Evolving Paradigms in the Treatment of Oligometastatic Pancreatic Ductal Adenocarcinoma.

Multiple randomized trials have suggested that the addition of comprehensive metastasis-directed therapy to best systemic therapy improves disease control and survival among patients with oligometastatic disease, even for histologies with a high propensity for rapid spread. Here, we review the growing literature supporting the oligometastatic paradigm in pancreatic ductal adenocarcinoma. We summarize key details from nascent institutional series and reflect on the recently reported phase II randomized EXTEND trial.

Optimising CPAP and oxygen levels to support spontaneous breathing in preterm rabbits.

Background: Very preterm infants often require respiratory support after birth with current recommendations suggesting the use of continuous positive airway pressure (CPAP) of 4-8 cmHO and an initial fraction of inspired oxygen (FiO) of 0.21-0.3.

A simple and highly efficient protocol for C-labeling of plant cell wall for structural and quantitative analyses via solid-state nuclear magnetic resonance.

Background: Plant cell walls are made of a complex network of interacting polymers that play a critical role in plant development and responses to environmental changes. Thus, improving plant biomass and fitness requires the elucidation of the structural organization of plant cell walls in their native environment. The C-based multi-dimensional solid-state nuclear magnetic resonance (ssNMR) has been instrumental in revealing the structural information of plant cell walls through 2D and 3D correlation spectral analyses.

The utility of split function testing in determining recovery of glomerular filtration rate after living kidney donation: a cohort study.

Background: A number of UK transplantation centres use isotope studies to estimate the relative contribution from each kidney in living kidney donor assessment. The evidence that the estimation of pre-donation split function of the non-donated kidney influences post-donation renal recovery is limited. The aim of this study was to analyse whether, in the context of other donor factors, the split function of the non-donated kidney predicts the percentage recovery of glomerular filtration rate (GFR) at one-year post-donation.

Novel bilayered zirconia systems using recycled 3Y-TZP for dental applications.

Objective: To synthesize bilayer zirconia systems based on commercial or recycled 3Y-TZP obtained from non-milled remnants and to compare their optical and mechanical properties before and after aging.

Methods: Bilayer zirconia samples were fabricated using either recycled 3Y-TZP (3Y-R/4Y and 3Y-R/5Y) or commercial powders (3Y/4Y and 3Y/5Y). Microstructure and phase composition were analyzed using ScanningElectronMicroscopy (SEM) and X-Ray Diffraction (XRD).

International Expert-Based Consensus Definition, Classification Criteria, and Minimum Data Elements for Osteoradionecrosis of the Jaw: An Inter-Disciplinary Modified Delphi Study.

Purpose: Osteoradionecrosis of the jaw (ORNJ) is a severe iatrogenic disease characterized by bone death after radiation therapy (RT) to the head and neck. With over 9 published definitions and at least 16 classification systems, the true incidence and severity of ORNJ are obscured by lack of a standard for disease definition and severity assessment, leading to inaccurate estimation of incidence, reporting ambiguity, and likely under-diagnosis worldwide. This study aimed to achieve consensus on an explicit definition and phenotype of ORNJ and related precursor states through data standardization to facilitate effective diagnosis, monitoring, and multidisciplinary management of ORNJ.

A thermoplastic chip for 2D and 3D correlative assays combining screening and high-resolution imaging of immune cell responses.

We present an easy-to-use, disposable, thermoplastic microwell chip designed to support screening and high-resolution imaging of single-cell behavior in two- and three-dimensional (2D and 3D) cell cultures. We show that the chip has excellent optical properties and provide simple protocols for efficient long-term cell culture of suspension and adherent cells, the latter grown either as monolayers or as hundreds of single, uniformly sized spheroids. We then demonstrate the applicability of the system for single-cell analysis by correlating the dynamic cytotoxic response of single immune cells grown under different metabolic conditions to their intracellular cytolytic load at the end of the assay.

Subspecies phylogeny in the human gut revealed by co-evolutionary constraints across the bacterial kingdom.

The human gut microbiome contains many bacterial strains of the same species ("strain-level variants") that shape microbiome function. The tremendous scale and molecular resolution at which microbial communities are being interrogated motivates addressing how to describe strain-level variants. We introduce the "Spectral Tree"-an inferred tree of relatedness built from patterns of co-evolutionary constraint between greater than 7,000 diverse bacteria.

Autoplanning in the setting of stereotactic body radiation therapy for lung cancer.

Purpose: Automatic planning (AP) has been compared to manual planning (MP) in lung stereotactic body radiation therapy (SBRT) to validate the former and to implement it in clinical practice.

Methods: A new developing Guided Planning System (GPS) engine was used to reoptimize 20 lung SBRT plans with the RayStation™ treatment planning system (TPS). The original manual plans were optimized to deliver 60 Gy in 5 or 8 fractions to the target with constraints on organs at risk (OARs) based on an internal protocol.

Configuration of Timepix3 read-out parameters for spectral measurements in proton therapy applications.

Purpose: With the increasing use of proton therapy, there is a growing emphasis on including radiation quality, often quantified by linear energy transfer, as a treatment plan optimization factor. The Timepix detectors offer energy-sensitive particle tracking useful for the characterization of proton linear energy transfer. To improve the detector's performance in mixed radiation fields produced in proton therapy, we customized the detector settings and performed the per-pixel energy calibration.

Multidimensional fatigue and its impact on work productivity, mood and quality of life in long-term survivors following definitive intensity-modulated radiotherapy for oropharyngeal cancer: A cross-sectional study.

Purpose: Radiotherapy (RT) for oropharyngeal cancer (OPC) can lead to late toxicity. Fatigue is a known debilitating issue for many cancer survivors, yet prevalence and severity of long-term fatigue in patients treated for OPC is unknown.

Method: As part of a mixed-methods study, fatigue in OPC patients ≥ 2 years post RT + / - chemotherapy was evaluated.

Machine learning-based assessment of morphometric abnormalities distinguishes bipolar disorder and major depressive disorder.

Introduction: Bipolar disorder (BD) and major depressive disorder (MDD) have overlapping clinical presentations which may make it difficult for clinicians to distinguish them potentially resulting in misdiagnosis. This study combined structural MRI and machine learning techniques to determine whether regional morphological differences could distinguish patients with BD and MDD.

Methods: A total of 123 participants, including BD (n = 31), MDD (n = 48), and healthy controls (HC, n = 44), underwent high-resolution 3D T1-weighted imaging.

Chicago Sky Blue Stain, Calcofluor White Stain, and Potassium Hydroxide Mount for Diagnosis of Dermatomycosis.

Objective: To evaluate Chicago Sky Blue (CSB) stain, Calcofluor white (CW) stain, and Potassium Hydroxide (KOH) mount for rapid diagnosis of dermatomycosis, using fungal culture as the gold standard.

Study Design: Cross-sectional analytical study. Place and Duration of the Study: This study was conducted in the Department of Microbiology, Armed Forces Institute of Pathology / National University of Medical Sciences, Rawalpindi, Pakistan, from July 2023 to February 2024.

Quantifying spatial and dynamic lung abnormalities with 3D PREFUL FLORET UTE imaging: A feasibility study.

Purpose: Pulmonary MRI faces challenges due to low proton density, rapid transverse magnetization decay, and cardiac and respiratory motion. The fermat-looped orthogonally encoded trajectories (FLORET) sequence addresses these issues with high sampling efficiency, strong signal, and motion robustness, but has not yet been applied to phase-resolved functional lung (PREFUL) MRI-a contrast-free method for assessing pulmonary ventilation during free breathing. This study aims to develop a reconstruction pipeline for FLORET UTE, enhancing spatial resolution for three-dimensional (3D) PREFUL ventilation analysis.

Tucatinib and trastuzumab in HER2-mutated metastatic breast cancer: a phase 2 basket trial.

Human epidermal growth factor receptor 2 (HER2, also known as ERBB2) signaling promotes cell growth and differentiation, and is overexpressed in several tumor types, including breast, gastric and colorectal cancer. HER2-targeted therapies have shown clinical activity against these tumor types, resulting in regulatory approvals. However, the efficacy of HER2 therapies in tumors with HER2 mutations has not been widely investigated.

Acoustic features of instrumental movie soundtracks elicit distinct and mostly non-overlapping extra-musical meanings in the mind of the listener.

Music can evoke powerful emotions in listeners. However, the role that instrumental music (music without any vocal part) plays in conveying extra-musical meaning, above and beyond emotions, is still a debated question. We conducted a study wherein participants (N = 121) listened to twenty 15-second-long excerpts of polyphonic instrumental soundtrack music and reported (i) perceived emotions (e.

Highly sensitive split ring resonator-based sensor for quality monitoring of edible oils.

This research presents the design and analysis of a compact metamaterial (MTM)-based star-shaped split-ring resonator (SRR) enclosed in a square, constructed on a cost-effective substrate for liquid chemical sensing applications. The designed structure has dimensions of 10 × 10 mm and is optimized for detecting adulteration in edible oils. When the sample holder is filled with different percentages of oil samples, the resonance frequency of the MTM-based SRR sensor shift significantly.

Microfluidic mixing probe: generating multiple concentration-varying flow dipoles.

This study advances microfluidic probe (MFP) technology through the development of a 3D-printed Microfluidic Mixing Probe (MMP), which integrates a built-in pre-mixer network of channels and features a lined array of paired injection and aspiration apertures. By combining the concepts of hydrodynamic flow confinements (HFCs) and "Christmas-tree" concentration gradient generation, the MMP can produce multiple concentration-varying flow dipoles, ranging from 0 to 100%, within an open microfluidic environment. This innovation overcomes previous limitations of MFPs, which only produced homogeneous bioreagents, by utilizing the pre-mixer to create distinct concentration of injected biochemicals.

Advanced microgrid optimization using price-elastic demand response and greedy rat swarm optimization for economic and environmental efficiency.

In this paper, a comprehensive energy management framework for microgrids that incorporates price-based demand response programs (DRPs) and leverages an advanced optimization method-Greedy Rat Swarm Optimizer (GRSO) is proposed. The primary objective is to minimize the generation cost and environmental impact of microgrid systems by effectively scheduling distributed energy resources (DERs), including renewable energy sources (RES) such as solar and wind, alongside fossil-fuel-based generators. Four distinct demand response models-exponential, hyperbolic, logarithmic, and critical peak pricing (CPP)-are developed, each reflecting a different price elasticity of demand.

Multidimensional free shape-morphing flexible neuromorphic devices with regulation at arbitrary points.

Biological neural systems seamlessly integrate perception and action, a feat not efficiently replicated in current physically separated designs of neural-imitating electronics. This segregation hinders coordination and functionality within the neuromorphic system. Here, we present a flexible device tailored for neuromorphic computation and muscle actuation.

Green extraction and IC analysis of trace impurities in TATB through deep eutectic solvents.

1,3,5-trinamino-2,4,6-trinitrobenzene (TATB) as an important insensitive high explosive has excellent safety performance due to strong hydrogen bonds. Ionic impurities including sulfate ions (SO), nitrate ions (NO) and chloride ions (Cl) formed during the preparation of TATB have negative effects on TATB-based explosives. However, strong hydrogen bonds result in extremely low solubility of TATB in traditional solvents, which poses a huge obstacle to extract and detect the impurities in TATB for quality control.

Advanced environmental remediation using enhanced performance of hollow ZnO@SnInS core-shell nanorod arrays for hazardous ion and organic pollutant removal.

Herein, novel hollow ZnO and ZnO@SnInS core-shell nanorods (NRs) with controlled shell thickness were developed via a facile synthesis approach for the efficient photocatalytic remediation of organic as well inorganic water pollutants. The introduction of SnInS shell layer coating over ZnO enhances visible light absorption, efficient exciton-mediated direct charge transfer, and reduces the band gap of ZnO@SnInS core-shell nanorods. The ZnO@SnInS core-shell nanorods show efficient solar-light driven catalytic efficiency for the disintegration of industrial dye (orange G), degradation of tetracycline, and reduction of hazardous Cr (VI) ions in aquatic systems.

4D flow cardiac magnetic resonance in pediatric congenital heart disease: Insights from over four years of clinical practice.

Background: Congenital heart diseases (CHDs) are common birth defects. This work presents over four years of clinical experience of 4D flow cardiovascular magnetic resonance (CMR), highlighting its value for pediatric CHD.

Methods: Children with various CHD diagnoses (n = 298) were examined on a 1.

Multi-institutional Knowledge-Based (KB) plan prediction benchmark models for whole breast irradiation.

Purpose: To train and validate KB prediction models by merging a large multi-institutional cohort of whole breast irradiation (WBI) plans using tangential fields.

Methods: Ten institutions (INST1-INST10, 1481 patients) developed their KB-institutional models for left/right WBI (ten models for right and eight models for left). The transferability of models among centers was assessed based on the overlap of the geometric Principal Component (PC1) of each model when applied to other institutions and/or on the presence of significantly different optimization policies.

Impact of intravenous CT contrast agents on internal calibration techniques to determine trabecular BMD of the lumbar spine.

Objectives: Contrast agents are frequently administered in computed tomography (CT) scans used for opportunistic screening of osteoporosis. The objective of this study is to compare the impact of contrast-related bone mineral density (BMD) increase between phantom-based and internal CT calibration techniques.

Materials And Methods: Phantom-based and internal CT calibration techniques were used to determine trabecular BMD in 93 existing clinical CT scans of the lumbar spine of 34 subjects, scanned before and after administration of contrast agents.