Predictive Factors for Chemoradiation-Induced Oral Mucositis and Dysphagia in Head and Neck Cancer: A Scoping Review.

Despite advances in head and neck cancer treatment, virtually all patients experience chemoradiation-induced toxicities. Oral mucositis (OM) and dysphagia are among the most prevalent and have a systemic impact on patients, hampering treatment outcome and harming quality of life. Accurate prediction of severe cases is crucial for improving management strategies and, ultimately, patient outcomes. This scoping review comprehensively maps the reported predictors and critically evaluates the performance, methodology, and reporting of predictive models for these conditions. A total of 174 studies were identified from database searches, with 73 reporting OM predictors, 97 reporting dysphagia predictors, and 4 reporting both OM and dysphagia predictors. These predictors included patient demographics, tumor classification, chemoradiotherapy regimen, radiation dose to organs-at-risk, genetic factors, and results of clinical laboratory tests. Notably, many studies only conducted univariate analysis or focused exclusively on certain predictor types. Among the included studies, numerous predictive models were reported: eight for acute OM, five for acute dysphagia, and nine for late dysphagia. The area under the receiver operating characteristic curve (AUC) ranged between 0.65 and 0.81, 0.60 and 0.82, and 0.70 and 0.85 for acute oral mucositis, acute dysphagia, and late dysphagia predictive models, respectively. Several areas for improvement were identified, including the need for external validation with sufficiently large sample sizes, further standardization of predictor and outcome definitions, and more comprehensive reporting to facilitate reproducibility.

Functionalized AIE nanoparticles with efficient deep-red emission, mitochondrial specificity, cancer cell selectivity and multiphoton susceptibility.

Multiphoton microscopy is an exciting tool for biomedical research because it can be used to image single cells in vivo due to its greater penetration depth, lower phototoxicity and higher resolution when compared to confocal laser scanning microscopy. This helps researchers understand how certain cells change over time and evaluate the efficacy of different therapies. Herein, we report a new AIE luminogen (AIEgen), abbreviated as TPE-TETRAD, with a favorable absorption and efficient deep-red emission in the solid state. TPE-TETRAD possesses a high two-photon absorption cross-section (313 MG at 830 nm) and a rich array of non-linear optical properties including aggregation-induced three-photon luminescence. Biotinylated TPE-TETRAD nanoparticles are also fabricated and applied to stain mitochondria in live cancer cells with high specificity. The purpose of this study is to characterize a novel deep-red AIEgen and fabricate biotinylated nanoparticles for applications as (1) biocompatible and photostable AIE probes for specific mitochondria imaging and (2) multiphoton imaging probes suitable for two/three-photon fluorescence microscopy.

Ultrafast Delivery of Aggregation-Induced Emission Nanoparticles and Pure Organic Phosphorescent Nanocrystals by Saponin Encapsulation.

Saponins are a class of naturally occurring bioactive and biocompatible amphiphilic glycosides produced by plants. Some saponins, such as α-hederin, exhibit unique cell membrane interactions. At concentrations above their critical micelle concentration, they will interact and aggregate with membrane cholesterol to form transient pores in the cell membrane. In this project, we utilized the unique permeabilization and amphiphilic properties of saponins for the intracellular delivery of deep-red-emitting aggregation-induced emission nanoparticles (AIE NPs) and pure organic room-temperature phosphorescent nanocrystals (NCs). We found this method to be biocompatible, inexpensive, ultrafast, and applicable to deliver a wide variety of AIE NPs and NCs into cancer cells.

Uptake, Distribution, and Bioimaging Applications of Aggregation-Induced Emission Saponin Nanoparticles in Arabidopsis thaliana.

The application of aggregation-induced emission luminogens (AIEgens) has heralded a new age in the analysis of subcellular events and has overcome many of the limitations of conventional fluorescent probes. Despite the extensive literature investigating AIEgens in mammalian cells, few reports exist of their bioimaging applications in plant cells. In this report, we describe the first systematic investigation of the uptake, distribution, and bioimaging applications of AIEgens and AIE saponin nanoparticles in the plant model system Arabidopsis thaliana. We find that the superior photostability, high colocalization with fluorescent proteins, and unique tissue-specific turn-on emission properties make AIEgens well-suited to tackle the emergent challenges faced in plant bioimaging.

An assessment of hand volumetric and temperature changes during office related repetitive activities.

BACKGROUND: Hand usage and movement is routinely performed by all individuals daily irrespective of age. These movements can vary and can be repetitive in nature. Exposure of the hard and soft tissues of the hand to prolonged repetitive activities could contribute to the development of work related upper limb disorders (WRULD). OBJECTIVE: Within the work setting, work related upper limb disorders (WRULDs) rank high in the United Kingdom (UK), second only to back complaints. This paper reports the amount of tendon travel and swelling that occurs in the hand during repetitive office activities associated with WRULDs. PARTICIPANTS: Nine healthy adults (five males; four females) participated in the study. METHODS: A 30-minute laboratory-based simulated office activity that consisted of data entry, mouse clicking and dragging, and mouse scrolling tasks was performed. Participants wore a custom-made cost effective flexible electrogoniometric glove (FEG) as two experimental conditions were tested; namely, FEG - only, and FEG using a Splint (FEG - Splint). RESULTS: The FEG - only condition produced a higher overall tendon travel compared to the FEG - Splint condition. Both hands presented no statistically significant differences in hand temperature (p > 0.05) and hand volume increments (p > 0.05) with respect to the FEG - only and FEG - Splint office activity experiments. All participants that showed a decrease in hand volumetric measurement produced final temperature measurements lower than initial temperature measurements taken at the commencement of the experiment. Based on participants' perception, the mouse scrolling task was deemed as most strenuous. CONCLUSION: The findings can help to advise patients on biomechanical 'risks' associated with repetitive activities.

The functional demand (FD) placed on the knee and hip of older adults during everyday activities.

Age-related decline in physical capacity and diminishing physiological reserves may increase the demand placed on lower extremity joints during everyday activities. This study aimed to characterize the FD at the knee and hip joints of older adults during various mobility activities. Eighty-four healthy participants (60-88 years) performed strength tests using a custom-built dynamometer. Biomechanical assessment of gait, chair rise (CR) and sit-down (CSt), stair ascent (SA) and descent (SD) was performed using an 8-camera VICON system (120Hz) and Kistler force plates. Comparisons between groups (60s, 70s and 80s) were made using ANOVA. The FD was defined as the muscle moment generated during a task, divided by the maximum isometric strength (expressed as a percentage). FD was higher in the 80s age group compared to those in the 60s. The demand on hip and knee extensors was normally higher than those of flexors across all the activities. The knee extensor demand during gait (101%), SA (103%) and SD (120%), and hip extensor demand during gait (127%) were high requiring moments in excess of the maximum isometric muscle strength available at these joints. FD during CR and CSt was comparatively lower with knee extensor demands of 73% and 69% and hip extensor demands of 88% and 51%, respectively. Gait, SA and SD placed high demands on the knee extensors while hip extensor demand was high for gait, CR, CSt and SA. The levels of demand leave little reserve capacity for the older adult to draw on in unexpected circumstances.

Objective assessment of surgical training in flexor tendon repair: the utility of a low-cost porcine model as demonstrated by a single-subject research design.

OBJECTIVES: This study evaluated the utility of a porcine flexor tendon model and standard biomechanical testing procedures to quantify the acquisition of surgical skills associated with Zone II flexor tendon repair in a trainee by benchmarking task performance outcomes relative to evidence-based standards. STUDY DESIGN: Single-subject repeated measures research design. Bench-top set-up of apparatus undertaken in a University Research laboratory. After initial directed learning, a trainee repaired 70 fresh flexor digitorum profundus tendons within the flexor sheath using either a Pennington or ventral-locking-loop modification of a two-strand Kessler core repair. Tendon repairs were then preconditioned and distracted to failure. Key biomechanical parameters of the repair, including the ultimate tensile strength (UTS), yield strength, 3 mm gap force and stiffness, were calculated. Repairs were divided into 3 categories, early (first 10 days), intermediate (ensuing 10 days), and late repairs (final 10 days), and potential changes in repair properties over the training period were evaluated using a general linear modeling approach. RESULTS: There was a significant change in the mechanical characteristics of the repairs over the training period, evidencing a clear learning effect (p < 0.05). Irrespective of the repair technique employed, early and intermediate repairs were characterized by a significantly lower UTS (29% and 20%, respectively), 3 mm gap (21% and 16%, respectively), and yield force (18% and 23%, respectively), but had a higher stiffness (33% and 38%, respectively) than late repairs (p < 0.05). The UTS of late repairs (47-48 N) were comparable to those published within the literature (45-51 N), suggesting surgical competence of the trainee. CONCLUSIONS: This simple, low-cost porcine model appears to be useful for providing preclinical training in flexor tendon repair techniques and has the potential to provide a quantitative index to evaluate the competency of surgical trainees. Further research is now required to identify optimal training parameters for flexor tendon repair and to develop procedure-specific standards for adequate benchmarking.

A wrist tendon travel assessment of hand movements associated with industrial repetitive activities.

OBJECTIVE: To investigate slow and fast paced industrial activity hand repetitive movements associated with carpal tunnel syndrome where movements are evaluated based on finger and wrist tendon travel measurements. METHODS: Nine healthy subjects were recruited for the study aged between 23 and 33 years. Participants mimicked an industrial repetitive task by performing the following activities: wrist flexion and extension task, palm open and close task; and pinch task. Each task was performed for a period of 5 minutes at a slow (0.33 Hz) and fast (1 Hz) pace for a duration of 3 minutes and 2 minutes respectively. RESULTS: Tendon displacement produced higher flexor digitorum superficialis (FDS) tendon travel when compared to the flexor digitorum profundus (FDP) tendons. The left hand mean (SD) tendon travel for the FDS tendon and FDP tendon were 11108 (5188) mm and 9244 (4328) mm while the right hand mean tendon travel (SD) for the FDS tendon and FDP tendon were 9225 (3441) mm and 7670 (2856) mm respectively. Of the three tasks mimicking an industrial repetitive activity, the wrist flexion and extension task produced the most tendon travel. CONCLUSION: The findings may be useful to researchers in classifying the level of strenuous activity in relation to tendon travel.

The relationships between muscle strength, biomechanical functional moments and health-related quality of life in non-elite older adults.

OBJECTIVE: to investigate the association between muscle strength, biomechanical functional moments during everyday tasks and health-related quality of life (HRQoL) in older adults. METHODS: eighty-four healthy adults aged 60-88 years were tested. A torque dynamometer was utilised to measure muscle moments at the knee and hip joints. Functional assessment involved three-dimensional biomechanical analysis of gait, chair rise and sit-down, stair ascent and descent using an 8-camera VICON® system with Kistler force plates. HRQoL was assessed using the Short Form-36 (SF-36) questionnaire. RESULTS: Spearman's correlation coefficient showed significant correlation (P < 0.001) between isometric strength and functional moments (r = 0.24-0.67). Muscle strength was significantly correlated with SF-36 scores, including physical functioning, bodily pain, vitality, social functioning and role emotional scores. Knee flexion moment was correlated with role physical, vitality, social functioning, role emotional, mental health and mental component scores (r = 0.24-0.40). CONCLUSION: loss of muscle strength is associated with poorer functional ability and both are associated with reduced HRQoL. The reduction in HRQoL is considerable in the physical functioning domain. Cause and effect was not established but studies need to be undertaken to evaluate the benefits of strength training, functional activity training or increased participation in life.

The biomechanical functional demand placed on knee and hip muscles of older adults during stair ascent and descent.

Age-related decline in physical capabilities may lead to older adults experiencing difficulty in performing everyday activities due to high demands placed on the muscles of their lower extremity. This study aimed to determine the biomechanical functional demand in terms of joint moments and maximal muscle capabilities at the knee and hip joints while older adults performed stair ascent (SA) and stair descent (SD). Eighty-four healthy older adults aged 60-88 years were tested. A torque dynamometer attached to a purpose-built plinth was utilized to measure muscle moments at the knee and hip joints. Participants also underwent full body 3-D biomechanical assessment of stair ascent and descent using an 8-camera VICON system (120Hz) with 3 Kistler force plates. Stair negotiation required knee extensor moments in excess of the maximum isometric muscle strength available (SA 103%, SD 120%). For the hip, the levels of demand were high, but were slightly lower than those of the knee joint. Stair negotiation placed a high level of demand on the knee extensors with demand in SA reaching maximal isometric capacity and demand in SD exceeding maximal isometric capacity. The levels of demand leave little reserve capacity for the older adult to draw on in unexpected situations or circumstances.

A comparison of two interventions designed to promote neutral wrist postures during simple computer operations.

OBJECTIVE: To compare two postural interventions, a wrist splint and a Wrist Alignment Device (WAD) with a biofeedback mechanism. PARTICIPANTS: Nine right-handed healthy individuals participated in the study. METHODS: Using both hands independently a 30-minute office-activity-experiment was performed that consisted of data entry, mouse clicking, text dragging, and mouse scrolling executed one after the other. Joint motion, tendon travel and productivity levels were measured. Participants wore a custom-made flexible electrogoniometric glove (FEG) as three scenarios were tested; namely FEG-only, FEG-Splint, and FEG-WAD. Data analysis was performed using descriptive statistics and ANOVA. RESULTS: The joint motion results produced insignificant differences (p>0.05) between hands. Both hands showed larger overall tendon travel for the FEG-only when compared with either FEG-Splint or FEG-WAD experiments. Wearing the splint reduced the overall tendon travel by 24% and 10% for the left and right hands while using the WAD further reduced the overall tendon travel for the left and right hands by 51% and 42%. Productivity levels were similar across participants with respect to experiment task and type. CONCLUSION: The WAD intervention is the most suitable device to promote a comfortable and non-restrictive neutral wrist posture.