Lipidomic Assessment of the Inhibitory Effect of Standardized Water Extract of Hydrangea serrata (Thunb.) Ser. Leaves during Adipogenesis.

Obesity is primarily exacerbated by excessive lipid accumulation during adipogenesis, with triacylglycerol (TG) as a major lipid marker. However, as the association between numerous lipid markers and various health conditions has recently been revealed, investigating the lipid metabolism in detail has become necessary. This study investigates the lipid metabolic effects of Hydrangea serrata (Thunb.) Ser. hot water leaf extract (WHS) on adipogenesis using LC-MS-based lipidomics analysis of undifferentiated, differentiated, and WHS-treated differentiated 3T3-L1 cells. WHS treatment effectively suppressed the elevation of glycerolipids, including TG and DG, and prevented a molecular shift in fatty acyl composition towards long-chain unsaturated fatty acids. This shift also impacted glycerophospholipid metabolism. Additionally, WHS stabilized significant lipid markers such as the PC/PE and LPC/PE ratios, SM, and Cer, which are associated with obesity and related comorbidities. This study suggests that WHS could reduce obesity-related risk factors by regulating lipid markers during adipogenesis. This study is the first to assess the underlying lipidomic mechanisms of the adipogenesis-inhibitory effect of WHS, highlighting its potential in developing natural products for treating obesity and related conditions. Our study provides a new strategy for the development of natural products for the treatment of obesity and related diseases.

Assessing objective cognitive impairments in cancer survivors: Features and validity of measures for research and clinical applications.

Objective: This narrative review aims to (1) identify neuropsychological tests for assessing cognitive function impairment in patients with cancer, specifically in the domains of attention and memory, (2) summarize the characteristics of these tests, including cognitive function domains, test content, readability, and psychometric quality, and (3) evaluate the feasibility of each test in cancer care. Methods: Data sources include published test manuals, documents from official web pages, and published journal articles. Results: Our study identified eight neuropsychological tests that are most frequently used to assess the attention and memory domains of objective cognitive function in patients with breast cancer. These tests include the California Verbal Learning Test, Hopkins Verbal Learning Test, Rey Auditory Verbal Learning Test, Rey-Osterrieth Complex Figure, CNS Vital Signs, Wechsler Adult Intelligence Scale, Wechsler Memory Scale, and Trail Making Test. They demonstrate acceptable evidence of psychometric quality and varying degrees of feasibility. Test feasibility is influenced by factors such as short testing time, brevity and comprehensiveness, clear cognitive domain distinctions, availability of normative data, minimal practice effects, ease of administration, and limited attention-span requirements. These attributes determine a test's feasibility for use in cancer care. Among the evaluated measures, the California Verbal Learning Test for memory, the Trail Making Test for attention, and the CNS Vital Signs for comprehensive assessment emerge as the most practical choices for cancer care. Conclusions: The assessment and management of cognitive function impairment are crucial for enhancing the quality of life in cancer survivors. Nurses should possess knowledge of assessment tools for early detection and the ongoing monitoring of this symptom's progression.

Compressible Separator and Catalyst for Simultaneous Separation and Purification of Emulsions and Aqueous Pollutants.

Oily wastewater, a global environmental concern, demands efficient oil/water separation and pollutant removal. Our compressible separator and catalyst (CSC) balls, prepared through sponge etching and metal nanoparticle synthesis, exhibited efficient degradation of dyes of varying sizes, spanning a molecular weight range from 139 to 696 g/mol during the oil/water separation. Control over the distance between catalysts was achieved by incorporating Ag-Pt-Pd catalysts into the sponge skeleton and by adjusting the compression rates. The dispersion of the catalysts improved degradation efficiency for larger dyes, while concentrating the catalysts proved to be more effective for the smaller ones. By optimizing the compression rates of CSC balls, we successfully achieved the effective removal of emulsions of different sizes and precise control of flux. Our CSC ball-loaded system offers efficient and versatile solutions for concurrent separation and purification of emulsions and pollutants with potential environmental benefits.

The role of cytokines and Indolamine-2.3 dioxygenase in experiencing a psycho-neurological symptom cluster in hematological cancer patients: IL-1alpha, IL-1beta, IL-4, IL-6, TNF-alpha, kynurenine, and tryptophan.

OBJECTIVE: This study examined (a) whether there are a subgroup of cancer patients experiencing the selected psycho-neurological symptoms as a cluster (depression, cognitive impairment, fatigue, sleep disturbance, and pain); (b) whether demographic and clinical characteristics and pro-inflammatory cytokines (IL-1α, IL-1ß, IL-4, IL-6, TNF-alpha) are associated with subgroup membership; and (c) whether the activity of indolamine-2.3 dioxygenase(IDO) is associated with pro-inflammatory cytokine activity and psycho-neurological symptom cluster experience. METHODS: This was a prospective cohort study where 149 hematologic patients were recruited from a university hospital and 65 healthy volunteers provided control data. Latent profile analyses were conducted to identify subgroups at two time points: the last day of chemotherapy and 1 week after chemotherapy completion. Influencing factors of subgroup membership were examined by logistic regression. RESULTS: A substantial number of patients (33%, 34% at each time point) experienced the selected psycho-neurological symptoms as a cluster. Older age and elevated IL-1α and IL-6 were associated with experiencing the psycho-neurological symptom cluster. IDO activity was higher in the patients experiencing psycho-neurological symptom cluster; and was positively associated with IL-6. Symptom severity, IL-1α, IL-6, and IDO activity were all significantly higher in cancer patients than in the healthy controls. The findings were preserved across time points. CONCLUSIONS: The activation of pro-inflammatory cytokines and their cross-talk with IDO may be a common biological mechanism, underlying a psycho-neurological symptom cluster experience. The novel approaches for symptom assessment and management can be developed by assessing multiple psycho-neurological symptoms as a cluster and by targeting their common biological pathway.

Unusual skin pigmentation after unilateral adrenalectomy due to pheochromocytoma: a case report.

Background: Skin pigmentation after adrenalectomy occurs due to an increase in adrenocorticotropic hormone (ACTH) following adrenal insufficiency. ACTH-induced pigmentation usually appears as generalized hyperpigmentation and is known to appear after bilateral adrenalectomy. We report a case of unusual transient hyperpigmentation that developed immediately after unilateral adrenalectomy for pheochromocytoma and spontaneously resolved without corticosteroid supplementation. Case Description: A 29-year-old woman was admitted to the hospital due to sudden-onset chest pain and headache. A 2.8-cm left adrenal mass with heterogeneous enhancement was incidentally found in chest computed tomography during the evaluation. Multiple old infarctions were observed in brain magnetic resonance imaging (MRI), and left ventricular thrombi were found by echocardiography. Biochemical evidence confirmed the diagnosis of pheochromocytoma, while serum ACTH and cortisol levels were within normal ranges. The patient underwent laparoscopic left adrenalectomy via a posterior retroperitoneal approach and recovered without immediate postoperative complications. On day 3 after surgery, a crescent-shaped café-au-lait skin pigmentation occurred on both the subcostal and the lumbar areas of the abdomen. Serial serum cortisol slightly decreased during the immediate postoperative period and recovered on day 3. Serum ACTH was elevated. Under close observation without corticosteroid supplementation, the pigmentation faded on day 8 after surgery. On day 15, the pigmentation clearly disappeared and serum ACTH decreased to within the normal range. A month later, ACTH and all adrenal hormones were within normal range. Conclusions: We hypothesized that skin pigmentation appeared due to an imbalance of the hypothalamic-pituitary-adrenal (HPA) axis after resection of one adrenal gland. Skin pigmentation may be the first and early manifestation of adrenal insufficiency in patients who undergo unilateral adrenalectomy due to a non-Cushing's tumor. Therefore, a careful physical examination may allow early detection of adrenal insufficiency and optimal treatment planning.

Prognostic influences of B-cell lymphoma 2-positive expression on late recurrence in breast cancer.

Purpose: B-cell lymphoma 2 (BCL2) has an antiapoptotic role, however, has resulted in it being a powerful favorable prognostic factor in breast cancer. Several studies revealed BCL2 is strongly associated with a lower rate of early recurrence after initial treatment in breast cancer patients, but study of a prolonged effect after 5 years is lacking. We investigated BCL2 as a prognostic factor in breast cancer in comparison to early and late recurrence. Methods: We retrieved data from 2,198 patients with primary breast cancer who underwent surgical treatment and adjuvant treatment at the breast cancer center between 2005 and 2015. Each molecular subtype was classified, and Ki-67 and BCL2 were also assessed by immunohistochemistry. BCL2 and the association between molecular subtypes were assessed in early and late recurrences, respectively. Five-year postrecurrence survival and BCL2 were also assessed. Results: The BCL2-positive group was associated with favorable clinicopathologic characteristics. The time to recurrence was significantly longer in the BCL2-positive group (P = 0.035). Late recurrence after 5 years was higher in the BCL2-positive group (P = 0.029). In multivariate survival analysis, tumor size and BCL2-positive expression were the only independent prognostic factors for late recurrence (P = 0.004). In the patients with recurrence, 5-year postrecurrence survival was significantly higher in the BCL2-positive group (P < 0.001). Conclusion: Our result showed that prognosis was better in BCL2-positive patients compared to BCL2-negative patients at late recurrence. We suggested that BCL2 expression could be used as a marker to help determine additional adjuvant therapy or extended hormone therapy in hormone-dependent breast cancer.

A Janus branch filter for washing machines: Simultaneous removal of microplastics and surfactants.

Emerging pollutants, such as microplastics (MPs), are becoming a significant issue worldwide. The highest percentage of MPs released into the environment occurs through daily laundry. The average weight of dreg obtained from 5 kg of laundry was 1.26 g/kg. According to energy dispersive X-ray (EDX) and thermogravimetric analysis (TGA) analyses, the dreg consisted of MPs (78.3-89 wt%, organic elements: C/O) and alien materials (11-21.7 wt%, inorganic elements: Al/Fe/Ca, etc.). Thus, to reproduce the real environment, alien materials (Fe3O4 and CaCO3) were added to various types of model MPs in the presence and absence of sodium dodecyl benzenesulfonate (SDBS) to test MP removal. Hydrophobic and hydrophilic MPs were generated upon laundering, accounting for 55-59% and 41-45% of MPs, respectively. We provide a novel approach to design a laundry filter system for the simultaneous removal of SDBS and hydrophilic/hydrophobic MPs.

Neuropsychological Effects of Chemotherapy: Systematic Review of Longitudinal Studies on Objective Cognitive Impairment in Breast Cancer Patients.

BACKGROUND: Findings from longitudinal studies can provide more conclusive evidence as to the impact of chemotherapy on cognitive functioning. OBJECTIVES: This study aimed to ( a ) synthesize the evidence from longitudinal studies of the neuropsychological effects associated with chemotherapy in breast cancer patients, ( b ) identify associated factors, and ( c ) evaluate methodological issues. METHODS: Data were extracted from PubMed, EMBASE, CINAHL, PsycINFO, and the Cochrane Library. Inclusion criteria included the original study with the breast cancer sample, validated measure, and at least 1 baseline data point before and after chemotherapy began. Data accrued for sample characteristics, data-collection time points, statistical methods for longitudinal data analysis, outcome measures, and major findings (eg, longitudinal changes in cognitive function). RESULTS: We selected 42 articles for this review. The sample sizes ranged from 20 to 610, and most recruited were younger than 70 years. We found a trend across studies-statistically significant objective cognitive function deteriorations in severity and prevalence after initiating chemotherapy compared with a control group or relative to their baseline observations. A subsample, as high as 65%, experienced marked declines in cognitive function after initiating chemotherapy. The memory domain was most affected. The consistently associated factors were education, IQ, and regimen. Major methodological concerns were the measurement-the wide range of neuropsychological tests and a test's unclear domains. CONCLUSION: Chemotherapy affects objective cognitive function in some subsets. The highest-impact time point, mechanisms, and clinical significance of chemotherapy-associated cognitive impairment need additional evidence. IMPLICATION FOR PRACTICE: Clinicians must assess and manage cognitive impairment during and after chemotherapy.

The Effect of Hydrolysis Pre-Treatment by Flavourzyme on Meat Quality, Antioxidative Profiles, and Taste-Related Compounds in Samgyetang Breast Supplemented with Black Garlic.

This study aimed to carefully investigate the effect of hydrolysis using Flavourzyme on meat quality, antioxidative status, and taste-related compounds in breast of Samgyetang that was supplemented with black garlic (BG). Four different treatment groups were compared: (1) conventional Samgyetang (control), (2) Samgyetang hydrolyzed with Flavourzyme (1%, v/w) (FS), (3) Samgyetang made with the BG extract without hydrolysis (NBG), and (4) BG samgyetang pre-treated with Flavourzyme (1%, v/w) in a water bath at 55°C for 2.5 h and hydrolyzed before being processed (HBG). All the treatment groups were cooked by retorting at conditions 121°C and 1.5 kg/cm2 for 1 h. Improved umami profiles through the increase of umami-related nucleotides (5'-GMP, 5'-IMP) and free amino acids-aspartic acid and glumtamic acid, in Samgyetang breast was recorded following hydrolysis. The HBG group tended to impart stronger scavenging activity toward free radicals compared with the other two groups, while not differing with NBG group regarding suppressing malondialdehyde. Textural properties were improved through hydrolysis, wherein the shear force value decreased from 2.29 kgf in the control to 1.19 and 1.25 kgf in the FS and HBG group. Moisture percentages were highly retained, with the redness score increasing and the lightness color decreasing following hydrolysis. In conclusion, the results of this study can be a preliminary information of the effect of hydrolysis pre-treatment for BG samgyetang. Further experiments are required to compare various enzymes along with its organoleptic acceptances.

Psychometric Evaluation of the Korean Version of the Functional Assessment of Chronic Illness Therapy-Fatigue.

BACKGROUND: The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue) instrument is a fatigue measure widely used on patients with cancer worldwide. The psychometric quality of the Korean version of the FACIT-Fatigue instrument has never been systematically evaluated. PURPOSE: The purpose of this study was to assess the reliability and validity of the Korean version of the FACIT-Fatigue instrument. METHODS: This study used data collected from 170 patients with cancer and 120 healthy individuals. Internal consistency reliability was analyzed using Cronbach's α and item-total correlation. Construct validity was analyzed using confirmatory factor analysis, and known-group validity was tested using t tests. Convergent validity was analyzed using Pearson's correlation with pain and functional limitations. Predictive validity was analyzed using receiver operating characteristic curves. RESULTS: The Cronbach's α was .93 for the reliability evaluation, and the item-total correlation ranged from .27 to .84. In the construct validity evaluation, the bifactor model showed good fit (Q = 1.93, comparative fit index = .97, Tucker-Lewis index = .96, root mean square error of approximation = .05), indicating using the instrument's total score to be more appropriate than using the subscale scores (explained common variance = .76, ω = .95, ωH = .85, ωH/ω = .89). The group of patients with cancer showed significantly higher fatigue than the healthy subject group, showing known-group validity (t = -10.40, p < .05). Fatigue showed significant and strong correlations with functional limitations and pain (all ps < .001). The area under the curve was .81 (cutoff point = 40, Youden's index: 0.47, sensitivity: 77.60%, specificity: 73.04%), verifying that the instrument is predictive of higher fatigue severity in patients with cancer. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The Korean version of the FACIT-Fatigue instrument was shown to be reliable and valid. Its construct validity supports the use of the total scale score rather than the subscale scores.

Association of chemotherapy and subjective cognitive impairment in breast cancer patients: Meta-analysis of longitudinal prospective cohort studies.

PURPOSE: This meta-analysis with longitudinal prospective cohort studies aimed to (a) determine whether chemotherapy is associated with time-dependent subjective cognitive impairment outcomes in breast cancer patients, and (b) identify the time point with the highest impact of chemotherapy on subjective cognitive impairment. METHODS: Data were gathered from PubMed, EMBASE, CINAHL, PsycInfo, and the Cochrane Library. The mean differences of the subjective cognitive impairment level between the chemotherapy-treated patients and controls (patients not treated by chemotherapy and healthy subjects) were calculated using effect sizes (Hedges' g) by clinical time periods. The five clinical time periods were (a) baseline, (b) during chemotherapy, (c) within 1 month postchemotherapy, (d) within 1 year postchemotherapy, and (e) 1 year or longer postchemotherapy. RESULTS: Longitudinal data from nine data sets from 13 studies were pooled and analyzed. At baseline, chemotherapy-treated patients showed slightly better subjective cognitive impairment compared to patients not treated by chemotherapy and did not differ from healthy controls. Yet, the chemotherapy-treated patients had significantly worse subjective cognitive impairment compared to both type of controls after initiating chemotherapy. The effect sizes for the group differences were larger for the group comparison with healthy controls than the nonchemotherapy control (-0.50 vs. -0.19). The largest effects were found within 1 month postchemotherapy (-0.85), suggesting the acute impact of chemotherapy. CONCLUSIONS: Chemotherapy is associated with subjective cognitive impairment. The impact of chemotherapy appears to be an acute rather than a chronic side effect. Clinicians must consider including the assessment and management of subjective cognitive impairment in their routine practice.

Hybrid Bead Air Filters with Low Pressure Drops at a High Flow Rate for the Removal of Particulate Matter and HCHO.

A tower air filtration system was designed in which bead air filters (BAFs) were actively rotated by a fan motor to remove particulate matter (PM) or HCHO gas. Three types of BAF, hydrophilic, hydrophobic, and hybrid, were prepared and compared for the removal of PM and HCHO gas. A tower air filtration system loaded with hybrid BAFs purified 3.73 L of PM (2500 µg/m3 PM2.5) at a high flow rate of 3.4 m/s with high removal efficiency (99.4% for PM2.5) and a low pressure drop (19 Pa) in 6 min. Against our expectations, the PM2.5 removal efficiency slightly increased as the air velocity increased. The hybrid BAF-200 showed excellent recyclability up to 50 cycles with high removal efficiencies (99.4-93.4% for PM2.5). Furthermore, hydrophilic BAF-200 could permanently remove 3.73 L of HCHO gas (4.87 ppm) and return the atmosphere to safe levels (0.41-0.31 ppm) within 60 min without any desorption of HCHO gas.

Solar-Driven Unmanned Hazardous and Noxious Substance Trapping Devices Equipped with Reverse Piloti Structures and Cooling Systems.

A solar-driven unmanned hazardous and noxious substance (HNS) trapping device that can absorb, evaporate, condense, and collect HNSs was prepared. The HNS trapping device was composed of three parts: a reverse piloti structure (RPS) for absorption and evaporation of HNSs, Al mirrors with optimized angles for focusing light, and a cooling line system for the condensation of HNSs. The RPS was fabricated by assembling a lower rectangle structure and an upper hollow column. The lower rectangular structure showed a toluene evaporation rate of 6.31 kg/m2 h, which was significantly increased by the installation of the upper hollow column (11.21 kg/m2 h) and led to the formation of the RPS. The installation of Al mirrors on the RPS could further enhance the evaporation rate by 9.1% (12.28 kg/m2 h). The RPS system equipped with an Al mirror could rapidly remove toluene, xylene, and toluene-xylene with high evaporation rates (12.28-8.37 kg/m2 h) and could effectively collect these substances with high efficiencies (81-65%) in an unmanned HNS trapping device. This prototype HNS trapping device works perfectly without human involvement, does not need electricity, and thus is suitable for fast cleanup and collection of HNSs in the ocean.

Impact of polymyxin B hemoperfusion therapy on high endotoxin activity level patients after successful infection source control: a prospective cohort study.

We sought to evaluate the clinical implication of endotoxin levels in gram-negative bacilli (GNB)-induced abdominal septic shock patients with polymyxin B-hemoperfusion (PMX-HP) treatment. A prospective cohort of 60 patients who received surgical infectious source control for abdominal sepsis from January 2019 to December 2020 was included in the study. Endotoxin activity (EA) levels and Sequential Organ Failure Assessment (SOFA) scores were assessed immediately after surgery (baseline), 24, and 48 h post baseline. With receiver operating characteristic curves, the patients were stratified into two groups by the EA cut-off value (high-risk group vs low-risk group) and the clinical outcomes were compared. Logistic regression was performed to identify the clinical impact of PMX-HP on in-hospital death. Among the 31 high-risk patients (EA level ≥ 0.54), 16 patients (51.6%) received PMX-HP treatment and showed significant decreases in EA levels compared to patients who underwent conventional treatment only (- 0.34 vs - 0.12, p = 0.01). SOFA scores also showed significant improvement with PMX-HP treatment (12.8-8.9, p = 0.007). Fourteen in-hospital deaths occurred (45.2%), and PMX-HP treatment had a protective effect on in-hospital death (odds ratio (OR) 0.04, p = 0.03). In 29 low-risk patients (EA level < 0.54), seven patients (24.1%) received PMX-HP treatment and showed significant decreases in EA levels (0.46-0.16, p = 0.018). However, SOFA scores and in-hospital deaths were not improved by PMX-HP treatment. EA level significantly decreased after PMX-HP treatment and it may represent a therapeutic option to improve organ impairment and in-hospital death in septic shock patients with EA levels exceeding 0.54.

Reduction of EUV resist damage by neutral beam etching.

Even though EUV lithography has the advantage of implenting a finer pattern compared to ArF immersion lithography due to the use of 13.5 nm instead of 193 nm as the wavelength of the light source, due to the low energy of EUV light source, EUV resist has a thinner thickness than conventional ArF resist. EUV resist having such a thin thickness is more vulnerable to radiation damage received during the etching because of its low etch resistance and also tends to have a problem of low etch selectivity. In this study, the radiation damage to EUV resist during etching of hardmask materials such as Si3N4, SiO2, etc using CF4gas was compared between neutral beam etching (NBE) and ion beam etching (IBE). When NBE was used, after the etching of 20 nm thick EUV resist, the line edge roughness increase and the critical dimension change of EUV resist were reduced by ∼1/3 and ∼1/2, respectively, compared to those by IBE. Also, at that EUV etch depth, the root mean square surface roughness value of EUV resist etched by NBE was ∼2/3 compared to that by IBE on the average. It was also confirmed that the etching selectivity between SiO2, Si3N4, etc and EUV resist was higher for NBE compared to IBE. The less damage to the EUV resist and the higher etch selectivity of materials such as Si3N4and SiO2over EUV resist for NBE compared to IBE are believed to be related to the no potential energy released by the neutralization of the ions during the etching by NBE.

Comparing the Postoperative Outcomes of Single-Incision Laparoscopic Appendectomy and Three Port Appendectomy With Enhanced Recovery After Surgery Protocol for Acute Appendicitis: A Propensity Score Matching Analysis.

PURPOSE: The objective of this study was to compare the perioperative outcomes between single-incision laparoscopic appendectomy (SILA) and 3-port conventional laparoscopic appendectomy (CLA) in enhanced recovery after surgery (ERAS) protocol. METHODS: Of 101 laparoscopic appendectomy with ERAS protocol cases for appendicitis from March 2019 to April 2020, 54 patients underwent SILA with multimodal analgesic approach (group 1) while 47 patients received CLA with multimodal analgesic approach (group 2). SILA and CLA were compared with the single institution's ERAS protocol. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM). RESULTS: After 1:1 PSM, well-matched 35 patients in each group were evaluated. Postoperative hospital stays for patients in group 1 (1.2 ± 0.8 vs. 1.6 ± 0.8 days, P = 0.037) were significantly lesser than those for patients in group 2. However, opioid consumption (2.0 mg vs. 1.4 mg, P=0.1) and the postoperative scores of visual analogue scale for pain at 6 hours (2.4±1.9 vs. 2.8 ± 1.4, P = 0.260) and 12 hours (2.4 ± 2.0 vs. 2.9 ± 1.5, P = 0.257) did not show significant difference between the 2 groups. CONCLUSION: SILA resulted in shortening the length of hospitalization without increase in complications or readmission rates compared to CLA with ERAS protocol.

Harnessing adipose­derived stem cells to release specialized secretome for the treatment of hepatitis B.

Mesenchymal stem cells (MSCs) have the function of repairing damaged tissue, which is known to be mediated by the secretome, the collection of secretory materials shed from MSCs. Adjusting the culture conditions of MSCs can lead to a significant difference in the composition of the secretome. It was hypothesized that pre­sensitization of MSCs with specific disease­causing agents could harness MSCs to release the therapeutic materials specialized for the disease. To validate this hypothesis, the present study aimed to generate a 'disease­specific secretome' for hepatitis caused by hepatitis B virus using hepatitis BX antigen (HBx) as a disease­causing material. Secretary materials (HBx­IS) were collected following the stimulation of adipose­derived stem cells (ASCs) with 100­fold diluted culture media of AML12 hepatocytes that had been transfected with pcDNA­HBx for 24 h. An animal model of hepatitis B was generated by injecting HBx into mice, and the mice were subsequently intravenously administered a control secretome (CS) or HBx­IS. Compared with the CS injection, the HBx­IS injection significantly reduced the serum levels of interleukin­6 and tumor necrosis factor­α (pro­inflammatory cytokines). Western blot analysis and immunohistochemistry of the liver specimens revealed that the HBx­IS injection led to a higher expression of liver regeneration­related markers, including hepatocyte growth factor and proliferating cell nuclear antigen, a lower expression of pro­apoptotic markers, such as cleaved caspase 3 and Bim in mouse livers, and a lower expression of pro­inflammatory markers (F4/80 and CD68) compared to the CS injection. HBx­IS exhibited higher liver regenerative, anti­inflammatory and anti­apoptotic properties, particularly in the mouse model of hepatitis B compared to CS. This suggests that the secretome obtained by stimulating ASCs with disease­causing agents may have a more prominent therapeutic effect on the specific disease than the naïve secretome.

Determinants of the Higher Prevalence and Severity of Subjective Cognitive Impairment in Cancer Patients Compared to Healthy Subjects: Fatigue and Stress.

This study examined whether (a) cancer patients in two cohorts reported greater subjective cognitive impairment (SCI) in prevalence and severity than noncancer healthy controls; and (b) selected psychoneurological factors (fatigue, stress, and sleep disturbance) contribute to such differences. Data from 60 prechemotherapy cancer patients, 81 active-chemotherapy cancer patients, and 116 noncancer healthy controls were analyzed using hierarchical regressions. The prevalence rate of SCI was higher in the prechemotherapy cancer cohort (41.6%) and in the active-chemotherapy cancer cohort (46.9%) than in healthy controls (21.5%; p < .001). SCI severity was also higher in two cancer cohorts than noncancer controls (p < .001). The two cancer cohorts were similar to each other in severity and prevalence of SCI. The two cancer cohorts experienced higher fatigue, stress, and sleep disturbance than healthy controls. After controlling for psychoneurological factors, however, the two cancer cohorts did not differ from healthy controls in experiencing SCI in prevalence and severity. Psychoneurological factors may be a major determinant of the higher prevalence and severity of SCI in cancer patients.

Surgical rectus sheath block combined with multimodal pain management reduces postoperative pain and analgesic requirement after single-incision laparoscopic appendectomy: a retrospective study.

PURPOSE: This study aimed to evaluate the impact of multimodal postoperative pain management, performing a surgical rectus sheath (RS) block via ropivacaine injection into the surgical field after single-incision laparoscopic appendectomy (SILA). METHODS: Patients who underwent single-incision laparoscopic appendectomy (SILA) for acute appendicitis were divided into three groups and compared: group 1 (multimodal pain management that included intraoperative application of a surgical RS block), group 2 (conventional pain management with intravenous opioids), or group 3 (multimodal pain management without RS block). Forty, 53, and 42 patients were registered, respectively (Table 1). RESULTS: Time to start a liquid (1.2 ± 0.4 h) in group 1 was statistically significantly shorter than that in group 2 (16.3 ± 8.4 h; p < 0.001) and group 3 (4.93 ± 2.3 h; p < 0.001). The median and max postoperative VAS scores in group 1 (1.6 ± 1.2 and 2.2 ± 1.8, respectively) were statistically significantly lower than that in group 2 (3.0 ± 1.2 and 4.2 ± 1.9, respectively; p < 0.001 on both accounts) and group 3 (2.9 ± 0.6 and 3.4 ± 1.2, respectively; p < 0.001 on both accounts). The postoperative hospital stay for group 1 (17.0 ± 9.4 h) was shorter than that for group 2 (44.7 ± 27.9 h; p < 0.001) and group 3 (35.4 ± 20.9 h; p < 0.001). RS block was a significant factor for reducing length of hospital stay and postoperative pain in 24 h. CONCLUSIONS: A surgical RS block combined with multimodal pain management after SILA is a safe and effective method that results in reduced postoperative pain and shorter hospitalization.