates of Monolithic and Layered Dental Resin Composites.

Usually, dentin and enamel shades are layered in dental restorations with the purpose of mimicking the natural appearance of teeth. The main objective of this study was to develop and assess accuracy of a color-prediction method for both monolithic and layered dental resin-based composites with varying shades and under different illuminants. A total of 15 different shades of VITAPAN Excell, VITAPAN Dentine and VITA Physiodens as well as VITA Enamel of five different thicknesses (0.5-2.5 mm range) were used to manufacture monolithic and layered samples. A non-contact spectroradiometer with CIE 45∘/0∘ geometry was used to measure the color of all samples over a standard ceramic black background. Second-degree polynomial regression was used as predictive method for CIE-L*a*b* color coordinates. Performance of predictive models was tested using the CIEDE2000 total color difference formula (ΔE00), while accuracy was evaluated by comparative assessment of ΔE00 with corresponding 50:50% acceptability (AT00) and perceptibly (PT00) thresholds for dentistry. A mean color difference between measured (real) and predicted color of ΔE00=1.71, with 62.86% of the color differences below AT00 and 28.57% below PT00, was registered for monolithic samples. For bi-layered samples, the mean color difference was roughly ΔE00=0.50, with generally 100% and more than 85% of the estimations below AT00 and PT00, respectively. The predictive method allowed highly accurate color estimations for both monolithic and layered dental resin-based composites with varying thicknesses and under different illuminations. These results could be useful to maximize the clinical success of dental restorations.