Conectar
by Qiong Zhou, Liwen Qian, Chong Shen, Xinyan Bei, Gaojie Liu, Xiaonan Sun
PurposeThis study aims to develop a fully automated VMAT planning program for short-course radiotherapy (SCRT) in Locally Advanced Rectal Cancer (LARC) and assess its plan quality, feasibility, and efficiency.
Materials and methodsThirty LARC patients who underwent short-course VMAT treatment were retrospectively selected from our institution for this study. An auto-planning program for neoadjuvant short-course radiotherapy (SCRT) in LARC was developed using the RayStation scripting platform integrated with the Python environment. The patients were re-planned using this auto-planning program. Subsequently, the differences between the automatic plans (APs) and existing manual plans (MPs) were compared in terms of plan quality, monitor units (MU), plan complexity, and other dosimetric parameters. Plan quality assurance (QA) was performed using the ArcCHECK dosimetric verification system.
ResultsCompared to MPs, the APs achieved similar target coverage and conformity, while providing more rapid dose fall-off. Except for the V5Gy dose level, other dosimetric metrics (V25 Gy, V23 Gy, V15 Gy, Dmean, etc.) for the small bowel were significantly lower in the AP compared to the MP (p Conclusion
We developed a fully automated, feasible SCRT VMAT planning program for LARC. This program significantly enhanced plan quality and efficiency while substantially reducing the dose to OARs.
To construct and validate a prediction model for enteral feeding intolerance in critically ill patients during the first 7 days of enteral feeding.
A retrospective cohort study.
We reviewed the medical records of two intensive care units from January 2015 to August 2023, to develop a prediction model by univariate analysis and logistic regression analysis. Model's performance was evaluated through discrimination, calibration and decision curve analysis.
This study involved a total of 471 patients, with an enteral feeding intolerance incidence rate of 35.7%. The prediction model comprised six variables, namely neurological disease, chronic gastrointestinal disease, Acute Physiological and Chronic Health Assessment II score, sedatives, acid suppressants and serum albumin. The model showed robust discrimination, calibration and clinical net benefit, indicating significant potential for practical application with readily available variables.
The model demonstrated strong predictive performance in assessing the risk of enteral feeding intolerance during the early stage of nutrition initiation.
Enhancing clinicians' capacity to reduce the incidence of enteral feeding intolerance and improve patient outcomes.
The prediction model shows a good capacity to discriminate critically ill patients at risk of enteral feeding intolerance, is helpful to provide personalised care.
TRIPOD + AI checklist.
No patient or public contribution.
Trial Registration: https://www.chictr.org.cn/ ChiCTR2400090757
by Bin Li, Yating Chen, Maoxiang Zhao, Zhijie Chen, Zhuhui Lin, Jie Liu, Xueping Wang, Jiancheng Zhang, Yang Li
Obesity is associated with abnormal repolarization manifested by QT interval prolongation, and oxidative stress is an important link between obesity and arrhythmias. However, the underlying electrophysiological and molecular mechanisms remain unclear. The aim of this study is to evaluate the role of obesity in potassium current in ventricular myocytes and the potential mechanism of NADPH oxidase 2 (Nox2). We investigated the effect of Nox2 on cardiac repolarization without compromising its expression and function in other systems using mice with conditional cardiac-specific deletions of Nox2 (knockout [KO]). Wild-type, KO, and Flox littermate mice were randomized to either the control or high-fat diet (HFD) groups. Surface electrocardiograms were recorded to analyze repolarization in vivo. Whole-cell patch-clamp techniques were used to evaluate the electrophysiological phenotype of isolated myocytes in vitro. Western blotting was performed to assess protein expression levels. Compared with the control mice, the HFD group had a prolonged QTc. The consequences of an HFD were not attributed to delayed rectifier K+ and inward-rectifier K+ currents but were associated with reduced peak outward KV and fast transient outward K+ currents. Downregulated expression of KV4.2 and KChIP2, comprising functional Ito channel pore-forming (α) and accessory (β) subunits, was detected in HFD mice. Nox2-KO reversed the effect of obesity on Ipeak and Ito amplitude. Our data demonstrate that obesity mediates impaired cardiac repolarization in mice, manifested by QTc at the whole organism level and action potential duration at the cellular level, and correlated with Nox2. The electrophysiological and molecular aspects of this phenomenon were mediated by repolarizing outward K+ currents.
by Wenli Cao, Xiaofeng Pan, Liming Jin, Jie Liu, Jie Cao, Lei Jin, Fangqiang Wei
Complex liver cancer is often difficult to expose or dissect, and the surgery is often challenging. 3D-printed models may realistically present 3D anatomical structure, which has certain value in planning and training of liver surgery. However, the existing 3D-printed models are all monolithic models, which are difficult to reuse and limited in clinical application. It is also rare to carry fluorescence to accurately present tumor lesions. Here we report reusable fluorescent assembled 3D-printed models to mimic minimally invasive resection of complex liver cancer. Based on the models, multiple copies of liver lesion structure assembled accessories can be printed for the same patient or different patients, ensuring the quantity and quality of simulated surgical training, and greatly reducing the cost of simulated surgical training. The addition of fluorescence is helpful in accurately presenting tumor lesions. The reusable fluorescent assembled 3D-printed models may mimic minimally invasive resection of complex liver cancer, demonstrating potential value in simulated surgery.
The clinical significance of cancer-related stigma on patients' well-being has been widely established. Stigma can be perceived and internalised by cancer patients or implemented by the general population and healthcare workers. Various interventions have been carried out to reduce cancer-related stigma, but their effectiveness is not well-understood. This review aims to synthesise evidence on the effectiveness of interventions to reduce cancer-related stigma.
An integrative review.
This integrative review combined both qualitative and quantitative studies and followed five steps to identify problems, search for the literature, appraise the literature quality, analyse data, and present data. Mixed Methods Appraisal Tool (version 2018) was applied to evaluate the quality of the included studies.
Databases included Web of Science, MEDLINE, SpringerLink, Wiley Online Journals, Cochrane Library, ScienceDirect, OVID, and China National Knowledge Infrastructure (from the inception of each database to 30 April 2021).
Eighteen quantitative, six qualitative, and five mixed-methods studies were included in this review. Cultural factors should be considered when conducting interventions to reduce cancer-related stigma. For cancer patients, multi-component interventions have demonstrated a positive effect on their perceived stigma. For general population, interactive interventions show promise to reduce their implemented stigma towards cancer patients. For healthcare workers, there is a paucity of studies to reduce their implemented stigma. Existing studies reported inconclusive evidence, partially due to the lack of a robust study design with an adequate sample size.
Multi-component and interactive interventions show promise to relieve cancer-related stigma. More methodologically robust studies should be conducted in different cultures to elucidate the most appropriate interventions for different populations to reduce cancer-related stigma.
These findings will facilitate healthcare workers to design and implement interventions to reduce cancer-related stigma, thus improving the quality of life for cancer patients.
No patient and public contribution.
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