Analysis of lithotripsy efficiency and stone retropulsion displacement according to pulse characteristics of Ho: YAG laser with Moses effect.

BACKGROUND AND OBJECTIVES: Compared to the conventional Ho: YAG laser, a Ho: YAG laser device has been reported that has a Moses effect to reduce stone retropulsion and increase lithotripsy efficiency. The principle of this equipment is to convert a single laser pulse into two pulses. Most studies on such lasers are limited to lithotripsy efficiency and the prevention of stone retropulsion; studies according to each pulse condition have not been performed. Therefore, the purpose of this study was to quantify the bubble shape, lithotripsy efficiency, and stone retropulsion displacement in a ureteral phantom according to the modulation of the first pulse characteristics of the Moses effect laser under conditions that maintained the total energy and repetition rate. MATERIAL AND METHODS: In this study, a Ho: YAG laser system (Holinwon Pro, Wontech Inc., Korea) with an emission wavelength of 2.10 µm and a Moses effect was used. To verify the Moses effect based on the changes in the pulse, a water tank was fabricated, and the ureteral phantom was manufactured in a structure that could be easily installed in the water tank. Additionally, a spherical artificial stone in the ureteral phantom was prepared by mixing calcined gypsum (Cacinated Gypsum) and water at a ratio of 3:1. In the ureteral phantom, a high-speed camera (FASTCAM NOVA S12, Photron Inc.) and visible light were used to record pulse-dependent image analysis of bubbles and stone retropulsion. RESULT: After mounting the artificial stone in the ureteral phantom, the pulse duration and energy of the first pulse of the Moses effect laser were varied; 30 laser shots for 3 s at a repetition rate of 10 Hz were applied to quantify the lithotripsy efficiency and stone retropulsion displacement, and the experimental values were compared. The fragmentation efficiency was confirmed by measuring the mass before and after the laser pulse application, the original position of the stone retropulsion displacement, and the distance moved. The minimum value of stone retropulsion displacement appeared when the pulse duration of the first pulse was 300 µs, the pulse energy was 100 mJ, and the value was approximately 0.28 mm. The highest fragmentation efficiency was observed under the same conditions, and the mass loss of the artificial stone at that time was approximately 3.7 mg. CONCLUSION: Quantitative indices, such as lithotripsy efficiency and stone retropulsion displacement, were confirmed using ultrahigh-speed cameras to determine the effect of the first pulse energy and duration of the Ho: YAG laser with the Moses effect on stone removal. It was confirmed that the longer the duration of the primary pulse and the lower the energy, the higher the fragmentation efficiency. In this study, the possibility of manufacturing a laser with an optimal stone-removal effect was confirmed according to the first-pulse condition of the laser with the Moses effect.

Evaluation of Efficacy and Safety Using Low Dose Radiation Therapy with Alzheimer's Disease: A Protocol for Multicenter Phase II Clinical Trial.

BACKGROUND: Alzheimer's disease (AD), the most common cause of dementia, is a neurodegenerative disease resulting from extracellular and intracellular deposits of amyloid-ß (Aß) and neurofibrillary tangles in the brain. Although many clinical studies evaluating pharmacological approaches have been conducted, most have shown disappointing results; thus, innovative strategies other than drugs have been actively attempted. OBJECTIVE: This study aims to explore low-dose radiation therapy (LDRT) for the treatment of patients with AD based on preclinical evidence, case reports, and a small pilot trial in humans. METHODS: This study is a phase II, multicenter, prospective, single-blinded, randomized controlled trial that will evaluate the efficacy and safety of LDRT to the whole brain using a linear accelerator in patients with mild AD. Sixty participants will be randomly assigned to three groups: experimental I (24 cGy/6 fractions), experimental II (300 cGy/6 fractions), or sham RT group (0 cGy/6 fractions). During LDRT and follow-up visits after LDRT, possible adverse events will be assessed by the physician's interview and neurological examinations. Furthermore, the effectiveness of LDRT will be measured using neurocognitive function tests and imaging tools at 6 and 12 months after LDRT. We will also monitor the alterations in cytokines, Aß42/Aß40 ratio, and tau levels in plasma. Our primary endpoint is the change in cognitive function test scores estimated by the Alzheimer's Disease Assessment Scale-Korea compared to baseline after 6 months of LDRT. CONCLUSIONS: This study is registered at ClinicalTrials.gov [NCT05635968] and is currently recruiting patients. This study will provide evidence that LDRT is a new treatment strategy for AD.

The effects of low-dose radiation therapy in patients with mild-to-moderate Alzheimer's dementia: an interim analysis of a pilot study.

PURPOSE: We aimed to determine whether low-dose radiotherapy (LDRT) is effective in patients with Alzheimer disease (AD). MATERIALS AND METHODS: We included patients according to the following criteria: probable Alzheimer's dementia according to the New Diagnostic Criteria for Alzheimer's Disease; confirmation of amyloid plaque deposits on baseline amyloid positron emission tomography (PET); a Korean Mini-Mental State Examination 2nd edition (K-MMSE-2) score of 13-26; and a Global Clinical Dementia Rating (CDR) score of 0.5-2 points. LDRT was performed six times at 0.5 Gy each. Post-treatment cognitive function tests and PET-CT examinations were performed to evaluate efficacy. The medication for AD treatment was maintained throughout the study period. RESULTS: At 6 months after LDRT, neurological improvement was seen in 20% of patients. Patient #2 showed improvement in all domains of the Seoul Neuropsychological Screening Battery II (SNSB-II). Moreover, the K-MMSE-2 and Geriatric Depression Score-Short Form scores improved from 20 to 23 and from 8 to 2, respectively. For patient #3, the CDR score (sum of box score) improved from 1 (4.0) to 1 (3.5) at 3 months follow-up. Moreover, the Z scores for language and related functions, memory, and frontal executive function improved to -2.56, -1.86, and -1.32, respectively at the 6-month follow-up. Two patients complained of mild nausea and mild hair loss during LDRT, which improved after treatment. CONCLUSION: One of the five patients with AD treated with LDRT experienced a temporary improvement in SNSB-II. LDRT is tolerable in patients with AD. We are currently under follow-up and will conduct cognitive function tests after 12 months after LDRT. A large-scale randomized controlled trial with a longer follow-up period is warranted to determine the effect of LDRT on patients with AD.

Effect of fermentation on antioxidant, antimicrobial, anti-inflammatory, and anti-Helicobacter pylori adhesion activity of Ulmus davidiana var. japonica root bark.

The limited yield of Ulmus davidiana var. japonica root bark (URB) extract is considered an economic loss to the food industry. Improving extraction yield and bioactivity through fermentation increase the industrial usage of URB. The study aims to optimize the fermentation with cellulolytic and pectinolytic bacteria and evaluate the bioactivity and anti-Helicobacter pylori activity of the fermented URB extract. URB fermentation with the Bacillus licheniformis FLa3, isolated from salted seafood (Sardinella zunasi), under optimal conditions (37 °C, pH 6, 10% inoculum dose, and 36 h) improved the extraction yield by 36% compared to the control. The antioxidant and antimicrobial activity of the fermented extract were significantly higher than non-fermented extract. High-performance liquid chromatography results confirmed that the fermentation increased the proportion of bioactive components such as catechin (171.7%), epicatechin (144.3%), quercetin (27.3%), and kaempferol (16.7%). The results confirmed that the fermentation increased both the extraction yield and bioactivity.

Impact of Teachers' Post-Traumatic Stress Due to Violence Victimization: Moderated Mediation Effect of Living a Calling.

Based on the Affective Events Theory, Work as a Calling Theory, and related studies, this research examined the moderated mediating effects of Living a Calling and the mediating effect of social interaction anxiety and psychological burnout on the relationships between post-traumatic stress disorder symptoms consequent to violence victimization, self-destructive behaviors, and turnover intention. Data from 420 Korean elementary and secondary school teachers were analyzed using the moderated mediation model. The analysis revealed that post-traumatic stress disorder caused by violence victimization positively affected self-destructive behavior and turnover intention through the sequential mediation of social interaction anxiety and psychological burnout. Further, Living a Calling moderated the indirect effect of violence victimization; the stronger the Living-a-Calling experience, the greater the indirect effect of violence victimization on turnover intention. Additionally, when the sense of Living a Calling was low, post-traumatic stress disorder caused by violence did not significantly affect turnover intention through social interaction anxiety, but contrary to expectations, the stronger the sense of Living a Calling, the more positive the mediating effect of social interaction anxiety. Therapeutic interventions in teachers' work environment, improvements, and suggestions for future research are discussed.

Single Camera-Based Dual-Channel Near-Infrared Fluorescence Imaging system.

In this study, we propose a single camera-based dual-channel near-infrared (NIR) fluorescence imaging system that produces color and dual-channel NIR fluorescence images in real time. To simultaneously acquire color and dual-channel NIR fluorescence images of two fluorescent agents, three cameras and additional optical parts are generally used. As a result, the volume of the image acquisition unit increases, interfering with movements during surgical procedures and increasing production costs. In the system herein proposed, instead of using three cameras, we set a single camera equipped with two image sensors that can simultaneously acquire color and single-channel NIR fluorescence images, thus reducing the volume of the image acquisition unit. The single-channel NIR fluorescence images were time-divided into two channels by synchronizing the camera and two excitation lasers, and the noise caused by the crosstalk effect between the two fluorescent agents was removed through image processing. To evaluate the performance of the system, experiments were conducted for the two fluorescent agents to measure the sensitivity, crosstalk effect, and signal-to-background ratio. The compactness of the resulting image acquisition unit alleviates the inconvenient movement obstruction of previous devices during clinical and animal surgery and reduces the complexity and costs of the manufacturing process, which may facilitate the dissemination of this type of system.

Cryopreservation of Roughscale Sole (Clidoderma asperrimum) Sperm: Effects of Cryoprotectant, Diluent, Dilution Ratio, and Thawing Temperature.

The roughscale sole, Clidoderma asperrimum is categorized as an endangered species. Sperm freezing is essential for preserving gametes. This study examined the CPA concentration, diluent, dilution ratio, and thawing temperature to design a sperm cryopreservation protocol for roughscale sole. The variables examined included sperm motility and kinematics, cell survival, fertilization, and DNA fragmentation. Sperm motility parameters were assessed via computer-assisted sperm analysis using a CEROS II instrument. Cell survival rate and DNA damage were assessed using the Cell Counting Kit-8 and single-cell gel electrophoresis assay, respectively. Sperm preservation was tested using several CPAs, including ethylene glycol, dimethyl sulfoxide (DMSO), glycerol, propylene glycol, and methanol. The diluents tested were 300 mM sucrose, 300 mM glucose, Stein's solution, Ringer's solution, and Hank's solution. The optimal conditions for sperm cryopreservation were 10% DMSO + Stein's solution. After thawing, sperm motility was highest with a 1:1 dilution ratio (sperm to CPA + diluent), at 69.20 ± 0.32%; thawing at 10 °C was optimal for post-thaw motility (72.03 ± 0.95%). The highest fertilization rate (40.00 ± 1.22%) was obtained using DMSO. The fresh sperm had the lowest tail DNA, followed by 10% DMSO + Stein's solution. The developed cryopreservation methods can be used in roughscale sole hatcheries.

Development of Intraoperative Near-Infrared Fluorescence Imaging System Using a Dual-CMOS Single Camera.

We developed a single-camera-based near-infrared (NIR) fluorescence imaging device using indocyanine green (ICG) NIR fluorescence contrast agents for image-induced surgery. In general, a fluorescent imaging system that simultaneously provides color and NIR images uses two cameras, which is disadvantageous because it increases the imaging head of the system. Recently, a single-camera-based NIR optical imaging device with quantum efficiency partially extended to the NIR region was developed to overcome this drawback. The system used RGB_NIR filters for camera sensors to provide color and NIR images simultaneously; however, the sensitivity and resolution of the infrared images are reduced by 1/4, and the exposure time and gain cannot be set individually when acquiring color and NIR images. Thus, to overcome these shortcomings, this study developed a compact fluorescent imaging system that uses a single camera with two complementary metal-oxide semiconductor (CMOS) image sensors. Sensitivity and signal-to-background ratio were measured according to the concentrations of ICG solution, exposure time, and camera gain to evaluate the performance of the imaging system. Consequently, the clinical applicability of the system was confirmed through the toxicity analysis of the light source and in vivo testing.

High-Attenuation Backing Layer for Miniaturized Ultrasound Imaging Transducer.

Current miniaturized ultrasound transducers suffer from insufficient attenuation from the backing layer due to their limited thickness. The thickness of the backing layer is one of the critical factors determining the device size and transducer performance for miniaturized transducers inserted and operated in a limited space. Glass bubbles, polyamide resin, and tungsten powder are combined to form a new highly attenuative backing material. It has high attenuation (>160 dB/cm at 5 MHz), which is five times greater than silver-based conductive epoxy commonly used for high-frequency ultrasound transducers, appropriate acoustic impedance (4.6 MRayl), and acceptable damping capability. An intravascular ultrasound (IVUS) transducer constructed with the 170 [Formula: see text] of the proposed backing layer demonstrated that the amplitude of the signal returned from the backing layer was 1.8 times smaller, with ring-down attenuated by 6 dB. Wire-phantom imaging revealed that the axial resolution was 30% better with the suggested backing than silver-based conductive epoxy backing. Because of its excellent attenuation capability even at a limited thickness, simple manufacturing process, and easy customization capability, the suggested highly attenuative backing layer may be used for miniaturized ultrasound transducers.

Fused toes homolog, a potential molecular regulator of human papillomavirus type 16 E6 and E7 oncoproteins in cervical cancer.

Human papillomavirus type 16 (HPV16) plays a major role in the development of cervical cancer. The oncogenic potential of HPV16 is attributed to E6 and E7 oncoproteins. Here, we investigated the relationship between fused toes homolog (FTS) and HPV16 E6 and E7 in cervical cancer cells. HPV16-positive CaSki and SiHa cell lines were used for in vitro studies. FTS silencing was performed using a small interfering RNA (siRNA)-based approach, and western blotting was performed to determine the protein expression of tumor suppressors and cell survival markers. Immunoprecipitation, immunofluorescence, in silico analysis, and immunohistochemistry were performed to determine the interaction between, and intracellular co-localization of, FTS and both the E6 and E7 proteins. Silencing of FTS reduced the expression of the E6 and E7 proteins in cervical cancer cell lines and conversely increased the expression of the tumor suppressor proteins p53 and retinoblastoma protein. However, the primary transcripts of HPV16 E6 and E7 were unaffected by FTS silencing; furthermore, FTS transcription was unaffected by silencing of either E6 or E7, suggesting their interaction occurs post-translationally. Immunofluorescence and immunohistochemistry analysis demonstrated co-localization of FTS with the HPV16 E6 and E7 proteins, while immunoprecipitation results suggested that FTS interacts with both E6 and E7. Furthermore, in silico structural analysis identified putative residues involved in the binding of FTS with E6 and E7. Taken together, these results show that FTS affects both HPV16 E6 and E7 oncogenes in cervical cancer. We propose FTS as a target for the prevention of cervical cancer development and progression.

A photoacoustic finder fully integrated with a solid-state dye laser and transparent ultrasound transducer.

The standard-of-care for evaluating lymph node status in breast cancers and melanoma metastasis is sentinel lymph node (SLN) assessment performed with a handheld gamma probe and radioisotopes. However, this method inevitably exposes patients and physicians to radiation, and the special facilities required limit its accessibility. Here, we demonstrate a non-ionizing, cost-effective, handheld photoacoustic finder (PAF) fully integrated with a solid-state dye laser and transparent ultrasound transducer (TUT). The solid-state dye laser handpiece is coaxially aligned with the spherically focused TUT. The integrated finder readily detected photoacoustic signals from a tube filled with methylene blue (MB) beneath a 22 mm thick layer of chicken tissue. In live animals, we also photoacoustically detected both SLNs injected with MB and subcutaneously injected melanomas. We believe that our radiation-free and inexpensive PAF can play a vital role in SLN assessment.

Virtual randomized study comparing lobectomy and particle beam therapy for clinical stage IA non-small cell lung cancer in operable patients.

To the best of our knowledge there have been no randomized controlled trials comparing lobectomy-a standard treatment for patients with early-stage non-small cell lung cancer (NSCLC)-and particle beam therapy (PBT), the best performing existing radiotherapy. We conducted a virtual randomized trial in medically operable patients with stage IA NSCLC to compare lobectomy and PBT effectiveness. A Markov model was developed to predict life expectancy after lobectomy and PBT in a cohort of patients with stage IA NSCLC. Ten thousand virtual patients were randomly assigned to each group. Sensitivity analyses were performed as model variables and scenarios changed to determine which treatment strategy was best for improving life expectancy. All estimated model parameters were determined using variables extracted from a systematic literature review of previously published articles. The preferred strategy differed depending on patient age. In young patients, lobectomy showed better life expectancy than that of PBT. The difference in life expectancy between lobectomy and PBT was statistically insignificant in older patients. Our model predicted lobectomy as the preferred strategy when operative mortality was under 5%. However, the preferred strategy changed to PBT if operative mortality post lobectomy was over 5%. For medically operable patients with stage IA NSCLC, our Markov model revealed the preferred strategy of lobectomy or PBT regarding operative mortality changed with varying age and comorbidity. Until randomized controlled trial results become available, we hope the current results will provide a rationale background for clinicians to decide treatment modalities for patients with stage IA NSCLC.

Modulation of Neuroinflammation by Low-Dose Radiation Therapy in an Animal Model of Alzheimer's Disease.

PURPOSE: Recently, several studies have reported that low-dose radiation therapy (RT) suppresses the release of proinflammatory cytokines in inflammatory-degenerative disorders, including Alzheimer disease (AD). AD is the most common cause of dementia, and neuroinflammation is one of the major contributing factors in AD pathogenesis. Therefore, low-dose RT may be used clinically for treating AD. However, the appropriate doses, effects, and underlying mechanisms of RT in AD have not been determined. In this study, we aimed to determine the appropriate RT dose and schedule for AD treatment and to investigate the therapeutic effects and mechanisms of low-dose RT in AD. METHODS AND MATERIALS: We first determined the proper dose and schedule for RT in late-stage AD using 8- to 9-month-old 5x Familial AD (5xFAD) mice, a well-known animal model of AD, by comparing the effects of a low total dose with low dose per fraction (LD-LDRT, 5 × 0.6 Gy) with those of a low moderate total dose with conventional dose per fraction (LMD-CDRT, 5 × 2 Gy). RESULTS: LD-LDRT and LMD-CDRT were found to reduce the levels of the proinflammatory cytokines CD54, IL-3, CXCL9/10, and CCL2/4 in the hippocampus of 5xFAD mice. Furthermore, increased microgliosis assessed using Iba-1 and CD68 dual immunostaining was significantly reduced by LD-LDRT and LMD-CDRT in the hippocampus of 5xFAD mice. Moreover, LD-LDRT and LMD-CDRT decreased the amyloid plaque burden in the hippocampus of 5xFAD mice and attenuated their cognitive impairment; these effects persisted for 4 to 5 weeks. CONCLUSIONS: The present study showed that LD-LDRT alleviates cognitive impairments and prevents the accumulation of amyloid plaques by regulating neuroinflammation in the late stage of AD in 5xFAD mice, with an efficacy equivalent to that of LMD-CDRT. Furthermore, the findings suggest that compared with LMD-CDRT, LD-LDRT may facilitate accessible and convenient treatment in clinical trials.

Development of a Minimally Invasive and Non-invasive Lipolysis Laser System for Effective Fat Reduction.

Introduction: Obesity is a global problem because it causes various complications. Methods for reducing fat for healthy life are being studied. In this study, we developed a minimally invasive and non-invasive lipolysis laser system for effective fat reduction. Methods: The laser had the wavelengths of 1980 nm and 2300 nm which have very good absorption of fat and water. We developed a minimally invasive laser system that breaks down fat by direct irradiation of fat tissue. This minimally invasive laser system uses a 808 nm diode laser and Nd:YVO4 to generate the 1064 nm wavelength, which is the pumping source of the nonlinear crystals. It is a mid-infrared lipolysis laser system having two wavelengths of 1980 nm and 2300 nm by controlling the temperature of nonlinear crystals. We also developed a non-invasive laser system that reduces fat with hyperthermia treatment by raising the temperature of adipocytes with a 1060 nm penetrating depth into the skin. In this non-invasive laser system, the In gallium arsenide (GaAs) diode laser is irradiated on the skin with an area of 4 × 8 cm2 through the hand-piece. The cooling system in the hand-piece protects the skin from burns. We studied the effectiveness and safety of each system through animal experiment. We studied the effects of lipolysis when these two systems were combined. Results: This research uses new wavelengths (1980 nm, 2300 nm) to increase the fat reduction effect with low energy (1.3 W). After using the 1060 nm (1.1 W/cm2) wavelength laser, when the 1980 nm and 2300 nm (1.3 W) laser were used, a lipolysis effect of about 35 % was obtained. Conclusion: We have developed a 1.3 W mid-infrared (1980 nm, 2300 nm) laser with good lipolysis effect with low power.

A case of primary hyperparathyroidism due to an intrathymic ectopic parathyroid adenoma in a 15-year-old boy.

Hypercalcemia due to primary hyperparathyroidism (PHPT) is uncommon in children. PHPT is typically caused by a single parathyroid adenoma. Ectopic parathyroid adenomas account for 6%-16% of all parathyroid adenomas and are rare in children but should be considered in cases that present with hypercalcemia. We report the case of a 15-year-old boy with PHPT due to an intrathymic ectopic parathyroid adenoma. Neck ultrasonography and Tc-99m-sestamibi (MIBI) scanning with single-photon emission computed tomography/computed tomography (SPECT/CT) revealed ectopic parathyroid adenoma in the thymus. Video-assisted thoracoscopic surgery was performed to remove the ectopic parathyroid adenoma. Pathology showed intrathymic ectopic parathyroid adenoma. After surgery, the patient's serum calcium level immediately normalized. Intact parathyroid hormone (iPTH) and alkaline phosphatase levels returned to normal ranges within 3 months. Delayed diagnosis of PHPT can cause end-organ damage; a timely diagnosis is especially critical to preserve bone and renal function. If ectopic parathyroid adenomas are well localized in preoperative imaging evaluation and intraoperative iPTH level decreases after resection, ectopic parathyroidectomy without bilateral neck exploration may be performed to avoid unnecessary morbidity.

In Vivo Dual-Modal Photoacoustic and Ultrasound Imaging of Sentinel Lymph Nodes Using a Solid-State Dye Laser System.

Photoacoustic imaging (PAI) is being actively investigated as a non-invasive and non-radioactive imaging technique for sentinel lymph node (SLN) biopsy. By taking advantage of optical and ultrasound imaging, PAI probes SLNs non-invasively with methylene blue (MB) in both live animals and breast cancer patients. However, these PAI systems have limitations for widespread use in clinics and commercial marketplaces because the lasers used by the PAI systems, e.g., tunable liquid dye laser systems and optical parametric oscillator (OPO) lasers, are bulky in size, not economical, and use risky flammable and toxic liquid dyes. To overcome these limitations, we are proposing a novel dual-modal photoacoustic and ultrasound imaging system based on a solid-state dye laser (SD-PAUSI), which is compact, convenient, and carries far less risk of flammability and toxicity. Using a solid-state dye handpiece that generates 650-nm wavelength, we successfully imaged the MB tube positioned deeply (~3.9 cm) in chicken breast tissue. The SLNs were also photoacoustically detected in the in vivo rats beneath a 2.2-cm-thick layer of chicken breast, which is deeper than the typical depth of SLNs in humans (1.2 ± 0.5 cm). Furthermore, we showed the multispectral capability of the PAI by switching the dye handpiece, in which the MB-dyed SLN was selectively highlighted from the surrounding vasculature. These results demonstrated the great potential of the SD-PAUSI as an easy but effective modality for SLN detection.

Simultaneous and synergistic effect of heavy metal adsorption on the enhanced photocatalytic performance of a visible-light-driven RS-TONR/TNT composite.

A hydrothermally synthesized rhodium/antimony co-doped TiO2 nanorod and titanate nanotube (RS-TONR/TNT) composite was prepared for removal of heavy metals and organic pollutants from water under visible light irradiation. The composite provides the dual function of simultaneous adsorption of heavy metal ions and enhanced degradation of dissolved organic compounds. Acid treatment transformed titanate nanotubes to irregular tubular structures distributed homogeneously over untransformed RS/TONRs. Synergistic removal and degradation was studied with various heavy metals, Orange (II) dye, and Bisphenol A. The adsorption capacity of the composite for heavy metal ions was Pb(II) > Cd(II) > Cu(II) > Zn(II). The adsorbed metals enhanced photocatalytic degradation of the organic pollutants, but Cu was most effective, with degradation exceeding 70% for the dye and 80% for Bisphenol A after 5 h of treatment. Photocatalytic activity was enhanced more by adsorption than photodeposition of Cu ions. A decrease in XRD rutile peak intensity with adsorbed metal indicates a change in crystallinity which may enhance photocatalytic activity. Thick and bulging nanostructures in FE-SEM images signify ion adsorption within titanate pores. BET analysis indicated titanate nanotubes with adsorbed metal are mesoporous but their tubular structure persists. XPS showed more active Cu 2p3/2 states under light, supporting an active role of Cu+ in photocatalytic ROS generation. Detection of ROS and Cu species using methanol, EDTA, pCBA, and benzoic acid probes provided strong evidence for degradation via a charge transfer mechanism. Findings demonstrate the potential of the RS-TONR/TNT composite for simultaneous removal of heavy metals and degradation of organic pollutants.

Total Bilirubin Is Associated with Small Intestinal Bacterial Overgrowth in Diarrhea Predominant Irritable Bowel Syndrome.

BACKGROUND: Small intestinal bacterial overgrowth (SIBO) associated with irritable bowel syndrome (IBS) can cause microscopic mucosal inflammation and oxidative damage. Bilirubin is a marker of oxidant stress that is responsible for anti-oxidative activities. The objective of this research was to determine whether or not total bilirubin is associated with SIBO according to IBS subtypes. MATERIALS AND METHODS: We retrospectively reviewed the charts of patients who showed IBS symptoms with documented results of lactulose breath test for SIBO. Multivariate models were used in order to assess the relationship of total bilirubin with SIBO according to IBS subtypes. In addition, we observed changes in total bilirubin when SIBO was treated with rifaximin in the relevant IBS subtype. RESULTS: The total bilirubin level of subjects with SIBO was significantly higher than it was in those without. An examination according to IBS subtype groups showed that total bilirubin was independently associated with SIBO only in the subjects with diarrhea-predominant IBS subtype (OR: 2.723, 95% CI: [1.303-5.692], p<0.001). Additionally, a decrease in total bilirubin level and overall improvement of abdominal symptoms were observed following rifaximin treatment. CONCLUSIONS: These findings suggest that total bilirubin levels may provide additional information regarding the presence of SIBO in diarrhea-predominant IBS patients.

Lobectomy versus stereotactic ablative radiotherapy for medically operable patients with stage IA non-small cell lung cancer: A virtual randomized phase III trial stratified by age.

BACKGROUND: Although the choice between stereotactic ablative radiotherapy (SABR) and lobectomy for early-stage non-small cell lung cancer (NSCLC) has been debated for years, the two procedures have not yet been directly compared in a randomized trial. We conducted a virtual randomized phase III trial stratified by age to compare the effectiveness of lobectomy and SABR for medically operable patients with stage IA (AJCC eighth) NSCLC using the Markov model analysis. METHODS: A Markov model was developed to simulate a cohort of patients aged 45-85 years with stage IA NSCLC who had undergone either lobectomy or SABR and were followed up for their remaining lifetime. Each virtual patient was randomly assigned to undergo lobectomy or SABR, and 10 000 patients were allocated to each group. All estimates of the variables were obtained by a systematic review of published articles. RESULTS: The lobectomy group showed a better life expectancy than the SABR group, in patients under 75 years of age. However, no statistically significant difference was seen in patients 75 years or older. The predicted life expectancy was 9.43 and 8.70 years in 75-year-old patients in the lobectomy and SABR groups, respectively. However, the 95%CI for the difference in life expectancy between the two groups was - 0.06-1.50 years (P = 0.0689). CONCLUSIONS: The Markov model showed no statistically significant difference in the expected overall survival in stage IA NSCLC patients who were older than 75 years and had undergone SABR or lobectomy.

A mechanism study on the photocatalytic inactivation of Salmonella typhimurium bacteria by CuxO loaded rhodium-antimony co-doped TiO2 nanorods.

This study presents the first report on the photocatalytic inactivation mechanism for a Salmonella typhimurium pathogen by visible-light active CuxO loaded rhodium-antimony co-doped TiO2 nanorods (CuxO/Rh-Sb-TiO2 NRs) under visible light irradiation (cutoff filter, λ ≥ 420 nm). Remarkably higher pathogenic inactivation of 4 log within 40 min by a CuxO supported Rh-Sb-TiO2 NR photocatalyst was observed. The visible light active photocatalyst mainly produced reduced Cu+ in the lattice of CuxO by charge separation. By this means, photo-generated electrons at the conduction band of Rh-Sb-TiO2 NRs play an important role in reducing Cu2+ to Cu+ through the photocatalytic reduction reaction (PRR), and at the valence band of Rh-Sb-TiO2 NRs, photo-generated holes generate OH˙ radicals through the photocatalytic oxidation reaction (POR). This Cu+ copper species is lethal to microbial pathogens. The inactivation mechanism for the Salmonella typhimurium pathogen was investigated by protein oxidation, HCHO production, and the API-ZYM system. To investigate the role of OH˙ radicals, t-BuOH and MeOH as hole scavengers were used in photocatalytic inactivation reactions. Our experimental results confirmed that the reduced Cu+ species play a major role in bacterial inactivation, while ROS have a major effect on the degradation of organic pollutants.