关键词： Hepatocellular carcinoma   Hepatic arterial infusion chemotherapy   Transarterial chemoembolization   treatment failure   unsuitability  

摘要： Objective: This study aimed to assess the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) with modified FOLFOX (5fluorouracil, leucovorin, and oxaliplatin) as an alternative treatment option in advanced hepatocellular carcinoma (HCC) patients with failed or unsuitability for transarterial chemoembolization (TACE). Materials and Methods: From September 2018 to January 2020, 87 advanced HCC patients who progressed on TACE or were not eligible for TACE received HAIC treatment with modified FOLFOX. The primary endpoint was overall survival (OS) and secondary endpoints included progression-free survival (PFS), tumor response assessed by Response Evaluation Criteria in Solid Tumors 1.1, and adverse events graded according to CTCAE 5.0. Based on prognostic factors determined by multivariate analysis, a nomogram was developed to predict patient survival. Results: The median OS and PFS were 9.0 months (95%CI 7.6-10.4) and 3.7 months (95%CI 3.1-4.3), respectively. The objective response rate was 13.8%, with a disease control rate of 48.3%. Grade 3 adverse events were observed, such as infection (9.2%), thrombocytopenia (5.7%), hyperbilirubinemia (3.4%), abdominal pain (2.3%) and alanine aminotransferase increase (2.3%). Albumin, AST, and extrahepatic metastasis were incorporated to construct a new nomogram that could stratify patients into three prognostic subgroups, including low-, intermediate-, and high-risk groups, with significant differences in 9-month OS rates (71%, 42% and 6%, respectively;p< 0.001). The nomogram was better than the Okuda, AJCC, and CLIP staging systems for OS prediction. Conclusion: These findings support the feasibility of HAIC with modified FOLFOX as an alternative treatment strategy for advanced HCC when TACE is ineffective or unsuitable.

关键词： Acetonitrile  

摘要： Background: Eprinomectin is used as an active pharmaceutical ingredient (API) in various drug products by the animal health industry. Several major related impurities of eprinomectin API are not separated and coelute by the current United States Pharmacopeia (USP) method for eprinomectin. Objective: The aim was to develop and validate a true and reliable stability-indicating reversed-phase (RP) HPLC method for assay and determination of related substances of eprinomectin in bulk batches of eprinomectin API. Method: HPLC analysis is carried out using a Kinetex C8 column (100mm x 4.6mm i.d. , 2.6 mu m particle size) maintained at 30 degrees C with water-acetonitrile-isopropanol (48+42+10, v/v/v) as mobile phase A and 100% acetonitrile as mobile phase B. Analytes are separated by gradient elution at a flow rate of 0.7mL/min and detected by UV at 252nm. The total run time of the method is 30min. Eprinomectin assay and estimation of all eprinomectin-related substances are obtained in a single HPLC run. Results: The HPLC method was able to separate all analytes of interest by gradient elution. The new method was successfully validated according to current The Internal Council for Hamonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) and International Cooperation on Hamonisation of Technical Requirements for Registration of Veterinary Medicinal Products (VICH) guidelines and was found to be specific, linear, accurate, precise, robust, and sensitive. Conclusions: An HPLC method for assay of eprinomectin and estimation of its related substances was successfully developed, validated, and demonstrated to be accurate, robust, specific, and stability-indicating. Highlights: The HPLC method presented in this paper is more desirable as compared to USP and suitable for routine analysis of bulk batches of eprinomectin API and stability samples in QC laboratories.

摘要： Background: Cocoa butter (CB), an expensive product containing a specific triacylglycerol (TAG)composition, is often the object of economic adulteration. Objective: The present study investigates the detection and quantification of cocoa butter substitutes (CBS) using differential scanning calorimetry. Method: CBS was mixed with CB (from 0 to 100%) as standard samples and analyzed using differential scanning calorimetry and gas chromatography to evaluate the thermal characteristics and fatty acid composition respectively. Results: Increasing the ratio of CBS/CB changed the thermal parameters and fatty acid profiles significantly. For quantification of CBS in commercial samples, medium melting fraction temperature (T(MMF)via r(2) = 0.922) and melting enthalpy (Delta H(f)via r(2) = 0.972) were successfully used to quantify the value of CBS in the samples suspected of being fraudulent. According to the results, all of the thermal parameters increased significantly (P<0.05) with increasing ratio of CBS/CB. It can be attributed to the presence of saturated fatty acids (C12-C22) in CBS which increases T-LMF. Conclusions: The promising results of the present study could be used as a tool for the fast identification of adulteration and quantification of CBS in chocolate compositions. Highlights: Differential scanning calorimetry methods has been developed for identification of CB adulteration. CBS adulteration was detected in CB and also in commercial chocolate samples.

关键词： TWDP fading channel   MGF   M-ary PSK   ASEP  

摘要： Two-wave with diffuse power (TWDP) is one of the most promising models for the description of small-scale fading effects in 5G networks, which employs mmWave band, and in wireless sensor networks deployed in different cavity environments. However, its current statistical characterization has several fundamental issues. Primarily, conventional TWDP parameterization is not in accordance with the model's underlying physical mechanisms. In addition, available TWDP expressions for PDF, CDF, and MGF are given either in integral or approximate forms, or as mathematically untractable closed-form expressions. Consequently, the existing TWDP statistical characterization does not allow accurate evaluation of system performance in all fading conditions for most modulation and diversity techniques. In this regard, physically justified TWDP parameterization is proposed and used for further calculations. Additionally, exact infinite-series PDF and CDF are introduced. Based on these expressions, the exact MGF of the SNR is derived in a form suitable for mathematical manipulations. The applicability of the proposed MGF for derivation of the exact average symbol error probability (ASEP) is demonstrated with the example of M-ary PSK modulation. The derived M-ary PSK ASEP expression is further simplified for large SNR values in order to obtain a closed-form asymptotic ASEP, which is shown to be applicable for SNR > 20 dB. All proposed expressions are verified by Monte Carlo simulation in a variety of TWDP fading conditions.

关键词： Child discomfort   Parental acceptability   Dental caries   SDF   ART  

摘要： Objectives: To compare pain perception of young children treated with SDF and ART, as well as their parents' acceptability of both modalities. Methods: Eighty, 3 to 8-years old children, having at least one deciduous asymptomatic tooth with active caries, as defined by the ICDAS II scores 4, 5, 6 were randomly assigned into two groups;SDF for caries arresting in the test group, and ART for caries removal in the control group. Pain perception was assessed using Sound, Eye, Motor scale (SEM), whereas parental acceptability was assessed using a self-administered questionnaire. Results: Patients treated with SDF reported significantly less discomfort and pain compared to the ART group, with a mean SEM of 3.70 +/- 1.47 and 6.18 +/- 3.06, respectively (p < 0.001). A significantly higher mean parental acceptability score was detected for SDF treatment (31.85 +/- 2.30) than ART treatment (26.75 +/- 3.60), p < 0.001, with regard to the treatment duration, child comfortability and quality of treatment (p < 0.001). The only dimension showing more satisfaction for the ART treatment was esthetics of anterior teeth (p= 0.01). Conclusions: Parental acceptability was higher for the SDF caries treatment of primary teeth compared to ART treatment, especially in relation to the shorter intervention time, child comfortability and acceptance as well as quality of treatment. Clinical Significance: The shorter average time needed and the ease of application of SDF on cavitated primary lesions, in addition to parental acceptability, place SDF in an advantageous position over the ART on clinical level.

关键词： Atmospheric pollution   Bio-based cover systems   Biogas   Greenhouse gases   Solid waste valorization  

摘要： Landfill is an important anthropogenic source of greenhouse gases (GHG). Aiming at methane mitigation through the use of a cover layer in the form of fugitive emissions, this study investigated the methane passive bio-oxidation in a Brazilian landfill in biofilters under two conditions: control column (packing material using only landfill cover soil with approximately equal to 0.8% organic matter) and enriched column (packing material using 45 cm landfill cover soil and 15 cm mixture of cover soil plus compost with approximately equal to 6% organic matter). Biogas was collected from a vertical drain pipe of a four-year-old cell and injected into the base of the columns with a high inlet loading (1000 g(CH4).m(-2).d(-1)) in upward flow mode. Ten campaigns were carried out for six months in order to determine the efficiency of the methane oxidation in each column. Soil temperature, moisture and nutrients content in both filter beds were also determined. The oxidation global efficiencies were higher in the enriched column throughout all campaigns, with approximate to 71 and approximate to 95% for the control and enriched columns, respectively, demonstrating that this technology can be applied even in landfills where there is no energy recovery from biogas (as in most landfills in developing countries). Our study demonstrated that the use of substrates with high organic matter content and low cost in landfill cover layers might present high efficacy in the reduction in methane fugitive emissions. Even operating in field-scale conditions, the results of this study were comparable to those obtained with biofilters on laboratory-scale (under controlled operational conditions). Graphic abstract

关键词： Ayurveda   healing   herbs   holistic   nature   oral medicine  

摘要： Complementary and alternative medicine (CAM) uses a holistic approach that finds natural solutions that help the immune system to fight off infection and diseases. In conventional medicine, the diseases are treated as a series of symptoms developed and not its actual cause or etiology, but CAM commonly targets the exact cause of the disorder thereby stimulating the body's healing process. This is based on an integrative literature review of methods and techniques used as complementary and alternative approaches for oral health care. A comprehensive electronic database search was conducted in PubMed, CINAHL, MEDLINE, EMBASE, Google, Google Scholar, and SCOPUS. Medicinal plants such as Medicago Sativa, Aloe Barbadensis Miller (Aloe Vera), and Trifolium Pratense (Red Clover) have excellent applications in treating gum disorders, prevent tooth decay, and have demonstrated good antifungal activity in the oral cavity. Homeopathic medicines such as Belladonna, Antimonium crudum, and Chamomilla have useful applications in relieving toothache. In Chinese medicine, various acupressure points (Acupuncture) have been used to relieve pain related to tooth, head-and-neck region, sinusitis, etc. Dental professionals can utilize these treatment modalities in their practice along with other conventional procedures as an integrative treatment approach to achieve better outcomes.

摘要： BACKGROUND Beyond submental fat reduction, injectable deoxycholic acid (DCA) has gained popularity in recent years for various minimally invasive lipolysis applications. OBJECTIVE To summarize and evaluate the evidence of off-label uses of injectable DCA. METHODS MEDLINE, Embase, CINAHL, Web of Science, and CENTRAL were searched. The outcomes measured included applications of DCA, treatment regimen, and its efficacy. An overall success rate for each condition was calculated based on the improvement defined in the included studies. RESULTS Eleven studies evaluated the cosmetic use of DCA for excess adipose tissue on various anatomical locations. The outcomes were evaluated at time points ranging from 1 to 21 months post-treatment, with overall success rates over 85%. Eight case reports and series reported the success of using DCA treating lipomas, xanthelasmas, paradoxical adipose hyperplasia, fibrofatty residue of infantile hemangioma, piezogenic pedal papules, and HIV-associated lipohypertrophy. Although the preliminary efficacies were high, the overall recommendations for off-label uses are weak because of the lack of high-level studies. CONCLUSION The review emphasizes the diversity of injectable DCA as a minimally invasive technique for lipolysis. Further high-level studies demonstrating consistent treatment regimens and methods of evaluation are warranted to make more definitive recommendations regarding off-label DCA use.

关键词： Stroke   Spasticity   Transcranial magnetic stimulation   Randomized-controlled trials   Meta-analysis  

摘要： Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) can be used to manage post-stroke spasticity, but a meta-analysis of the recent randomized-controlled trials (RCTs) is lacking. Our aim is to perform a meta-analysis of the RCTs that investigated the efficacy of rTMS in patients with post-stroke spasticity. PubMed, Embase, and Cochrane Library databases were searched for eligible papers published up to February 2020. The primary outcome was the Modified Ashworth Scale (MAS), measured as the effect of rTMS compared with controls and after rTMS (using a change score calculated separately in the active and sham treatment groups). Finally, five papers and eight data sets were included. rTMS had no significant benefit on MAS in patients with post-stroke spasticity compared to sham treatment (WMD = - 0.29, 95% CI - 0.58, 0.00;P = 0.051). When analyzing the change score in the treatment groups, a significant effect of rTMS was observed (WMD = - 0.27, 95% CI - 0.51, - 0.04;P = 0.024). When analyzing the change score in the sham treatment groups, no significant effect of sham treatment was observed, indicating no placebo effect (WMD = 0.32, 95% CI: - 0.40, 1.04;P = 0.387). We included the sample size, year of publication, percentage of male patients, and age difference in each study as covariates, and performed a meta-regression. The results showed no association between these variables and the MAS. Compared with sham stimulation, rTMS did not show a significant reduction in MAS for the patients who experienced post-stroke spasticity, but the patients reported a better outcome in MAS on a before-after scenario.

关键词： Ascaridia   Heterakis   Capillaria   Cestodes   Chicken   Methods  

摘要： The prevalence of gastrointestinal helminths was investigated in sixty-six commercial non-caged layer flocks. Twenty-nine flocks were housed indoors in aviaries or floor systems, nineteen flocks were kept in conventional free-range systems with outdoor access, and eighteen flocks in organic free-range systems. Flocks were investigated at end of rearing (mean age 17 weeks), peak of egg production (mean age 38 weeks) and before slaughter (mean age 74 weeks). Four different methods were applied to determine worm infestation. During necropsies, worm infestations were recorded and mucosal scrapings were evaluated for the presence of worm eggs. Faecal samples from each flock were investigated by simple flotation method and McMaster counting technique. No gastrointestinal helminths were found in pullets. During production, 87.9 % of the layer flocks were infected with at least one nematode species at the peak of production. The prevalence further increased significantly up to 98.5 % at the end of production (p=0.05). This increase could be ascribed mainly to infections with Ascaridia (A.) galli and/or Heterakis (H.) gallinarum which were most prevalent in all husbandry systems. Furthermore, their prevalence increased significantly with the age of birds (p=0.023;p < 0.001). With regard to the husbandry system, the prevalence of Capillaria spp. was significantly higher in flocks from outdoor systems compared to flocks that were kept indoors. Cestodes were only detected at the end of production with a prevalence of 15.2 % and significantly more flocks with access to outdoor run were found positive. Interestingly, H. gallinarum was found with a high prevalence indoor and in outdoor systems. Anthelminthic treatment did not impact the prevalence of nematode infections. Comparing four different methods for the detection of helminths it was revealed that their efficiencies varied depending on the worm species. Overall, the simple flotation method was superior to detect A. galli an