Artificial Neural Networks as a Way to Predict Future Kidney Cancer Incidence in the United States

IntroductionThe incidence of kidney cancer is increasing; it could be counteracted with new ways to predict and detect it. We aimed to implement an artificial neural network in order to predict new cases of renal-cell carcinoma (RCC) in the population using population rate, obesity, smoking incidence, uncontrolled hypertension, and life expectancy data in the United States.Patients and MethodsStatistics were collected on US population numbers, life expectancy, obesity, smoking, and hypertension. We used MATLAB R2018 (MathWorks) software to implement an artificial neural network. Data were repeatedly and randomly divided into training (70%) and validation (30%) subsets.ResultsThe number of new RCC cases will grow from 44,400 (2020) to 55,400 (2050), an increase of +24.7%. Our data show that preventing hypertension would have the greatest impact on reduction of the incidence, estimated at ?775 and ?575 cases per year in 2020 and in 2030, respectively. The prevention of obesity and smoking would have a more limited impact, estimated at ?64 and ?180 cases per year in 2020 and in 2030, respectively, for obesity, and ?173 and ?21 cases per year in 2020 and in 2030, respectively, for smoking.ConclusionsOur predictions underline the need for accurate studies on RCC-related risk factors to reduce the incidence.     

Locoregional therapy and systemic cetuximab to treat colorectal liver metastases

AIM: To investigate efficacy and safety of second-line treatment with irinotecan-loaded drug-eluting beads (DEBIRI) and cetuximab (DEBIRITUX) of unresectable colorectal liver metastases.METHODS: Patients with the following characteristics were included in the study: unresectable hepatic metastases from colorectal carcinoma (CRC-LM), progression after first line chemotherapy (any type of chemotherapeutic drug and combination was allowed), second line treatment (mandatory), which included for each patient (unregarding the KRas status) two cycles of DEBIRI (using 100-300 μm beads loaded with irinotecan at a total dose 200 mg) followed by 12 cycles of cetuximab that was administered weekly at a first dose of 400 mg/m² and then 250 mg/m²; good performance status (0-2) and liver functionality (alanine aminotransferase and gamma-glutamyl transferase not exceeding three times the upper limit of normal, total bilirubin not exceeding 2.5 mg/mL). Data were collected retrospectively and included: tumor response (evaluated monthly for 6 mo then every 3 mo), overall response rate (ORR), KRas status, type and intensity of adverse events (G according to the Common Terminology Criteria for Adverse Events v3.0, CTCAE), overall survival (OS) and progression free survival (PFS).RESULTS: Forty consecutive cases of CRC hepatic metastases were included in the study. Median duration of DEBIRITUX was 4.4 mo (range, 4.0-6.5). Sixteen patients (40%) received the planned 2 cycles of DEBIRI and an average of 10 cetuximab cycles. ORR of the whole sample was 50%, in particular 4 patients were complete responders (10%) and 16 (40%) partial responders. The most observed side effects (G2) were: post-embolization syndrome (30%), diarrhea (25%), skin rushes (38%) and asthenia (35%). The retrospective evaluation of KRas status (24 wild type, 16 mutated) showed that the group of patients with wild type KRas had ORR significantly higher than mutant KRas. Median follow-up was 29 mo (8-48 range); median PFS was 9.8 mo and OS was 20.4 mo. Future randomized trials are required in this setting to establish a role for DEBIRITUX compared with systemic chemotherapy.CONCLUSION: DEBIRITUX seems to be efficacious after first line chemotherapy for the treatment of unresectable CRC-LM.     

Multimodal imaging for a theranostic approach in a murine model of B-cell lymphoma with engineered nanoparticles

Nanoparticles (NPs) are a promising tool for in vivo multimodality imaging and theranostic applications. Hyaluronic acid (HA)-based NPs have numerous active groups that make them ideal as tumor-targeted carriers. The B-lymphoma neoplastic cells express on their surfaces a clone-specific immunoglobulin receptor (Ig-BCR). The peptide A20-36 (pA20-36) selectively binds to the Ig-BCR of A20 lymphoma cells. In this work, we demonstrated the ability of core-shell chitosan-HA-NPs decorated with pA20-36 to specifically target A20 cells and reduce the tumor burden in a murine xenograft model. We monitored tumor growth using high-frequency ultrasonography and demonstrated targeting specificity and kinetics of the NPs via in vivo fluorescent reflectance imaging. This result was also confirmed by ex vivo magnetic resonance imaging and confocal microscopy. In conclusion, we demonstrated the ability of NPs loaded with fluorescent and paramagnetic tracers to act as multimodal imaging contrast agents and hence as a non-toxic, highly specific theranostic system.     

Capacity of coronal dentin to increase fiberglass post retention: a pull-out test

PURPOSE: To evaluate the capacity of residual dentin in the coronal part of the root canal to increase the retention of serrated fiberglass posts (Extra-glass P-6%). METHODS: 40 freshly-extracted maxillary central incisors were randomly and evenly divided into four test groups (TGs) with no (TG0), one (TG1), two (TG2) and three (TG3) coronal walls, respectively. After shaping, the canals were filled with gutta-percha and prepared to receive fiberglass posts. Coronal wall dentin was etched with 38% phosphoric acid for 60 seconds, rinsed, and dried. Dentin bonding agent (Prime & Bond NT) was applied, and fiberglass posts were luted for 8 mm into the post space using a self-cure composite (ResiLute). All samples were then subjected to tensile forces in a universal testing machine. Data were analyzed with ANOVA and Student t-tests (P< 0.01). RESULTS: The samples with residual coronal dentin showed higher bond strength than the samples without residual crown walls (TG0=100.30N; TG1=201.83N; TG2=263.54N; TG3=278.86N). The differences between the groups were all statistically significant at P< 0.01, except for the difference in tensile strength between TG2 and TG3, which was not statistically significant. Residual crown walls significantly increased the tensile load required to displace the posts.     

Rational basis for the use of a new clinical procedure in immediately loaded implant rehabilitations: a case report

This report presents a new clinical protocol that facilitates the diagnostic, surgical, and prosthetic phases of immediately loaded implant rehabilitations. The proposed technique aims to simplify recording of the centric relation, which is usually done immediately after surgery, during the surgical impression phase. This shortens operative time while meeting requirements for an accurate impression and is thus simple and cost effective. The case report of a maxillary full-arch immediately loaded implant rehabilitation in a 45-year-old patient illustrates the clinical steps in the proposed procedure and confirms its repeatability.     

Effect of application technique of luting agent on the retention of three types of fiber-reinforced post systems

The aim of this study was to evaluate retentive strengths of three adhesive/resin cement/fiber post systems to the apical third of post-space dentin varying the application method of the luting agent. ENA post (Micerium, Avegno, Genova, Italy), FRC Postec Plus (Ivoclar Vivadent, Schaan, Liechtenstein), and Anatomical Post (Dentalica, Milano, Italy) were luted in prepared root canals using the adhesive system and resin cement provided by the respective manufacturer. Each group was randomly divided into three subgroups (n = 10) according to the technique used to place the luting agent into post space: using a lentulo spiral, applying the cement onto the post surface, and injecting the material with a specific syringe. A push-out test was performed on sections from the post-space apical part of each specimen. All fractured specimens were observed using a stereomicroscope. Bond strength values were not significantly affected by the application technique of the luting agent (p > 0.05). The ENA post system showed the highest retentive strengths. The other two post groups exhibited similar bond strengths to each other. Microscopic analysis revealed a prevalence of post/cement and mixed failures.     

Comparative analysis of low-level laser therapy (660 nm) on inflammatory biomarker expression during the skin wound-repair process in young and aged rats

The wound-healing process plays an essential role in the protective response to epidermal injury by tissue regeneration. In the elderly, skin functions deteriorate as a consequence of morphological and structural changes. This study aimed to evaluate and compare the effect of low-level laser therapy (LLLT) in cutaneous wound healing in young and aged rats. A total of 60 male rats comprising 30 young (±30 days) and 30 aged (±500 days) was used. The animals were divided into four experimental groups and underwent skin wound and/or treatment with LLLT (660 nm, 30 mW, 1.07 W/cm², 0.028 cm², 72 J/cm², and 2 J). Analyses were conducted to verify the effects of LLLT in the tissue repair process, in the gene expression, and protein expression of TNF-α, IL-1β, and IL-10, obtained in skin wound model. Results showed that there were significant differences between the young control group and the aged control group and their respective treated groups (LLLT young and LLLT aged). We conclude that LLLT has shown to be effective in the treatment of skin wounds in young and aged animals at different stages of the tissue repair process, which suggests that different LLLT dosimetry should be considered in treatment of subjects of different ages. Further clinical trials are needed to confirm these findings in clinical settings.