Pancreatic ductal adenocarcinoma (PDAC) has a five-year survival rate of less than 10% due to its late diagnosis, rapid metastasis, and chemotherapeutic resistance. For a small proportion (10–20%) of early-stage patients however, surgical resection of the pancreatic tumor offers the best chance for survival but the effect of surgery on disease dissemination is unknown. The primary objective of this study was to characterize cellular and acellular blood-based analytes in portal and peripheral blood before pancreatic manipulation, during tumor dissection and immediately after surgical resection to determine the effects of the surgery. This study used the non-enriching third generation High-Definition Single Cell Assay (HDSCA3.0) workflow to investigate heterogeneous circulating rare cell population in the blood. Blood from both sites taken before surgical manipulation of the pancreas had significantly greater incidence of total rare cellular and acellular analytes than normal donor samples. Post-surgery portal and peripheral blood had significantly greater incidence of specific cellular and acellular subtypes compared to the matched pre- and during-surgery samples. Our results reveal that in patients with PDAC liquid biopsy analytes are increased in both the portal and peripheral blood; portal blood contains a higher frequency of analytes than in the peripheral blood; total analytes in the portal and peripheral blood samples were significantly associated with the tumor volume and pathological T stage; and the surgical procedure increased the blood levels of circulating cellular and acellular analytes, but not Epi.CTCs or Mes.CTCs. This study demonstrates liquid biopsy’s utility in monitoring patients with PDAC with surgically resectable disease.
Background: Cochlear implants (CIs) serve diverse populations with hearing loss, but patients with single-sided deafness (SSD) often show lower post-implantation usage and satisfaction than bilateral CI users. This disparity may stem from their normal contralateral ear providing sufficient auditory input for many daily situations, reducing the perceived need for consistent CI use. Consequently, uniform screening and evaluations, typically designed for bilateral hearing loss, often fail to address SSD’s unique needs. Methods: This narrative review synthesizes the current literature to explore patient and device factors shaping CI integration, outcomes, and experience in SSD. It highlights implications for developing personalized care strategies distinct from those used in bilateral hearing loss. Results: SSD patients face unique challenges: reliance on compensatory behaviors and significant auditory processing difficulties like acoustic–electric mismatch and place–pitch discrepancy. Anatomical factors and deafness of duration also impact outcomes. Traditional measures are often insufficient due to ceiling effects. Music perception offers a sensitive metric and rehabilitation tool, while big data and machine learning show promise for predicting outcomes and tailoring interventions. Conclusions: Optimizing CI care for SSD necessitates a personalized approach across candidacy, counseling, and rehabilitation. Tailored strategies, including individualized frequency mapping, adaptive auditory training, advanced outcome metrics like music perception, and leveraging big data for precise, data-driven predictions, are crucial for improving consistent CI usage and overall patient satisfaction.