Spectral CT assists differentiation of osteoblastic bone metastasis from bone island in newly diagnosed cancer patients.

OBJECTIVES: To investigate measurements derived from plain and enhanced spectral CT in differentiating osteoblastic bone metastasis (OBM) from bone island (BI). MATERIALS AND METHODS: From January to November 2020, 73 newly diagnosed cancer patients with 201 bone lesions (OBM = 92, BI = 109) having received spectral CT were retrospectively enrolled. Measurements including CT values of 40-140 keV, slope of the spectral curve, effective atomic number (Zeff), water (calcium) density, calcium (water) density, and Iodine (calcium) density were derived from manually segmented lesions on plain and enhanced spectral CT, and then analyzed using Student t-test and Pearson's correlation. Multivariate analysis was performed to build models (plain spectral model, enhanced spectral CT model, and combined model) for the discrimination of OBM and BI with performance evaluated using receiver operator characteristics curve and DeLong test. RESULTS: All features were significantly different between the BI group and OBM group (all p < 0.05), highly correlated with the corresponding features between plain and enhanced spectral CT both in OBM (r: 0.392-0.763) and BI (r: 0.430-0.544). As for the model performance, the combined model achieved the best performance (AUC = 0.925, 95% CI: 0.879 to 0.957), which significantly outperformed the plain spectral CT model (AUC = 0.815, 95% CI: 0.754 to 0.866, p < 0.001) and enhanced spectral CT model (AUC = 0.901, 95% CI: 0.852 to 0.939, p = 0.024) in differentiating OBM and BI. CONCLUSION: In addition to plain spectral CT measurements, enhanced spectral CT measurements would further significantly benefit the differential diagnosis. CLINICAL RELEVANCE STATEMENT: Measurements derived either from plain or enhanced spectral CT could provide additional valuable information to improve the differential diagnosis between OBM and BI in newly diagnosed cancer patients. KEY POINTS: • We intend to investigate plain and enhanced spectral CT measurements in differentiating OBM from BI. • Both plain and enhanced spectral CT help in discriminating OBM and BI in newly diagnosed cancer patients. • Enhanced spectral CT measurements further improve plain spectral CT measurements-based differential diagnosis.

The influence of genetic predisposition to oxidative stress on painful diabetic peripheral neuropathy: A mendelian randomization study.

Genetic predisposition to oxidative stress (OS) may influence the risk of Painful Diabetic Peripheral Neuropathy (PDPN). This study employed a Mendelian Randomization (MR) approach to investigate the causal relationship between genetic predisposition to OS and PDPN. Genetic instruments associated with OS biomarkers were selected as exposures. Summary-level data on PDPN was obtained from the largest available genome-wide association study (GWAS). MR analyses were conducted using the inverse-variance weighted (IVW) method, with sensitivity analyses employing the MR-Egger, weighted median, and MR-PRESSO approaches. Genetic predisposition to increased glutathione S-transferase (GST) activity was associated with a reduced risk of PDPN (OR=0.66, 95%CI: 0.49-0.89, P=0.006). Higher ascorbate levels conferred a protective effect against PDPN (OR=0.83, 95%CI: 0.71-0.97, P=0.018). No significant association was observed between genetic predisposition to OS biomarkers and PDPN severity. Genetic predisposition to increased GST activity and higher ascorbate levels protect against the development of PDPN, suggesting a causal relationship.

Mechanical properties and marginal fit of prefabricated versus customized dental implant abutments: A comparative study.

INTRODUCTION: Dental implant abutments play an important role in the health and aesthetics of soft and hard tissues around implants. PURPOSE: To compare mechanical properties and marginal fit of prefabricated and customized dental implant abutments and provide references to evaluate the relationship between abutment choice and clinical indications. METHODS: Titanium abutments were randomly divided into prefabricated and customized abutments. Static and dynamic loads were applied according to ISO14801:2016. Mechanical properties, including fracture strength, fatigue strength, rotational torque value, and torque loss rate, were measured. The biological properties of the implant abutments were assessed using an internal marginal fit. The samples were sliced, and the internal marginal fit was examined using a scanning electron microscope before and after cyclic loading. The length of the tight contact was calculated at the level of the conical connection, lower internal connection, and screw threads. Microleakage was evaluated by immersing the samples in 1% methylene blue and measuring the absorbance. RESULTS: The fracture strengths of the prefabricated abutments were greater than those of the customized abutments before and after cyclic loading. The average fatigue strengths of the prefabricated and customized abutments were 350 and 300 N, respectively. The removal torque loss of the customized abutments was significantly greater than that of the prefabricated abutments. Significant differences were found in conical connection before loading, while the screw threads showed substantial differences between the two groups after loading. Microleakage in the customized abutments was significantly higher than that in the prefabricated abutments before and after loading. CONCLUSIONS: Prefabricated abutments showed superior mechanical and biological properties compared with customized abutments in vitro, suggesting a greater risk of mechanical and biological complications occurring with the use of customized abutments. This study provides a reference for the clinical selection of implant abutments.

Reliability and validity of the Chinese version of the spiritual health scale.

BACKGROUND: In recent years, spiritual health became a focus of interest and nurses' spiritual health is crucial to the quality of their own lives and patients' health care. In China, high workloads, tense nurse-patient relationships, and low social status have been found to have negative impacts on the work attitude and nursing quality and spiritual health offers direction for solving this problem. This study assessed the spiritual health levels of nurses on the Chinese mainland using a revised Chinese version of the spiritual health scale (SHS-C). METHODS: A total of 747 nurses were recruited in Zhejiang Province, China. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) of the revised SHS-C were performed using convenience sampling, with 291 and 456 nurses used for each analysis type, respectively. Items on the SHS-C were screened using the discrete trend method, the extreme group approach, correlation analysis, and EFA to create a revised mental health questionnaire for nurses. An internal consistency test and CFA were then performed to verify the spiritual health questionnaire for nurses. A self-reporting questionnaire consisting of demographic questions and the revised SHS-C items was used for this cross-sectional correlation study. RESULTS: The revised SHS-C included 6 subscales comprising a total of 28 items. Cronbach's α and retest reliability for the revised questionnaire were 0.90 and 0.73, respectively. The fit of the model was analyzed by CFA [χ2/df =1.79; goodness of fit index (GFI) =0.83; adjusted GFI (AGFI) =0.79; root mean square error of approximation (RMSEA) =0.06; normed fit index (NFI) =0.86; comparative fit index (CFI) =0.93; non-NFI (NNFI) =0.92; incremental fit index (IFI) =0.93; parsimony NFI (PNFI) =0.76; parsimony CFI (PCFI) =0.83; and parsimony GFI (PGFI) =0.69; with each index score higher than those of the 5-subscale SHS short form previously developed by Hsiao et al.]. A reliability test showed that the overall Cronbach's α was 0.93, with a Cronbach's α of between 0.82 and 0.92 for each section. This study developed and validated a revised SHS-C. CONCLUSIONS: Our research will help policymakers, administrators, nursing leaders, and educators to identify areas for improvement regarding nurses' spiritual health, which could translate into significant improvements in patients' health care.

Fast and equilibrium CEST imaging of brain tumor patients at 3T.

Chemical exchange saturation transfer (CEST) MRI, versatile for detecting endogenous mobile proteins and tissue pH, has proved valuable in tumor imaging. However, CEST MRI scans are often performed under non-equilibrium conditions, which confound tissue characterization. This study proposed a quasi-steady-state (QUASS) CEST MRI algorithm to standardize fast and accurate tumor imaging at 3 T. The CEST signal evolution was modeled by longitudinal relaxation rate during relaxation delay (Td) and spinlock relaxation during RF saturation time (Ts), from which the QUASS CEST effect is derived. Numerical simulation and human MR imaging experiments (7 healthy volunteers and 19 tumor patients) were conducted at 3 T to compare the CEST measurements obtained under two representative experimental conditions. In addition, amide proton transfer (APT), combined magnetization transfer (MT) and nuclear overhauser enhancement (NOE) effects, and direct water saturation were isolated using a 3-pool Lorentzian fitting in white matter and gray matter of healthy volunteers and for patients in the contralateral normal-appearing white matter and tumor regions. Finally, the student's t-test was performed between conventional and QUASS CEST measurements. The routine APT and combined MT & NOE measures significantly varied with Ts and Td (P < .001) and were significantly smaller than the corresponding QUASS indices (P < .001). In contrast, the results from the QUASS reconstruction showed little dependence on the scan protocol (P > .05), indicating the accuracy and robustness of QUASS CEST MRI for tumor imaging. To summarize, the QUASS CEST reconstruction algorithm enables fast and accurate tumor CEST imaging at 3 T, promising to expedite and standardize clinical CEST MRI.

Separation of Bioproducts through the Integration of Cyanobacterial Metabolism and Membrane Filtration: Facilitating Cyanobacteria's Industrial Application.

In this work, we propose the development of an efficient, economical, automated, and sustainable method for separating bioproducts from culture medium via the integration of a sucrose-secreting cyanobacteria production process and pressure-driven membrane filtration technology. Firstly, we constructed sucrose-secreting cyanobacteria with a sucrose yield of 600-700 mg/L sucrose after 7 days of salt stress, and the produced sucrose could be fully separated from the cyanobacteria cultures through an efficient and automated membrane filtration process. To determine whether this new method is also economical and sustainable, the relationship between membrane species, operating pressure, and the growth status of four cyanobacterial species was systematically investigated. The results revealed that all four cyanobacterial species could continue to grow after UF filtration. The field emission scanning electron microscopy and confocal laser scanning microscopy results indicate that the cyanobacteria did not cause severe destruction to the membrane surface structure. The good cell viability and intact membrane surface observed after filtration indicated that this innovative cyanobacteria-membrane system is economical and sustainable. This work pioneered the use of membrane separation to achieve the in situ separation of cyanobacterial culture and target products, laying the foundation for the industrialization of cyanobacterial bioproducts.

Baseline Amide Proton Transfer Imaging at 3T Fails to Predict Early Response to Induction Chemotherapy in Nasopharyngeal Carcinoma.

BACKGROUND: Early identification of nasopharyngeal carcinoma (NPC) patients with high risk of failure to induction chemotherapy (IC) would facilitate prompt individualized treatment decisions and thus reduce toxicity and improve overall survival rate. This study aims to investigate the value of amide proton transfer (APT) imaging in predicting short-term response of NPC to IC and its potential correlation with well-established prognosis-related clinical characteristics. METHODS AND MATERIALS: A total of 80 pathologically confirmed NPC patients receiving pre-treatment APT imaging at 3T were retrospectively enrolled. Using asymmetry analysis, APT maps were calculated with mean (APTmean), 90th percentile (APT90) of APT signals in manually segmented NPC measured. APT values were compared among groups with different histopathological subtypes, clinical stages (namely, T, M, N, and overall stages), EBV-related indices (EBV-DNA), or responses to induction chemotherapy, using Mann-Whitney U test or Kruskal-Wallis H test. RESULTS: NPC showed significantly higher APTmean than normal nasopharyngeal tissues (1.81 ± 0.62% vs.1.32 ± 0.56%, P <0.001). APT signals showed no significant difference between undifferentiated and differentiated NPC subtypes groups, different EBV-DNA groups, or among T, N, M stages and overall clinical stages of II, III, IVA and IVB (all P >0.05). Similarly, baseline APT-related parameters did not differ significantly among different treatment response groups after IC, no matter if evaluated with RECIST criteria or sum volumetric regression ratio (SVRR) (all P >0.05). CONCLUSION: NPC showed significantly stronger APT effect than normal nasopharyngeal tissue, facilitating NPC lesion detection and early identification. However, stationary baseline APT values exhibited no significant correlation with histologic subtypes, clinical stages and EBV-related indices, and showed limited value to predict short-term treatment response to IC.