Monday, December 27, 2021

Enhanced removal of radioactive iodine anions from wastewater using modified bentonite: Experimental and theoretical study

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Chemosphere. 2021 Dec 22:133401. doi: 10.1016/j.chemosphere.2021.133401. Online ahead of print.

ABSTRACT

Efficient and cost-effective removal of radioactive iodine anions from contaminated water has become a crucial task and a great challenge for waste treatment and environmental remediation. Herein, we present hexadecylpyridinium chloride monohydrate modified bentonite (HDPy-bent) for the efficient and selective removal of iodine anions (I- and IO3-) from contaminated water. Batch experiments showed that HDPy-bent could remove more than 95% of I- and IO3- within 10 min, and had maximum I- and IO3- adsorption capacities of 80.0 and 50.2 mg/g, respectively. Competitive experiments indicated that HDPy-bent exhibited excellent I- and IO3- selectivity in the excessive presence of common concomitant anions including PO43-, SO42-, HCO3-, NO3-, Cl- (maximum mole ratio of anions vs iodine anions was ∼50,000). An anion exchange mechanism was proposed for the selective adsorption of iodine anions. Optimal adsorption structure of HDPy+/I- (IO3-) at atomic level and driving forces of the I- (IO3-) adsorption were calculated by density functional theory (DFT) simulati ons. Moreover, the good durability and reusability of the HDPy-bent has been demonstrated with 5 adsorption-desorption cycles. Dynamic column experiment also demonstrated that HDPy-bent exhibited excellent removal and fractional recovery capabilities towards I- and IO3- from simulated groundwater and environmental water samples. In conclusion, this work presents a promising adsorbent material for the decontamination of radioactive iodine anions from wastewater on a large scale.

PMID:34953880 | DOI:10.1016/j.chemosphere.2021.133401

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Clinical responses following inspiratory muscle training in exercise-induced laryngeal obstruction

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Eur Arch Otorhinolaryngol. 2021 Dec 26. doi: 10.1007/s00405-021-07214-5. Online ahead of print.

ABSTRACT

PURPOSE: Exercise-induced laryngeal obstruction (EILO) is relatively common in young people. Treatment rests on poor evidence; however, inspiratory muscle training (IMT) has been proposed a promising strategy. We aimed to assess laryngeal outcomes shortly after IMT, and to compare self-reported symptoms with a control group 4-6 years later.

METHODS: Two groups were retrospectively identified from the EILO-register at Haukeland University Hospital, Norway; one group had received only information and breathing advice (IBA), and another additionally IMT (IBA + IMT). At diagnosis, all participants performed continuous laryngoscopy during exercise (CLE), with findings split by glottic and supraglottic scores, and completed a questionnaire mapping exercise-related symptoms. After 2-4 weeks, the IBA + IMT-group was re-evaluated with CLE-test. After 4-6 years, both groups were re-assessed with a questionnaire.

RESULTS: We identified 116 eligible patients from the EILO-register. Response rates after 4-6 years were 23/58 (40%) and 32/58 (55%) in the IBA and IBA + IMT-group, respectively. At diagnosis, both groups rated symptoms similarly, but laryngeal scores were higher in the IBA + IMT-group (P = 0.003). After 2-4 weeks, 23/32 in the IBA + IMT-group reported symptom improvements, associated with a decrease of mainly glottic scores (1.7-0.3; P < 0.001), contrasting unchanged scores in the 9/32 without symptom improvements. After 4-6 years, exercise-related symptoms and activity levels had decreased to similar levels in both groups, with no added benefit from IMT; however, full symptom resolution was reported by only 8/55 participants.

CONCLUSION: Self-reported EILO symptoms had improved after 4-6 years, irrespective of initial treatment. Full symptom resolution was rare, suggesting individual follo w-up should be offered.

PMID:34954812 | DOI:10.1007/s00405-021-07214-5

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Incidence of Head and Neck Cancers before and after 9/11 in New York City and New York State

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Introduction: The incidence of cancers in New York State (NYS) before and after 9/11 including lung, colorectal, and renal cancers has been previously described. To date, the incidence of head and neck cancers (HNCs) before and after 9/11 has not been described. Methods: Cancers involving the oral cavity and oropharynx; the nose, nasal cavity, nasopharynx, and middle ear; larynx; and thyroid were identified using the New York State Cancer Registry (NYSCR). Age-adjusted incidence and rates per 100,000 residents from 1987 to 2015 were analyzed using joinpoint regression. Trends in incidence using annual percent changes are presented. Results: The overall rate of HNC increased slightly by 0.7% (p #x3c; 0.001) from 1987 to 2003 in NYS. From 2003 to 2008, the rate increased by 5.73% (p #x3c; 0.001), and from 2008 to 2015, the rate increased by 1.68% (p #x3c; 0.001). The rate of thyroid cancer increased by 6.79% (p #x3c; 0.001) from 1987 to 2003, by 9.99% (p #x3c; 0.001) from 2003 to 2009, and by 2.41% (p = 0.001) from 2009 to 2015. The rate of thyroid cancer was higher in women at all time points. In a subset analysis of HNCs excluding thyroid cancer, the rate decreased by 2.02% (p #x3c; 0.001) from 1991 to 2001, followed by a nonsignificant increase of 0.1% (p = 0.515) from 2001 to 2015. The rate of oropharyngeal (OP) cancer significantly increased from 1999 to 2015 (2.65%; p #x3c; 0.001). The rate of oral cavity cancer significantly decreased from 1987 to 2003 (1.97%; p #x3c; 0.001), with no significant change after 2003. The rate of laryngeal cancer decreased significantly by 2.43% (p #x3c; 0.001) from 1987 to 2015, as did the rate of nasal cavity/nasopharyngeal cancer (0.33%; p = 0.03). Conclusions: In NYS, OP cancer and thyroid cancer rates increased significantly during the study period. The rate of thyroid cancer wa s higher in women. The rate of combined HNC increased significantly after 9/11 compared to before 9/11; however, in a subset analysis of all HNC patients excluding thyroid cancer, the rate decreased significantly prior to 9/11 and then nonsignificantly increased afterward. This suggests that the increase in thyroid cancer accounts for the increase in combined HNC in NYS. The impact of 9/11 on rates of HNC requires further research.
ORL
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Priority setting in breast reconstructive surgery: A DELPHI consensus

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J Plast Reconstr Aesthet Surg. 2021 Dec 1:S1748-6815(21)00613-6. doi: 10.1016/j.bjps.2021.11.068. Online ahead of print.

ABSTRACT

OBJECTIVES: Breast reconstructive surgery is often performed following breast cancer treatment to restore the natural appearance of the breast. Despite various research performed in this field, there is a discrepancy between the research question that is considered crucial jointly by patients, carers and healthcare professionals and the research performed. The Breast Reconstruction Priority Setting Partnership was formed to determine the top research priorities in all aspects of breast reconstructive surgery.

METHODS: The Priority Setting Partnership (PSP) was conducted in line with James Lind Alliance (JLA) principles involving patients and clinicians. An online survey was conducted to gather uncertainties related to breast reconstruction by involving patients, carers and clinicians. Following this, a modified Delphi consensus process was performed to identify the top 10 research priorities.

RESULT: A total of 239 unique research uncertainties were identified via the online survey, which involved 100 participants. A review of literature established that 58 of these uncertainties did not have a high-quality systematic review, prompting the need for more in-depth research. A further 28 research uncertainties were obtained by performing a literature search. Of the final 86 unique questions, the Delphi panel achieved consensus on the top ten research priorities. Recommendations to address these research priorities have been put forward based on current evidence.

CONCLUSION: This study involved patients, carers and healthcare professionals to establish the top 10 priority areas for research in breast reconstructive surgery. Recommendations have been put forward on the necessary future research that is required to address these uncertainties.

PMID:34955391 | DOI:10.1016/j.bjps.2021.11.068

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Construct validity of the anglicised FACE-Q skin cancer module

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J Plast Reconstr Aesthet Surg. 2021 Dec 1:S1748-6815(21)00636-7. doi: 10.1016/j.bjps.2021.11.093. Online ahead of print.

ABSTRACT

OBJECTIVES: The FACE-Q Skin Cancer module is a patient-reported outcome measure (PROM) for facial skin cancer. It has been anglicised for the UK population and undergone psychometric testing using classical test theory. In this study, further evaluation of construct validity using Rasch measurement theory and hypothesis testing was performed.

METHODS: Patients were prospectively recruited to the Patient-Reported Outcome Measures In Skin Cancer Reconstruction (PROMISCR) study and asked to complete the anglicised FACE-Q Skin Cancer module. The scalability and unidimensionality of the data were assessed with a Mokken analysis prior to Rasch analysis. Response thresholds, targeting, fit statistics, local dependency, and internal consistency were examined for all items and subscales. Four a priori hypothese s were tested to evaluate the convergent and divergent validity. We additionally hypothesised that the median 'cancer worry' score would be lower in post-operative than pre-operative patients.

RESULTS: 239 patients self-completed the questionnaire between August 2017 and May 2019. Of the ten subscales assessed, five showed relative fit to the Rasch model. Unidimensionality was present for all five subscales, with most demonstrating ordered item thresholds and appropriate fit statistics. Two items in the 'cancer worry' subscale had either disordered or very close response thresholds. Subscales of the FACE-Q Skin Cancer module demonstrated convergent and divergent validity with relevant Skin Cancer Index comparators (p < 0.001). Median 'cancer worry' was lower in post-operative patients (44 vs 39, p < 0.001).

CONCLUSION: The anglicised FACE-Q Skin Cancer module shows psychometric validity through hypothesis testing, and both classical and modern test theory.

PM ID:34955401 | DOI:10.1016/j.bjps.2021.11.093

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An anthropometric study of the external ear

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J Plast Reconstr Aesthet Surg. 2021 Nov 27:S1748-6815(21)00608-2. doi: 10.1016/j.bjps.2021.11.065. Online ahead of print.

ABSTRACT

Auricular dimensions are important data for the treatment of auricular deformities, either congenital or acquired. Many previous studies have shown that the auricular dimension varies among ethnic groups; however, there are currently no available data for the Thai population. The objective of this investigation was to provide normative values regarding the adult ear dimensions in Thailand. A total of 200 Thai volunteers between the ages of 18 and 70 years (80 men, 120 women) were enrolled in this study. We measured six dimensions, including the auricular, lobular, and conchal length and width and the auricular projection at the superaurale and tragal levels. Moreover, we calculated the auricular, lobular, and conchal indices. The selected dimensions of the external ears were shown as means ± standard devia tions. These parameters were then compared between the right and left sides, men and women and participants aged ≥50 and <50 years. We found that men have a significantly larger and more projected ear than women do. The length of the entire auricles and the length of the earlobe were also significantly longer in the population ≥50 years than those <50 years. This study provides normative data of the external ear dimension and projection in the adult Thai population. These data can be used to reconstruct the ear and face more appropriately for Thai individuals.

PMID:34955402 | DOI:10.1016/j.bjps.2021.11.065< /a>

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Prevention is better than cure: Surgical methods for neuropathic pain prevention following amputation - A systematic review

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J Plast Reconstr Aesthet Surg. 2021 Dec 5:S1748-6815(21)00628-8. doi: 10.1016/j.bjps.2021.11.076. Online ahead of print.

ABSTRACT

BACKGROUND: Pain after amputation can be known as residual limb pain (RLP) or phantom limb pain (PLP); however, both can be disabling in daily life with reported incidences of 8% for finger amputations and up to 85% for major limb amputations. The current treatment is focused on reducing the pain after neuropathic pain occurs. However, surgical techniques to prevent neuropathic pain after amputation are available and effective, but they are underutilized. The purpose of the review is to investigate the effects of techniques during amputation to prevent neuropathic pain.

METHODS: A systematic review was performed in multiple databases (Embase, Medline, Web of Science, Scopus, Cochrane, and Google Scholar) and following the PRISMA guidelines. Studies that reported surgical techniques to prevent neuropath ic pain during limb amputation were included.

RESULTS: Of the 6188 selected studies, 13 eligible articles were selected. Five articles reported techniques for finger amputation: neurovascular island flap, centro-central union (CCU), and epineural ligatures, and flaps. For finger amputations, the use of prevention techniques resulted in a decrease of incidences from 8% to 0-3% with CCU being the most beneficial. For major limb amputations, the incidences for RLP were decreased to 0 to 55% with TMR and RPNI and compared to 64-91% for the control group. Eight articles reported techniques for amputations on major limbs: targeted muscle reinnervation (TMR), targeted nerve implantation, concomitant nerve coaptation, and regenerative peripheral nerve interface (RPNI).

CONCLUSIONS: Based on the current literature, we state that during finger and major limb amputation, the techniques to prevent neuropathic pain and PLP should be performed.

PMID:34955394 | DOI:10.1016/j.bjps.2021.11.076

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Mise à jour 2021 des recommandations pour la pratique clinique de Nice/Saint-Paul-de-Vence dans le cancer de l’ovaire épithélial de haut grade: Updated 2021 recommendations for the clinical practice of Nice/Saint-Paul-de-Vence in epithelial high grade ovarian cancer

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Bull Cancer. 2021 Dec;108(9S1):S1-S4. doi: 10.1016/S0007-4551(21)00581-6.

ABSTRACT

Since the previous 2013 and 2016 recommendations for clinical practice (RPC) Nice/Saint-Paul-de-Vence for gynecological cancers, the management of ovarian cancer has become more complex with the evolution of the quality criteria recommended for surgery and the integration of molecular biology for the decision of medical treatments, especially for high grade epithelial ovarian cancers. Surgical indications have become more precise both in the first line and in the context of relapse. Treatments with PARP inhibitors is a major advance in medical management with significant efficacy in maintenance after response to platinum-based chemotherapy. The benefit already known in the case of late relapse has also been demonstrated in first-line treatment with progression-free survival never observed in this pathology with patients with very long responses, especial ly in the case of BRCA gene abnormalities (somatic or constitutional). In 2021, medical and surgical strategies in front line including PARP inhibitors associated or not with bevacizumab as a maintenance complement after platinum chemotherapy are guided by both response to platinum agents and molecular profiling including BRCA (somatic or constitutional) genetic status and homologous recombination pathway (HRD) abnormalities, that should be early tested. On behalf of the GINECO national oncologist group, we have updated the guidelines for high grade ovarian epithelial cancer (excepted rare tumors) in order to allow rapid dissemination of the latest advances to the medical community and improve daily practice.

PMID:34955157 | DOI:10.1016/S0007-4551(21)00581-6

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Diagnostic histologique et moléculaire des cancers de l'ovaire - recommandations pour la pratique clinique Saint-Paul 2021: Histological and molecular diagnosis of ovarian

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Bull Cancer. 2021 Dec;108(9S1):S33-S38. doi: 10.1016/S0007-4551(21)00585-3.

ABSTRACT

Oncogenetic testing is now part of standard management in high grade ovarian cancer, including at least mutational status of BRCA1/BRCA2 genes. If necessary, tumor genetic testing is followed by constitutional testing to either confirm the constitutional origin of variants identified in BRCA1/2 genes or detect variants in other predisposition genes. The whole process including prescription of tumoral testing, retrieval of analysis report and communication of results must be formalized, as well as information on possible consequences of the results for the patient and her family. Tumor material must meet criteria of size and cellularity to allow high-quality analysis. These samples are processed during the preanalytical phase with two major steps : time of cold ischemia and fixation. Only pathogenic (Class V) and likely pathogenic (Class IV) variants sh own in tumor tissue are mentioned in the report. Currently, only BRCA1 and BRCA2 genes are routinely studied but, in the future, analysis will be extended to other genes involved in homologous recombination repair. In patients without BRCA mutation, other biomarkers reflecting sensitivity to PARP inhibitors, such as HRD scores (homologous recombination deficiency) that appeared recently, will have to be implemented in routine practice in order to better select patients for these treatments and choose optimal therapy.

PMID:34955160 | DOI:10.1016/S0007-4551(21)00585-3

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Prise en charge chirurgicale du cancer épithélial de l'ovaire - première ligne et première rechute: Surgical management of epithelial ovarian cancer - first line and first relapse

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Bull Cancer. 2021 Dec;108(9S1):S13-S21. doi: 10.1016/S0007-4551(21)00583-X.

ABSTRACT

Based on recently published data, these recommendations present some evolutions in the surgical management of high grade epithelial ovarian cancers. In apparently early stages (FIGO I and II), surgical staging must be undertaken to confirm the absence of both peritoneal lesions and lymph node involvement (that might change stage and management). Neoadjuvant chemotherapy is not indicated, surgical exploration should be performed upfront, by laparotomy, to reduce the risk of rupture of the primary tumor. In advanced stages, the first step is to evaluate the feasibility of primary surgery with complete tumor cytoreduction. If it appears unfeasible, 3 or 4 cycles of neoadjuvant chemotherapy are administered before interval surgey. Whether it is implemented in the primary or interval setting, surgery must be performed by experimented teams, in an approved f acility, having developed a rehabilitation program. Lymph node dissection is not mandatory if no adenopathies have been identified by imaging and by peroperative palpation. At first relapse, the surgical decision must be made by a multidisciplinary team, using scores predictive of complete cytoreduction (AGO or iMODEL criteria). Similarly as in first line, the objective is to achieve resection without any residual disease. Surveillance after first-line treatment must be adapted, according to the probability of another complete cytoreduction in case of late relapse, especially in patients who benefited from primary complete surgery and maintained good performance status.

PMID:34955158 | DOI:10.1016/S0007-4551(21)00583-X

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The immunologic balance: three cases of rituximab-associated melanoma

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imageCurrently, there is no known clinical evidence that rituximab increases the rate of subsequent primary malignancies; however, some studies have raised the question of increased melanoma risk following rituximab treatment for non-Hodgkin lymphoma. We report three interesting cases of suspected rituximab-induced melanoma. We hypothesize that this association is secondary to rituximab-driven shifts in the immunologic balance. Based on these cases, it is possible that the number of post-rituximab melanoma cases is underreported. Further mechanistic research into individual cases and population-level studies are required to better define association and risk; however, given the increasing prevalence of oncologic and nononcologic rituximab use, awareness across all fields is essential.
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