Degnvind2923

Type 2 diabetes mellitus (T2DM) affects males and females disproportionately. In midlife, more males have T2DM than females. The sex difference in T2DM prevalence is, in part, explained by differences in regional adipose tissue characteristics. With obesity, changes to regional adipokine and cytokine release increases the risk of T2DM in both males and females with males having greater levels of TNFα and females having greater levels of leptin, CRP, and adiponectin. Regional immune cell infiltration appears to be pathogenic in both sexes via different routes as males with obesity have greater VAT ATM and a decrease in the protective Treg cells, whereas females have greater SAT ATM and T cells. Lastly, the ability of female adipose tissue to expand all regions through hyperplasia, rather than hypertrophy, protects them against the development of large insulin-resistant adipocytes that dominate male adipose tissue. The objective of this review is to discuss how sex may affect regional differences in adipose tissue characteristics and how these differences may distinguish the development of T2DM in males and females. In doing so, we will show that the origins of T2DM development differ between males and females.Site-selective N-1 and C-3 arylation of indole has been sought after because of the prevalent application of arylindoles and the intricate reactivities associated with the multiple sites of the N-unsubstituted indole. Represented herein is the first regioselective heteroarylation of indole via a radical-radical cross-coupling by visible-light irradiation. Steady and time-resolved spectroscopic and computational studies revealed that the hydrogen-bonding interaction of organic base and its conjugated acid, namely with indole and heteroarylnitrile, determined the reaction pathway, which underwent either proton-coupled electron-transfer or energy-transfer for the subsequent radical-radical cross-coupling, leading to the regioselective formation of C-3 and N-1 heteroarylation of indoles, respectively. The parallel methodologies for regioisomeric N-1 and C-3 heteroaryl indoles with good functional group compatibility could be applied to large-scale synthesis and late-stage derivatization of bioactive compounds under extremely mild reaction conditions.

Total body irradiation (TBI) is an integral part of stem cell transplant. However, patients are at risk of treatment-related toxicities, including radiation pneumonitis. While lung dose is one of the most crucial aspects of TBI dosimetry, currently available data are based on point doses. As volumetric dose distribution could be substantially altered by lung block parameters, we used 3D dosimetry in our treatment planning system to estimate volumetric lung dose and measure the impact of various lung block designs.

We commissioned a TBI beam model in RayStation that matches the measured tissue-phantom ratio under our clinical TBI setup. Cerrobend blocks were automatically generated in RayStation on thoracic Computed Tomography (CT) scans from three anonymized patients using the lung, clavicle, spine, and diaphragmatic contours. The margin for block edge was varied to 0, 1, or 2cm from the superior, lateral, and inferior thoracic borders, with a uniform margin 2.5cm lateral to the vertebral bodies. The lungferent from the nominal dose assumed with HVL lung blocks. Point doses under the block are insufficient to accurately gauge the relationship between dose and pneumonitis, and TBI dosimetry could be highly variable between patients and institutions as more descriptive parameters are not included in protocols. Much progress remains to be made to optimize and standardize technical aspects of TBI, and better dosimetry could provide more precise dosimetric predictors for pneumonitis risk.

To evaluate a feasibility of normal distribution transform (NDT) algorithm compared with the iterative closest point (ICP) method as a useful surface registration in stereotactic body radiotherapy (SBRT)/stereotactic radiosurgery (SRS).

Point cloud images using the 3D triangulation technology were obtained from a depth camera-based optical imaging (OSI) system equipped in a radiosurgery room. Two surface registration algorithms, NDT and ICP, were used to measure and compare the discrepancy values between the reference and the current surfaces during the positioning of the patient. The performance evaluation was investigated by calculating the registration error and root-mean-square (RMS) values for the surface model, reposition, and target accuracy, which were analyzed statistically using a paired t-test.

For surface model accuracy, the average of the registration error and RMS values were measured as 3.56 ± 2.20mm and 6.98 ± 1.89mm for ICP method, and 1.76 ± 1.32mm and 3.58 ± 1.30mm for NDT method (p<0.05). For reposition accuracy, the average registration error and RMS values were calculated as 1.41 ± 0.98mm and 2.53 ± 1.64mm using ICP method, and 0.92 ± 0.61mm and 1.75 ± 0.80mm using NDT method (p=0.005). The overall target accuracy using the NDT method reduced the average of the reposition error and overall RMS value by 0.71 and 1.32mm, respectively, compared to the ICP method (p=0.03).

We found that the surface registration algorithm based on NDT method provides more reliable accuracy in the values of surface model, reposition, and target accuracies than the classic ICP method. The NDT method in OSI systems offers reasonable accuracy in SBRT/SRS.

We found that the surface registration algorithm based on NDT method provides more reliable accuracy in the values of surface model, reposition, and target accuracies than the classic ICP method. The NDT method in OSI systems offers reasonable accuracy in SBRT/SRS.

Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are increasingly being considered as first-line treatment for type 2 diabetes (T2D). The benefits of SGLT-2i from cardiovascular outcome trials may lead to preferential prescribing of SGLT-2i to patients at high cardiovascular risk, possibly causing confounding in non-randomized studies of SGLT-2i as first-line treatment. We assessed evolving imbalances in characteristics of patients starting SGLT-2i versus metformin as first-line monotherapy.

Using claims data from two US commercial health insurance and Medicare, we identified patients with T2D aged ≥18 years (>65 years in Medicare) initiating first-line SGLT-2i or metformin from 2013 through 2019. Standardized differences (SDs) for patient characteristics were assessed during four consecutive calendar time blocks (T14/2013-12/2014; T21/2015-6/2016; T37/2016-12/2017; and T41/2018-12/2019). We also estimated the propensity score of receiving SGLT-2i versus metformin within each time block and evaluate cardiovascular risk. Evolving channeling in prescribing first-line SGLT-2i should be expected and accounted for in non-randomized comparative effectiveness research.

Medical distrust is both a psychosocial construct and an underappreciated individual social determinant of health with the potential to affect oncology care and clinical trial participation. A community-based participatory research effort, called the Forward Movement Project (FMP), identified multilevel factors affecting trust for healthcare and research in an underserved urban community. In FMP Phase II, we implemented a community-responsive approach to provide lay-oriented education and address misinformation, with the goal of beginning to remediate distrust for healthcare systems and biomedical research.

Community residents (N=154 adults, 64% male, M=61.5years old, 53% annual income <$10,000, 83% African American/Black) engaged in participant-driven dialogues with oncology clinicians/clinical researchers and support services professionals. A program evaluation focused on trust for healthcare and biomedical research.

Participants reported positive evaluations of both the program and the cancer center clinicians and staff, who were rated as trustworthy (80% strong agreement). However, trust for healthcare systems ("Strongly agree"=58%) and medical researchers ("Strongly agree"=50%) following the program was moderate. Over half of the sample (52%) strongly agreed they would participate in a clinical trial compared to before joining this study.

Findings supported the user-generated program approach. The FMP is an example of a model for true community engaged research and has implications for rebuilding trust in healthcare and research.

Findings supported the user-generated program approach. The FMP is an example of a model for true community engaged research and has implications for rebuilding trust in healthcare and research.

Direct support professionals (DSP) are instrumental in supporting the health care of individuals with intellectual disabilities, yet receive little training and support for this role. We implemented a capacity building intervention for DSPs in a community agency in Ontario, Canada. This study evaluated the perceived value and feasibility of the intervention and the value of a structured implementation approach.

The intervention included communication tools, a health resource toolkit, and training. A mixed methods evaluation was used to collect feedback from DSPs and people with intellectual disabilities.

Participants generally found the intervention valuable and feasible. Although practice change is difficult, extensive engagement and being responsive to feedback were helpful strategies. PPI-0903 The primary concern reported by DSPs was resistance from health care providers.

An important next step is to engage health care providers to ensure the tools are valuable and feasible for everyone involved in the health encounter.

An important next step is to engage health care providers to ensure the tools are valuable and feasible for everyone involved in the health encounter.

Post-acne erythema is described as erythema due to release of inflammatory cytokines, dilatation of microcapillaries within papillary dermis and thinning of epidermis. The erythema usually fades; however, it can persist for months.

In this review, we decided to evaluate efficacy of light and laser treatments in acne-induced erythema.

We searched PUBMED, Embase, Cochrane, and Google Scholar for relevant key words. Inclusion criteria were randomized clinical trials (RCTs) that evaluated efficacy of laser or light in PAE until September 2021.

Twelve RCTs were selected for the final assessment. Light and laser treatments included pulsed dye laser (PDL), intense pulsed light (IPL), Q-switched neodymium-doped yttrium aluminum garnet (QS NdYAG), fractional photothermolysis, alexandrite, solid-slate 589-1319nm, and pro-yellow laser.

Light and laser treatments are effective treatment modalities in reduction of acne-induced erythema along with active acne lesions and atrophic acne scars.

Light and laser treatments are effective treatment modalities in reduction of acne-induced erythema along with active acne lesions and atrophic acne scars.Obesity is a critical risk factor for the development of metabolic diseases, and its prevalence is increasing worldwide. Stem cell-based therapies have become a promising tool for therapeutic intervention. Among them are adipose-derived mesenchymal stem cells (ADMSCs), secreting numerous bioactive molecules, like growth factors, cytokines, and chemokines. Their unique features, including immunosuppressive and immunomodulatory properties, make them an ideal candidates for clinical applications. Numerous experimental studies have shown that ADMSCs can improve pancreatic islet cell viability and function, ameliorate hyperglycemia, improve insulin sensitivity, restore liver function, counteract dyslipidemia, lower pro-inflammatory cytokines, and reduce oxidative stress in the animal models. These results prompted scientists to use ADMSCs clinically. However, up to date, there have been few clinical studies or ongoing trails using ADMSCs to treat metabolic disorders such as type 2 diabetes mellitus (T2DM) or liver cirrhosis.