OBJECTIVE: This review aimed to investigate the usage of radiosensitisers in the biomedical field, determine their important parameters, and suggest radiosensitisers with potential among the analysed radiosensitisers.
RESULTS AND CONCLUSION: This review has discussed several parameters for radiosensitisers, including median lethal dose, cell survival, tumour size, cell viability, Dose Enhancement Factor (DEF), Reactive Oxygen Species (ROS) concentration, radiosensitiser production complexity, radiosensitiser administration technique, and radiosensitiser toxicity. General trends regarding the development of radiosensitisers, including the types, effectiveness, and their production complexity, have also been discussed within this review article.
METHODS: In this international, double-blind trial, we randomly assigned patients with heart failure and a left ventricular ejection fraction of 40% or greater, in a 1:1 ratio, to receive finerenone (at a maximum dose of 20 mg or 40 mg once daily) or matching placebo, in addition to usual therapy. The primary outcome was a composite of total worsening heart failure events (with an event defined as a first or recurrent unplanned hospitalization or urgent visit for heart failure) and death from cardiovascular causes. The components of the primary outcome and safety were also assessed.
RESULTS: Over a median follow-up of 32 months, 1083 primary-outcome events occurred in 624 of 3003 patients in the finerenone group, and 1283 primary-outcome events occurred in 719 of 2998 patients in the placebo group (rate ratio, 0.84; 95% confidence interval [CI], 0.74 to 0.95; P = 0.007). The total number of worsening heart failure events was 842 in the finerenone group and 1024 in the placebo group (rate ratio, 0.82; 95% CI, 0.71 to 0.94; P = 0.006). The percentage of patients who died from cardiovascular causes was 8.1% and 8.7%, respectively (hazard ratio, 0.93; 95% CI, 0.78 to 1.11). Finerenone was associated with an increased risk of hyperkalemia and a reduced risk of hypokalemia.
CONCLUSIONS: In patients with heart failure and mildly reduced or preserved ejection fraction, finerenone resulted in a significantly lower rate of a composite of total worsening heart failure events and death from cardiovascular causes than placebo. (Funded by Bayer; FINEARTS-HF ClinicalTrials.gov number, NCT04435626.).
METHODS: A comprehensive search was conducted across PubMed, Scopus, Web of Science, and preprint servers for eligible trials up to July 8, 2024. Two investigators independently screened the records and assessed the risk of bias using the Cochrane Risk of Bias Tool. Trials were eligible if they compared vitamin D with control interventions in adults with COVID-19. Data extraction and analysis were carried out independently, employing a random-effects model to estimate pooled odds ratios for mortality.
RESULTS: Nineteen randomized controlled trials with 2495 participants were included. The meta-analysis showed a significant reduction in all-cause mortality with vitamin D supplementation (pooled OR 0.72, 95% CI 0.53-0.98; I2 = 20%). Subgroup analysis for severe COVID-19 cases also indicated significant mortality reduction (pooled OR 0.57, 95% CI 0.35-0.92; I2 = 18%).
CONCLUSION: Vitamin D supplementation appears to reduce mortality in COVID-19 patients, especially in severe cases. These findings highlight the potential benefits of vitamin D as an adjunct treatment in COVID-19, though further large-scale trials are needed to confirm these effects and determine optimal dosing.
METHODS: We reviewed complications in a total of 85 consecutive patients who underwent cryoablation using a liquid nitrogen-based system in various lesions between April 2017 and October 2022. There were none liver and renal lesions. Complications were categorized using the Society of Interventional Radiology (SIR) classification.
RESULTS: 85 patients were treated for 96 lesions in the bone (36.4%; 35 of 96), lung (18.8%; 18 of 96), and soft tissue (44.8%; 43 of 96). The primary technical success rate was 97.7% (83 of 85). The total grade 2 and 1 complication rates were 5.2% (5/96) and 20.8% (20/96), respectively. Two patients had asymptomatic pulmonary embolisms incidentally noted at the 24-hour follow-up computed tomography (grade 2). The most frequent complications were simple and hemorrhagic pleural effusions (18.7%; 18 of 96). Lung procedures had the highest complication rate where 13 patients (72.2%; 13 of 18) reporting complications, including two cases of symptomatic hydropneumothorax requiring drainage (grade 2) and an additional two days of hospital stay. Eight patients (24.2%; 8 of 33) with bone lesions and four (9.3%; 4 of 43) with soft tissue lesions experienced complications.
CONCLUSION: Cryoablation using a liquid nitrogen-based system is safe, with only minor complications observed.
PURPOSE: The purpose of part II of this study was to evaluate the stress distribution in different designs of Aramany class I obturators using finite element analysis (FEA) and photoelastic stress analysis.
MATERIAL AND METHODS: Four finite element and 8 photoelastic models, including 2 acrylic resin base obturators retained with 2 Adams clasps, 2 linear, 2 tripodal, and 2 fully tripodal design obturators, were used in this study. The frameworks were fabricated on the casts obtained from a modified printed model. Vertical and oblique loads were applied on 2 points (anterior and posterior) of the models. The quantitative measurement was done by measuring the fringe orders and von Mises values to compare the influences of occlusal forces on the obturator components and their supporting structures. The qualitative evaluation was done by visual color mapping to identify the stress concentration.
RESULTS: In the photoelastic analysis, the anterior abutments of the tripodal showed the highest stress, followed by the fully tripodal obturators, while, in FEA, the anterior abutments of the linear design received the most in both vertical and oblique load. The central incisor received the most stress in photoelastic (3 or more fringe orders) and FEA (687.3 and 150.1 MPa for vertical and oblique loads, respectively), followed by the lateral incisors. Upon posterior loading, the base of the defect of the linear design demonstrated the most stress in photoelastic (3 or more fringes) and FEA (94.3 and 130.5 MPa for vertical and oblique loads, respectively). The acrylic resin base obturator retained with Adams clasps demonstrated the lowest stress distribution in abutments and their supporting bone upon anterior and posterior loads.
CONCLUSIONS: Upon vertical and oblique load application, the fully tripodal design was comparable with the tripodal in terms of stress distribution. Both designs were better than the linear in response to the same loading. The stress was concentrated at the anterior palatal part of the obturator, the base of the defect, and the junction of the metal and acrylic resin part of the prostheses upon anterior and posterior loading, respectively.
METHODS: We conducted a two-round modified Delphi survey among local and international communication experts, and also recipients of medicines risk communication in Malaysia. We developed a list of 37 strategies based on the findings of our previous studies. In Round 1, participants were asked to rate the priority for each strategy using a 5-point Likert scale and suggest additional strategies via free-text comments. Strategies scoring a mean of ≥ 3.75 were included in Round 2. We defined consensus for the final list of strategies a priori as > 75% agreement. Data were analysed using descriptive statistics and thematic analysis.
RESULTS: Our final Delphi panel (n = 39, 93% response rate) comprised medicines communication experts from nine countries and Malaysian healthcare professionals. Following Round 1, we dropped 14 strategies and added 11 strategies proposed by panellists. In the second round, 21 strategies achieved consensus. The priority areas identified were to improve the format and content of risk communication, increase the use of technology, and increase collaboration with various stakeholders. Priority ratings for the strategy "to offer incentives to pharmaceutical companies which maintain effective communication systems" were significantly higher among recipients compared to communicators [χ2(1, N = 39) = 10.1; p = 0.039] and among local versus international panellists [χ2(1, N = 39) = 14.3; p = 0.007].
CONCLUSIONS: Our study identified 21 priority strategies, which were used to develop a strategic plan for enhancing medicines risk communication. This plan is potentially adaptable to all countries with developing pharmacovigilance systems. The difference in views between communicators and recipients, as well as local and international panellists, highlights the importance of involving multiple stakeholders in research.
METHODS: This is a prospective cohort study, where cognitive assessments were done 1-day before surgery, at discharge, and during 6 weeks of follow-up. Sample size calculation, accounting for an estimated 20% dropout rate, determined a minimum of 170 subjects were required for the study. Reduction of MMSE score of more than 2.5 was considered as having POCD. Score differences between groups were analysed using T-test and analysis of variance (ANOVA), while consistency between tools was analysed using correlation and regression.
RESULTS: A total of 188 patients completed the study, with a POCD prevalence of 20.2% and 6.9% at discharge and at the 6 week follow up, respectively. All cognitive tools show a significant difference between preoperative and postoperative scores. All tests show a significant moderate correlation with MMSE.
CONCLUSIONS: In conclusion, it is imperative to employ a battery of cognitive assessments to evaluate cognitive changes comprehensively.