bluuebunny/crossref_metadata_2025 huggingface dataset:
Expression of Immunity- and Stress-Related Genes during an Intermolt Period in the Colorado Potato Beetle
Authors: Kryukov Vadim Yu. , Rotskaya Ulyana N. , Yaroslavtseva Olga N. , Noskov Yury A. , Glupov Viktor V.
Published: December 2022

Different developmental stages of insects may be dissimilar in immunity functioning. Additionally, the stages often inhabit diverse environments with specific microbial communities. In the Colorado potato beetle, a strong increase in resistance to entomopathogenic fungi is observed during the intermolt period of last-instar larvae, but mechanisms of this change are insufficiently understood. We studied changes in the expression of immunity- and stress-related genes in the fat body and integument during this intermolt period by quantitative PCR. By the end of the instar, there was upregulation of transcription factors of Toll, IMD, and Jak–Stat pathways as well as genes encoding metalloprotease inhibitors, odorant-binding proteins, and heat shock proteins. Nonetheless, the expression of gene LdRBLk encoding β-lectin did not change during this period. Most of the aforementioned genes were upregulated in response to Metarhizium robertsii topical infection. The expression alterations were more pronounced in recently molted larvae than in finishing feeding larvae and in the integument compared to the fat body. We believe that upregulation of immune-system- and stress-related genes at the end of the intermolt period is an adaptation caused by migration of larvae into soil, where the probability of encountering entomopathogenic fungi is high.
In Silico and In Vivo Evaluation of Synthesized SCP-2 Inhibiting Compounds on Life Table Parameters of Helicoverpa armigera (Hübner)
Authors: Saeed Qamar , Ahmad Faheem , Yousaf Numan , Ali Haider , Tirmazi Syed Azhar Ali Shah , Alshammari Abdulrahman , Kausar Naeema , Ahmed Mahmood , Imran Muhammad , Jamshed Muhammad , Alharbi Metab , Muddassar Muhammad
Published: December 2022

For environment-friendly, safe and nonpersistent chemical control of a significant polyphagous insect pest, Helicoverpa armigera, discovery of growth-regulating xenobiotics can offer a sustainable alternative to conventional insecticides. For this purpose, chemically synthesized compounds to inhibit sterol carrier protein (SCP-2) function using in silico and in vivo assays were evaluated to estimate their impact on the survivals and lifetable indices of H. armigera. From nine chemically synthesized compounds, OA-02, OA-06 and OA-09 were selected for this study based on binding poses mimicking cholesterol, a natural substrate of sterol carrier protein and molecular dynamics simulations. In vivo bioassays revealed that all compounds significantly reduced the larval and pupal weight accumulations and stadia lengths. Subsequently, the pupal periods were prolonged upon treatment with higher doses of the selected compounds. Moreover, OA-09 significantly reduced pupation and adult emergence rates as well as the fertility of female moths; however, fecundity remained unaffected, in general. The life table parameters of H. armigera were significantly reduced when treated with OA-09 at higher doses. The population treated with 450 μM of OA-09 had the least net reproductive rates (Ro) and gross reproductive rate (GRR) compared to the control population. The same compound resulted in a declining survival during the early stages of development coupled with reduced larval and pupal durations, and fertility. These results have a significant implication for developing an effective and sustainable chemical treatment against H. armigera infestation.
Unexpected High Species Diversity of Mesolycus Gorham (Coleoptera, Lycidae) from China, with a Preliminary Investigation on Its Phylogenetic Position Based on Multiple Genes
Authors: Liu Haoyu , Du Ruolan , Kang Ya , Ge Xueying , Yang Xingke , Yang Yuxia
Published: December 2022

The lycid genus Mesolycus Gorham, 1883 is mainly distributed in East Palaearctic and Indochinese regions, but poorly studied in China; moreover, its phylogenetic placement remains controversial but has never been rigorously tested. In this study, Mesolycus was reviewed and its placement within Lycidae was tested based on a multilocus phylogeny (cox1, nad5, cox2 and Lrna) by both ML and BI analyses. The reconstructed phylogenies show that Mesolycus is a consistently recovered sister to Dilophotes Waterhouse, 1879, and they form a monophyletic clade which is well supported. This suggests that Mesolycus definitely belongs to Dilophotini rather than to Macrolycini of Lycinae. Besides, three species originally described or placed in Dilophotes are transferred to Mesolycus, including M. atricollis (Pic, 1926) comb. n., M. particularis (Pic, 1928) comb. n. and M. pacholatkoi (Bic, 2002) comb. n. Four new species are discovered in China, including M. shaanxiensis sp. n., M. dentatus sp. n., M. breviplatus sp. n. and M. varus sp. n. Two species, M. murzini Kazantsev, 2004 and M. rubromarginatus Kazantsev, 2013, are recorded from China for the first time. A key for the identification of all Mesolycus species is provided. China was revealed as the region with the highest species diversity of this genus.
Transcriptomic Analyses Suggest the Adaptation of Bumblebees to High Altitudes
Authors: Liang Chengbo , Liu Daoxin , Song Pengfei , Zhou Yuantao , Yu Hongyan , Sun Guo , Ma Xiaoxuan , Yan Jingyan
Published: December 2022

Determining the adaptive mechanisms by which bumblebees adapt to high altitudes can help us to better understand their distribution, providing a basis for the future protection and utilization of bumblebee resources. For this study, the adaptive mechanisms of two dominant bumblebee species in the northeastern Qinghai-Tibet Plateau—Bombus kashmirensis and B. waltoni—were studied through transcriptomics methods. For each species, enrichment analysis of the differentially expressed genes and gene set enrichment analysis were carried out between samples collected at different altitudes (4000 m, 4500 m, and 5000 m). The results indicate that these bumblebees tend to up-regulate energy metabolism-related genes when facing extremely high-altitude environments. Of the enriched pathways up-regulated in higher altitudes, the pentose and glucuronate interconversions pathway presented the most severe up-regulation in multiple comparisons of different altitudes for B. kashmirensis, as well as the AMPK signaling pathway, which was found to be up-regulated in both species. Notably, limited by the extreme hypoxic conditions in this study, oxidative phosphorylation was found to be down-regulated with increasing altitude, which is uncommon in studies on bumblebee adaptation to high altitudes.
Use of a Sprayable Sex Pheromone Formulation in Landscape-Level Control of Choristoneura fumiferana Populations
Authors: Roscoe Lucas E. , MacKinnon Wayne , Régnière Jacques , Forbes Glen , Brophy Matt , Lamb Rosanna
Published: December 2022

Choristoneura fumiferana (SBW) is a major defoliating pest of balsam fir and spruce in eastern North America. As part of an integrated management strategy for SBW, we evaluated the effectiveness of mating disruption as a landscape-level population control tactic. Using a sprayable formulation (CONFOUNDSBW) containing a synthetic sex pheromone blend, we treated five 300 ha blocks in Northern New Brunswick with an aerially applied microencapsulated mixture. There were significant reductions in adult trap catches in treated blocks compared to untreated control blocks. Branch sampling in treated blocks showed uniform distribution of CONFOUNDSBW deposition throughout the blocks. Population densities following treatment were not significantly affected when compared to densities in control blocks, or prior to treatment. Analysis of egg:adult ratios indicates that no immigration events occurred within treatment or control blocks. The lack of population reduction following treatment strongly suggests that widespread application of CONFOUNDSBW at a rate of 50 g of active ingredient per hectare is not an effective tool in controlling SBW populations.
Performance Analysis of OPC UA for Industrial Interoperability towards Industry 4.0
Authors: Ladegourdie Marc , Kua Jonathan
Published: December 2022

Open Platform Communications Unified Architecture (OPC UA) incorporates a wide range of features and covers most of the requirements for a platform-independent interoperability standard which can be used to transmit data and information from the factory production floor to the enterprise and management level. Due to its highly scalable and interoperable architecture, it is well-positioned for future deployment in smart embedded devices towards Industry 4.0, especially in environments where there are heterogeneous communication nodes. In this paper, we aim to evaluate the performance of OPC UA for communication in Industrial Internet of Things (IIoT) environments to better understand the technical implementation of OPC UA and the feasibility of incorporating OPC UA directly to resource-constrained edge devices. We propose an architectural system framework for OPC UA performance evaluation across a wide range of experiments. Our experimental results demonstrated the efficacy of the proposed system and evaluation framework. The OPC UA-based IIoT system architecture and budget-friendly/cost-effective testbed setup can be flexibly adopted for protocol testing, prototyping and educational purposes.
Improved Survival after Transarterial Radioembolisation for Hepatocellular Carcinoma Gives the Procedure Added Value
Authors: Mosconi Cristina , Cappelli Alberta , Pettinato Cinzia , Cocozza Maria Adriana , Vara Giulio , Terzi Eleonora , Morelli Maria Cristina , Lodi Rizzini Elisa , Renzulli Matteo , Modestino Francesco , Serenari Matteo , Bonfiglioli Rachele , Calderoni Letizia , Tabacchi Elena , Cescon Matteo , Morganti Alessio Giuseppe , Trevisani Franco , Piscaglia Fabio , Fanti Stefano , Strigari Lidia , Cucchetti Alessandro , Golfieri Rita
Published: December 2022

Background: Transarterial Radioembolisation (TARE) requires multidisciplinary experience and skill to be effective. The aim of this study was to identify determinants of survival in patients with hepatocellular carcinoma (HCC), focusing on learning curves, technical advancements, patient selection and subsequent therapies. Methods: From 2005 to 2020, 253 patients were treated. TARE results achieved in an initial period (2005–2011) were compared to those obtained in a more recent period (2012–2020). To isolate the effect of the treatment period, differences between the two periods were balanced using “entropy balance”. Results: Of the 253 patients, 68 were treated before 2012 and 185 after 2012. In the second period, patients had an Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) score of 1 (p = 0.025) less frequently, less liver involvement (p = 0.006) and a lesser degree of vascular invasion (p = 0.019). The median overall survival (OS) of patients treated before 2012 was 11.2 months and that of patients treated beginning in 2012 was 25.7 months. After reweighting to isolate the effect of the treatment period, the median OS of patients before 2012 increased to 16 months. Conclusions: Better patient selection, refinement of technique and adoption of personalised dosimetry improved survival after TARE. Conversely, sorafenib after TARE did not impact life expectancy.
Radiosynovectomy for the Treatment of Chronic Hemophilic Synovitis: An Old Technique, but Still Very Effective
Authors: Rodriguez-Merchan Emerito Carlos , De la Corte-Rodriguez Hortensia , Alvarez-Roman Maria Teresa , Gomez-Cardero Primitivo , Jimenez-Yuste Victor
Published: December 2022

A radiosynovectomy (RS) should be indicated when recurrent articular bleeds related to chronic hemophilia synovitis (CHS) exist, established by clinical examination, and confirmed by imaging techniques that cannot be constrained with hematological prophylaxis. RS can be performed at any point in life, mainly in adolescents (>13–14 years) and adults. Intraarticular injection (IAI) of a radioactive material in children might be arduous since we need child collaboration which might include general anesthesia. RS is our initial option for management of CHS. For the knee joint we prescribe Yttrium-90, while for the elbow and ankle we prescribe Rhenium-186 (1 to 3 IAIs every 6 months). The procedure is greatly cost efficient when compared to surgical synovectomy. Chemical synovectomy with rifampicin has been reported to be efficacious, inexpensive, simple, and especially practical in developing countries where radioactive materials are not easily available. Rifampicin seems to be more efficacious when it is utilized in small joints (elbows and ankles), than when utilized in bigger ones (knees). When RS and/or chemical synovectomy fail, arthroscopic synovectomy (or open synovectomy in some cases) should be indicated. For us, surgery must be performed after the failure of 3 RSs with 6-month interims. RS is an effective and minimally invasive intervention for treatment of repeated articular bleeds due to CHS. Although it has been published that the risk of cancer does not increase, and that the amount of radioactive material used in RS is insignificant, the issue of chromosomal and/or deoxyribonucleic acid (DNA) changes remains a concern and continued surveillance is critical. As child and adulthood prophylaxis becomes more global, RS might become obsolete in the long-term.
Artificial Intelligence in Endoscopic Ultrasound for Pancreatic Cancer: Where Are We Now and What Does the Future Entail?
Authors: Dahiya Dushyant Singh , Al-Haddad Mohammad , Chandan Saurabh , Gangwani Manesh Kumar , Aziz Muhammad , Mohan Babu P. , Ramai Daryl , Canakis Andrew , Bapaye Jay , Sharma Neil
Published: December 2022

Pancreatic cancer is a highly lethal disease associated with significant morbidity and mortality. In the United States (US), the overall 5-year relative survival rate for pancreatic cancer during the 2012–2018 period was 11.5%. However, the cancer stage at diagnosis strongly influences relative survival in these patients. Per the National Cancer Institute (NCI) statistics for 2012–2018, the 5-year relative survival rate for patients with localized disease was 43.9%, while it was 3.1% for patients with distant metastasis. The poor survival rates are primarily due to the late development of clinical signs and symptoms. Hence, early diagnosis is critical in improving treatment outcomes. In recent years, artificial intelligence (AI) has gained immense popularity in gastroenterology. AI-assisted endoscopic ultrasound (EUS) models have been touted as a breakthrough in the early detection of pancreatic cancer. These models may also accurately differentiate pancreatic cancer from chronic pancreatitis and autoimmune pancreatitis, which mimics pancreatic cancer on radiological imaging. In this review, we detail the application of AI-assisted EUS models for pancreatic cancer detection. We also highlight the utility of AI-assisted EUS models in differentiating pancreatic cancer from radiological mimickers. Furthermore, we discuss the current limitations and future applications of AI technology in EUS for pancreatic cancers.
Long-Term Survival Outcomes beyond the First Year after Liver Transplantation in Pediatric Acute Liver Failure Compared with Biliary Atresia: A Large-Volume Living Donor Liver Transplantation Single-Center Study
Authors: Lee Sola , Yi Nam-Joon , Han Eui Soo , Hong Su young , Lee Jeong-Moo , Hong Suk Kyun , Choi YoungRok , Kim Hyun-Young , Youn Joong Kee , Ko Dayoung , Ko Jae Sung , Moon Jin Soo , Yang Seong Mi , Lee Kwang-Woong , Suh Kyung-Suk
Published: December 2022

Pediatric acute liver failure (PALF) is a common cause of liver transplantation (LT) but showed poor post-LT outcomes. We reviewed 36 PALF patients and 120 BA patients who underwent LT in our institution. The cause of PALF was unknown in 66.7%. PALF patients were older (6.2 vs. 2.9 years) with higher PELD scores (31.5 vs. 24.4) and shorter waitlist time (15.7 vs. 256.1 days) (p < 0.01). PALF patients showed higher rates of post-transplant renal replacement therapy (RRT) (13.9% vs. 4.2%) and hepatic artery complications (13.9% vs. 0.8%), while portal vein complications rates were lower (0% vs. 10.8%), (p < 0.05). Although PALF patients showed lower 5-year survival rates (77.8% vs. 95.0 %, p < 0.01), the 5-year survival rates of patients who lived beyond the first year were comparable (96.6% vs. 98.3%, p = 0.516). The most common cause of deaths within one year was graft failure (75.0%) in PALF patients, but infection (67.7%) in BA patients. In multivariate analysis, lower body weight, hepatic artery complications and post-transplant RRT were associated with worse survival outcomes (p < 0.05). In conclusion, physicians should be alert to monitor the immediate postoperative graft dysfunction and hepatic artery complications and patients on post-transplant RRT in order to improve survival outcomes in PALF patients.
Pathological Diagnosis of Adult Craniopharyngioma on MR Images: An Automated End-to-End Approach Based on Deep Neural Networks Requiring No Manual Segmentation
Authors: Teng Yuen , Ran Xiaoping , Chen Boran , Chen Chaoyue , Xu Jianguo
Published: December 2022

Purpose: The goal of this study was to develop end-to-end convolutional neural network (CNN) models that can noninvasively discriminate papillary craniopharyngioma (PCP) from adamantinomatous craniopharyngioma (ACP) on MR images requiring no manual segmentation. Materials and methods: A total of 97 patients diagnosed with ACP or PCP were included. Pretreatment contrast-enhanced T1-weighted images were collected and used as the input of the CNNs. Six models were established based on six networks, including VGG16, ResNet18, ResNet50, ResNet101, DenseNet121, and DenseNet169. The area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, and specificity were used to assess the performances of these deep neural networks. A five-fold cross-validation was applied to evaluate the performances of the models. Results: The six networks yielded feasible performances, with area under the receiver operating characteristic curves (AUCs) of at least 0.78 for classification. The model based on Resnet50 achieved the highest AUC of 0.838 ± 0.062, with an accuracy of 0.757 ± 0.052, a sensitivity of 0.608 ± 0.198, and a specificity of 0.845 ± 0.034, respectively. Moreover, the results also indicated that the CNN method had a competitive performance compared to the radiomics-based method, which required manual segmentation for feature extraction and further feature selection. Conclusions: MRI-based deep neural networks can noninvasively differentiate ACP from PCP to facilitate the personalized assessment of craniopharyngiomas.
Extent of Left Ventricular Mass Regression and Impact of Global Left Ventricular Afterload on Cardiac Events and Mortality after Aortic Valve Replacement
Authors: Chen Jer-Shen , Huang Jih-Hsin , Chiu Kuan-Ming , Chiang Chih-Yao
Published: December 2022

Patient-prosthesis mismatch (PPM) causes a high transvalvular pressure gradient and residual left ventricular (LV) hypertrophy, consequently influencing long-term results. This study aimed to find the relationships between hemodynamic parameters and LV mass regression and determine the risk predictors of major adverse cardiovascular and cerebral events (MACCE) after aortic valve replacement (AVR) for aortic stenosis. Methods and Results: Preoperative and postoperative Doppler echocardiography data were evaluated for 120 patients after AVR. The patients’ mean age was 67.7 years; 55% of the patients were male. Forty-four (37%) patients suffered from MACCE during a mean follow-up period of 3.6 ± 2 years. The following hemodynamic parameters at follow-up were associated with lower relative indexed LV mass (LVMI) regression: lower postoperative indexed effective orifice area, greater mean transvalvular pressure gradient (MPG), greater stroke work loss (SWL), and concentric or eccentric LV remodeling mode. The following hemodynamic parameters at follow-up were associated with a higher risk of MACCE: higher valvuloarterial impedance (ZVA), greater SWL, greater MPG, greater relative wall thickness, greater LVMI, and hypertrophic LV remodeling mode. Lower relative LVMI regression was associated with a higher risk of MACCE (hazard ratio, 1.01: 95% confidence interval, 1.003–1.03). The corresponding cutoff of relative LVMI regression was −14%. Conclusions: Changes in hemodynamic parameters were independently associated with relative LVMI regression. Impaired reverse remodeling and persistent residual LV hypertrophy were independent risk predictors of MACCE. An LVMI regression lower than 14% indicated higher MACCE. A postoperative ZVA greater than 3.5 mmHg/mL/m2 was an independent risk predictor of cardiac events and mortality after AVR. Preventive strategies should be used at the time of the operation to avoid PPM.
Annexin A1 Is Associated with Adverse Clinical Outcomes in Patients with COVID-19
Authors: Busch Matthias H. , Timmermans Sjoerd A. M. E. G. , Aendekerk Joop P. , Ysermans Renée , Amiral Jean , Damoiseaux Jan G. M. C. , Reutelingsperger Chris P. , Paassen Pieter van
Published: December 2022

Severe coronavirus disease 2019 (COVID-19) is characterized by hyperinflammation, vascular damage, and hypercoagulability. Insufficient responses of Annexin A1 (AnxA1), a pro-resolving inhibitor of neutrophil infiltration and activation, might contribute to a severe course of the disease. We longitudinally evaluated AnxA1′s role in terms of inflammation, vascular damage, and clinical outcomes in a large prospective cohort of patients with COVID-19. AnxA1 was measured at presentation and during follow-up in the sera of 220 consecutive patients who presented at our hospital during the first wave. AnxA1 was significantly higher in the moderate and severe cases of COVID-19 compared to the healthy controls. Elevated AnxA1 was associated with markers of inflammation and endothelial damage. AnxA1 was significantly higher in patients with thrombotic events and ICU admission. Multivariable logistic regression indicated baseline AnxA1 (per ten units) as a predictor of thrombotic events. Linear mixed models predicted that AnxA1 tended to increase more steeply over time in patients without adverse events, with a statistically significant rise in patients without thrombotic events. These findings might reflect an insufficient increase in AnxA1 as a response to the excessive hyperinflammation in COVID-19. Future studies should evaluate whether hyperinflammation could be reduced through the administration of human recombinant AnxA1 or Ac2-26 peptide.
Minimal Extracorporeal Circulation and Microplegia in the Setting of Urgent Coronary Artery Bypass Grafting
Authors: Koechlin Luca , Gahl Brigitta , Miazza Jules , Zenklusen Urs , Rrahmani Bejtush , Vasiloi Ion , Santer David , Berdajs Denis , Eckstein Friedrich S. , Reuthebuch Oliver
Published: December 2022

Background: We aimed to analyse the performance of minimal invasive extracorporeal circulation (MiECC) concomitantly with Microplegia, in patients with recent myocardial infarction (MI) undergoing urgent coronary artery bypass grafting (CABG) surgery. Methods: We included patients with a recent MI (≤7 days) undergoing isolated CABG surgery using MiECC. The primary endpoint was a major cardiovascular or cerebrovascular event (MACCE). In a secondary analysis, we compared our institutional Microplegia concept with the use of a crystalloid single-shot cardioplegic solution. Results: In total, 139 patients (mean ± standard deviation (SD) age 66 ± 10 years) underwent urgent CABG surgery using Microplegia; 55% (n = 77) of the patients had an acute MI within 1–7 days preoperatively; 20% (n = 28) had an acute MI within 6–24 h; and 24% (n = 34) had an acute MI within <6 h preoperatively. The number of distal anastomoses was a geometric mean of 4 (95% confidence interval 3–4). The MACCE and in-hospital mortality were 7% (n = 10) and 1% (n = 2), respectively. The results were confirmed in a secondary analysis comparing Microplegia with crystalloid cardioplegic solution (n = 271). Conclusion: The use of MiECC with Microplegia in urgent CABG surgery is feasible and safe and provides a straight-forward intraoperative setting. Therefore, it can also be considered to retain the benefits of MiECC in urgent CABG surgery.
Evaluating the Value of Anti-SARS-CoV-2 Antibody-Based Tests for COVID-19 Diagnosis
Authors: Yu Xiao-Lu , Xie Jia-Wen , Wang Mao , Lin Mei-Qi , Zheng Ya-Wen , Lin Li-Rong
Published: December 2022

Background: The early detection of COVID-19 patients is fundamental for containing the pandemic. A reverse-transcriptase quantitative polymerase chain reaction (RT-PCR), which detects SARS-CoV-2 RNA, is the gold standard diagnostic test, although it can contribute to false-negative results. Consequently, supplementary diagnostic tests are urgently needed. Methods: To assess the value of anti-SARS-CoV-2 antibody-based tests for confirming COVID-19, a retrospective study was conducted on 3120 inbound overseas travelers who underwent a 14-day government quarantine in Xiamen from August 2020 to October 2020. The diagnostic accuracy of the total antibody that detected the anti-SARS-CoV-2 antibody and the RT-PCR that detected SARS-CoV-2 RNA was determined in comparison to the clinical diagnosis. Results: The COVID-19 positive rate was 3.14% (98/3120). The sensitivity and specificity of the RT-PCR test on the first day of quarantine were 14.29% and 100%, respectively, and the sensitivity and specificity of the total antibody were 93.88% and 99.40%, respectively. The kappa value between an RT-PCR on the first day of quarantine and a clinical diagnosis was 0.24 (95% CI, 0.14–0.35), indicating poor consistency. The kappa value between total antibodies and a clinical diagnosis was 0.88 (95% CI, 0.83–0.93), indicating perfect consistency. There were no differences in the positive rates of an RT-PCR in symptomatic COVID-19 (7.41% (2/27)) and asymptomatic COVID-19 (16.90 (12/71) (p = 0.338). Similarly, the positive rate of the total antibody tests showed no difference in symptomatic COVID-19 (96.30% (26/27)) and asymptomatic COVID-19 (92.96% (66/71)) (p = 0.676). Conclusion: SARS-CoV-2 antibodies are developed by the body in response to an infection or after vaccination; this can easily lead to a missed diagnosis. In the context of low sensitivity for an RT-PCR, SARS-CoV-2 antibody detection is an effective adjunct to RT-PCR detection, which can improve the diagnostic accuracy of COVID-19 and provide an effective complement to the false-negative results of an RT-PCR.
Statins Use in Patients with Cardiovascular Diseases and COVID-19 Outcomes: An Italian Population-Based Cohort Study
Authors: Antonazzo Ippazio Cosimo , Fornari Carla , Rozza Davide , Conti Sara , Di Pasquale Raffaella , Cortesi Paolo Angelo , Kaleci Shaniko , Ferrara Pietro , Zucchi Alberto , Maifredi Giovanni , Silenzi Andrea , Cesana Giancarlo , Mantovani Lorenzo Giovanni , Mazzaglia Giampiero
Published: December 2022

Background: The role of statins among patients with established cardiovascular diseases (CVDs) who are hospitalized with COVID-19 is still debated. This study aimed at assessing whether the prior use of statins was associated with a less severe COVID-19 prognosis. Methods: Subjects with CVDs infected with SARS-CoV-2 and hospitalized between 20 February 2020 and 31 December 2020 were selected. These were classified into two mutually exclusive groups: statins-users and non-users of lipid-lowering therapies (non-LLT users). The relationship between statins exposure and the risk of Mechanical Ventilation (MV), Intensive Care Unit (ICU) access and death were evaluated by using logistic and Cox regressions models. Results: Of 1127 selected patients, 571 were statins-users whereas 556 were non-LLT users. The previous use of statins was not associated with a variation in the risk of need of MV (Odds Ratio [OR]: 1.00; 95% Confidence Intervals [CI]: 0.38–2.67), ICU access (OR: 0.54; 95% CI: 0.22–1.32) and mortality at 14 days (Hazard Ratio [HR]: 0.42; 95% CI: 0.16–1.10). However, a decreased risk of mortality at 30 days (HR: 0.39; 95% CI: 0.18–0.85) was observed in statins-users compared with non-LLT users. Conclusions: These findings support the clinical advice for patients CVDs to continue their treatment with statins during SARS-CoV-2 infection.
Underlying Causes of Myocardial Infarction with Nonobstructive Coronary Arteries: Optical Coherence Tomography and Cardiac Magnetic Resonance Imaging Pilot Study
Authors: Fluder-Wlodarczyk Joanna , Milewski Marek , Roleder-Dylewska Magda , Haberka Maciej , Ochala Andrzej , Wojakowski Wojciech , Gasior Pawel
Published: December 2022

Background: Scientific statements recommend multimodality imaging in myocardial infarction with non-obstructive coronary arteries (MINOCA) to define the underlying cause. Aim: We evaluated the diagnostic yield of intravascular optical coherence tomography (OCT) and cardiac magnetic resonance (CMR) in the MINOCA setting. Methods: In this prospective, single center, observational pilot study, we enrolled patients with MINOCA without previous coronary interventions. All patients underwent three vessel OCT, followed by CMR. Imaging results were combined to determine the mechanism of MINOCA, when possible. Results: We enrolled 10 patients in this pilot study. Women constituted 50% of the analyzed population. The mean age of patients was 52 years. ST-segment elevation was found in 30% of patients. A possible culprit lesion was identified by OCT in 70% of participants, most commonly plaque rupture or erosion. An ischemic pattern of CMR abnormalities was identified in 70% of participants. Myocarditis and Tako-Tsubo were identified in 30%. A cause of MINOCA was identified in all patients using multimodality imaging, while using OCT alone identification occurred in only 70% of patients. Conclusion: In this pilot study, multimodality imaging with OCT and CMR identified potential mechanisms in all patients with a diagnosis of MINOCA, and it has the potential to guide medical therapy for secondary prevention.
Axial Length Shortening and Choroid Thickening in Myopic Adults Treated with Repeated Low-Level Red Light
Authors: Liu Guihua , Li Bingqin , Rong Hua , Du Bei , Wang Biying , Hu Jiamei , Zhang Bin , Wei Ruihua
Published: December 2022

This study aimed to explore the effect of repeated low-level red light (RLRL) on axial length (AL), choroid blood flow, and anterior segment components in myopic adults. Ninety-eight myopic adults were randomly divided into the RLRL group (n = 52) and the control group (n = 46). Subjects in the RLRL group completed a 4-week treatment composed of a 3-min RLRL treatment session twice daily, with an interval of at least 4 h. Visits were scheduled before and on 7, 14, 21, and 28 days after the treatment. AL, subfoveal choroidal thickness (SChT), choroidal vascularity index (CVI), and anterior segment parameters were measured at each visit. A linear mixed-effects model showed that the AL of the subjects in RLRL decreased from 24.63 ± 1.04 mm to 24.57 ± 1.04 mm, and the SChT thickened by 18.34 μm. CVI had a slight but significant increase in the 0–6 zone. However, all the anterior segment parameters did not change after RLRL treatment. Our study showed that the choroid’s thickening is insufficient to explain the axial length shortening. The unchanged anterior segment and improved choroid blood flow suggest that the AL shortening in this study is mainly related to changes in the posterior segment.
Syphilis Infections, Reinfections and Serological Response in a Large Italian Sexually Transmitted Disease Centre: A Monocentric Retrospective Study
Authors: Marchese Valentina , Tiecco Giorgio , Storti Samuele , Degli Antoni Melania , Calza Stefano , Gulletta Maurizio , Viola Francesca , Focà Emanuele , Matteelli Alberto , Castelli Francesco , Quiros-Roldan Eugenia
Published: December 2022

Background: Syphilis infection does not confer definitive and protective immunity against reinfection, and crucial aspects of repeated episodes of syphilis are far from being understood, especially among people living with HIV (PLWH). Methods: In order to explore the burden of syphilis in a large cohort of HIV-negative patients and PLWH, this retrospective study describes the demographics, clinical presentation and treatment outcome of patients with syphilis treated at our clinic from 2013 to 2021. Results: Within the study period, 1859 syphilis episodes (827, 44.5% first infections and 1032, 55.5% reinfections) were recorded. A total of 663 patients, of whom 347 (52%) had PLWH, were considered. Syphilis was mostly diagnosed in males (77%) and European (79%) patients. More than half of syphilis episodes were recorded during the late latent stage (64%) or during follow-up/screening visits for other diseases, while symptomatic stages led to a diagnosis in almost half of HIV-negative patients (p < 0.001). PLWH with syphilis infection were predominantly homo/bisexual (p < 0.001). A significantly higher rate of syphilis reinfection was observed in PLWH, who also demonstrated a higher range of subsequent episodes. The serofast state was found to be similar at the 6- and 12-month follow-up visits. The multivariate analysis carried out in the HIV-positive group showed that an RPR titre >1:16 was an independent predictor for serological non-response. Conclusions: Syphilis reinfections are predominantly diagnosed in HIV-positive MSM. The high rate of asymptomatic presentation among PLWH supports the role of periodical syphilis screening. In PLWH, the only baseline factor associated with an increased risk of non-response was an RPR titre >1:16, while assessment at 12 months after treatment increased the possibility of detecting a serological response, indicating that PLWH have a slower serological response to treatment.
Effect of CytoSorb Coupled with Hemodialysis on Interleukin-6 and Hemodynamic Parameters in Patients with Systemic Inflammatory Response Syndrome: A Retrospective Cohort Study
Authors: Persic Vanja , Jerman Alexander , Malgaj Vrecko Marija , Berden Jernej , Gorjup Vojka , Stecher Adela , Lukic Milica , Jereb Matjaz , Taleska Stupica Gordana , Gubensek Jakob
Published: December 2022

Excessive release of cytokines during systemic inflammatory response syndrome (SIRS) often leads to refractory hypotension and multiple organ failure with high mortality. Cytokine removal with hemoadsorption has emerged as a possible adjuvant therapy, but data on interleukin-6 (IL-6) reduction and outcomes in clinical practice are scarce. We aimed to evaluate the effect of CytoSorb hemoadsorption on laboratory and clinical outcomes in shocked patients with SIRS. We designed a retrospective analysis of all patients with SIRS treated with CytoSorb in intensive care units (ICU). IL-6, laboratory and hemodynamic parameters were analyzed at approximate time intervals during CytoSorb treatment in the whole cohort and in a subgroup with septic shock. Observed and predicted mortality rates were compared. We included 118 patients with various etiologies of SIRS (septic shock 69%, post-resuscitation shock 16%, SIRS with acute pancreatitis 6%, other 9%); in all but one patient, CytoSorb was coupled with renal replacement therapy. A statistically significant decrease in IL-6 and vasopressor index with an increase in pH and mean arterial pressure was observed from 6 h onward. The reduction of lactate became significant at 48 h. Results were similar in a subgroup of patients with septic shock. Observed ICU and in-hospital mortalities were lower than predicted by Sequential Organ Failure Assessment (SOFA) (61% vs. 79%, p = 0.005) and Acute Physiology and Chronic Health Evaluation (APACHE) II (64% vs. 78%, p = 0.031) scores. To conclude, hemoadsorption in shocked patients with SIRS was associated with a rapid decrease in IL-6 and hemodynamic improvement, with improved observed vs. predicted survival. These results need to be confirmed in a randomized study.
Visual Thinking Strategies as a Tool for Reducing Burnout and Improving Skills in Healthcare Workers: Results of a Randomized Controlled Study
Authors: Ferrara Vincenza , Shaholli David , Iovino Antonio , Cavallino Sabrina , Colizzi Marina Andrea , Della Rocca Carlo , La Torre Giuseppe
Published: December 2022

Objective: The purpose of this study was to measure the effect that a learning method using art, such as Visual Thinking Strategies, can have on nursing students and residents in Hygiene and Preventive Medicine; we also aimed to improve skills of observation, communication, empathy and collaboration with the patient and other team members, and evaluate the impact on quality of life, burnout and positivity. Methods: The experimentation was based on administering a form (written assessment) before and after the intervention, to measure the impact of the method on improving some useful skills for the nursing and medical professions by inserting one image of an artistic type and the other of a clinical type, and asking participants to answer basic questions on the VTS method. Students participated in groups of eight in 90-min sessions for four meetings in the classroom and one at the museum, on a weekly basis. Results: The experimental study concerned a randomized controlled sample involving undergraduate nursing students who voluntarily participated in the survey. 84 students took part in the study, including 50 undergraduate nursing students (mean age 22.5, SD 2.7; 14 males and 34 females) and 34 residents in Hygiene and Preventive Medicine (mean age 28.7, SD 2.6; 8 males and 26 females). For the artistic image, the median of the total score for all skills was −1.5 for the control group and 3 for the intervention group (p = 0.002), registering an increase for the Delta identified items, which was −1.5 for the control group and 1 for the intervention group (p = 0.007). For the clinical image, the median of the total score for all skills was 0 for the control group and 2 for the intervention group (p = 0.025), recording an increase for Delta observation skills, found to be 0 for the control group and 1 for the intervention group (p = 0.007). Conclusions: Most students who participated in the intervention reported considerable improvements in the skills the method promises to improve, and a reduction in personal and work burnout scores, suggesting that the use of the VTS method in health professions curricula is viable.
Risk-Reducing Salpingo-Oophorectomy (RRSO) Combined with Simultaneous Mastectomy in Women with BRCA 1–2 Mutation Carriers: The Surgical Technique, the Feasibility and Patients’ Satisfaction of Multiple Surgeries
Authors: Saccardi Carlo , Spagnol Giulia , Saibene Tania , De Lorenzo Luciana Serena , Marchetti Matteo , Bonaldo Giulio , Michieletto Silvia , Toffanin Maria Cristina , Noventa Marco , Tozzi Roberto
Published: December 2022

The main goal of our study was to evaluate the surgical technique, the feasibility and patient’s satisfaction of multiple surgeries: Risk-reducing salpingo-oophorectomy (RRSO) combined with mastectomy in patients with BRCA 1–2 mutation carriers. We conducted a retrospective analysis of patients with BRCA 1–2 variants who underwent RRSO combined with risk-reducing bilateral mastectomy (RRBM) or surgeries for breast cancer from January-2015 to December-2021. We collected data about surgeries, complications, and patients’ satisfaction using a questionnaire submitted 30 days after surgery. We included 54 patients. Forty-eight patients underwent RRSO, and six patients underwent RRSO + Total laparoscopic hysterectomy (LTH). The minor postoperative complications within 30 days were four: one breast seromas aspiration (1.9%), one infectious reconstructive complication treated with antibiotics therapy (1.9%), one Red-Breast-Syndrome (1.9%) and one trocar abdominal hematoma (1.9%) associated with RRSO. The major postoperative complications within 30 days were five: two evacuations of a breast hematoma (3.7%) and three infectious reconstructive complications treated with removal expander/implant (5.6%). No postoperative complications after 30 days were observed. According to the satisfaction questionnaire, more than 90% of patients were satisfied and would have combined surgery again. In conclusion, the multiple surgeries seem feasible and safety with a single anesthesia, a single surgical time, a single postoperative recovery, and a high patients’ satisfactions without increasing morbidity.
Cuproptosis-Related Genes Are Associated with Cell Cycle and Serve as the Prognostic Signature for Clear Cell Renal Cell Carcinoma
Authors: Guo Tuanjie , Zhang Jian , Yuan Zhihao , Tang Heting , Wang Tao , Wang Xiang , Chen Siteng
Published: December 2022

Cuproptosis is a newly discovered type of cell death. The role and potential mechanism of Cuproptosis-related genes (CRGs) in the prognosis of cancer patients are not fully understood. In this study, we included two cohorts of clear cell renal cell carcinoma patients, TCGA and E-MTAB-1980. The TCGA cohort is used as a training set to construct a CRG signature using the LASSO-cox regression analysis, and E-MTAB-1980 is used as a cohort for verification. A total of eight genes (FDX1, LIAS, LIPT1, DLAT, PDHA1, MTF1, GLS, CDKN2A) were screened to construct a prognostic model in the TCGA cohort. There is a significant difference in OS (p < 0.0001) between the high and low cuproptosis score group, and a similar difference is also observed in the OS (p = 0.0054) of the E-MTAB-1980 cohort. The area under the ROC curves (AUC) were 0.87, 0.82, and 0.78 at 1, 3, and 5 years in the TCGA cohort, respectively. Finally, gene set enrichment analysis revealed that CRGs were associated with cell cycle and mitotic signaling pathways.
Prognostic Value of Systemic Immune-Inflammation Index (SII) in Patients with Glioblastoma: A Comprehensive Study Based on Meta-Analysis and Retrospective Single-Center Analysis
Authors: Yang Chao , Hu Bo-Wen , Tang Feng , Zhang Qing , Quan Wei , Wang Jie , Wang Ze-Fen , Li Yi-Rong , Li Zhi-Qiang
Published: December 2022

Inflammation is related to cancer. The systemic immune-inflammation index (SII) has been linked to the prognosis of many types of cancer. The present study aimed to determine the prognostic value of the SII in glioblastoma (GBM) patients based on meta-analysis and single-center retrospective analysis. Relevant publications published before 1 October 2022 were identified by searching PubMed, EMBASE, Cochrane Library databases, and Web of Science. Moreover, 208 GBM patients from Zhongnan Hospital were incorporated. Kaplan–Meier and Cox regression analyses determined the prognostic significance of inflammatory markers. By combining these indicators, we developed scoring systems. Nomograms were also built by incorporating independent variables. The accuracies of nomograms were evaluated by Harrell’s concordance index (c-index) and the calibration curve. According to meta-analysis, an elevated SII predicted the worst overall survival (OS) (Hazard ratio [HR] = 1.87, p < 0.001). Furthermore, a higher SII (>510.8) (HR = 1.782, p = 0.007) also predicted a poorer outcome in a retrospective cohort. The scoring systems of SII-NLR (neutrophil-to-lymphocyte ratio) showed the best predictive power for OS. The nomogram without MGMT (c-index = 0.843) exhibited a similar accuracy to that with MGMT (c-index = 0.848). A pre-treatment SII is independently associated with OS in GBM. A nomogram integrating the SII-NLR score may facilitate a comprehensive survival evaluation independent of molecular tests in GBM.
Unraveling Pathophysiology of Takotsubo Syndrome: The Emerging Role of the Oxidative Stress’s Systemic Status
Authors: Viceconte Nicola , Petrella Greta , Pelliccia Francesco , Tanzilli Gaetano , Cicero Daniel Oscar
Published: December 2022

Takotsubo Syndrome (TTS) is usually triggered by emotional or physical stressors, thus suggesting that an increased sympathetic activity, leading to myocardial perfusion abnormalities and ventricular dysfunction, plays a major pathogenetic role. However, it remains to be elucidated why severe emotional and physical stress might trigger TTS in certain individuals but not others. Clinical research has been focused mainly on mechanisms underlying the activation of the sympathetic nervous system and the occurrence of myocardial ischemia in TTS. However, scientific evidence shows that additional factors might play a pathophysiologic role in the condition’s occurrence. In this regard, a significant contribution arrived from metabolomics studies that followed the systemic response to TTS. Specifically, preliminary data clearly show that there is an interplay between inflammation, genetics, and oxidative status which might explain susceptibility to the condition. This review aims to sum up the established pathogenetic factors underlying TTS and to appraise emerging mechanisms, with particular emphasis on oxidative status, which might better explain susceptibility to the condition.
Prevention and Treatment of Grade C Postoperative Pancreatic Fistula
Authors: Xiang Chengzhi , Chen Yonghua , Liu Xubao , Zheng Zhenjiang , Zhang Haoqi , Tan Chunlu
Published: December 2022

Postoperative pancreatic fistula (POPF) is a troublesome complication after pancreatic surgeries, and grade C POPF is the most serious situation among pancreatic fistulas. At present, the incidence of grade C POPF varies from less than 1% to greater than 9%, with an extremely high postoperative mortality rate of 25.7%. The patients with grade C POPF finally undergo surgery with a poor prognosis after various failed conservative treatments. Although various surgical and perioperative attempts have been made to reduce the incidence of grade C POPF, the rates of this costly complication have not been significantly diminished. Hearteningly, several related studies have found that intra-abdominal infection from intestinal flora could promote the development of grade C POPF, which would help physicians to better prevent this complication. In this review, we briefly introduced the definition and relevant risk factors for grade C POPF. Moreover, this review discusses the two main pathways, direct intestinal juice spillover and bacterial translocation, by which intestinal microbes enter the abdominal cavity. Based on the abovementioned theory, we summarize the operation techniques and perioperative management of grade C POPF and discuss novel methods and surgical treatments to reverse this dilemma.
Impact of Time-To-Surgery on the Prognosis of Patients with T1 Renal Cell Carcinoma: Implications for the COVID-19 Pandemic
Authors: Ou Wei , Wang Changxuan , Un Hiocheng , Guo Shengjie , Xiao Han , Huang Bin , Li Bin , Lei Jiahao , Wei Jinhuan , Peng Sui , Luo Junhang , Wang Zongren , Chen Lingwu
Published: December 2022

Background: During the COVID-19 pandemic, elective surgery has to undergo longer wait times, including nephrectomy for T1 renal cell carcinoma (RCC). This study aimed to investigate the time-to-surgery (TTS) of Chinese T1 RCC patients and its influencing factors, and to illustrate the impact of TTS on the prognosis of T1 RCC. Methods: We retrospectively enrolled 762 Chinese patients with pathological T1 RCC that underwent nephrectomy. To discover the impact of TTS on survival outcomes, we explored the possible delay intervals by week using the Kaplan-Meier method and Log-rank test. Cox proportional hazard models with inverse probability-treatment weighting (IPTW) were used to assess the association between TTS and disease-free survival (DFS) and overall survival (OS). Results: The median TTS of T1 RCC patients was 15 days. The Charlson comorbidity index, the Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) score, and the maximal tumor diameter on presentation were independent influencing factors for TTS. The cut-off point of TTS was selected as 5 weeks according to the Log-rank analysis. For T1a RCC, patients with TTS > 5 weeks had similar DFS (HR = 2.39; 95% CI, 0.82–6.94; p = 0.109) and OS (HR = 1.28; 95% CI, 0.23–7.16; p = 0.779) compared to patients with TTS ≤ 5 weeks. For T1b RCC, patients with TTS > 5 weeks had shorter DFS (HR = 2.90; 95% CI = 1.46–5.75; p = 0.002) and OS (HR = 2.49, 95% CI = 1.09–5.70; p = 0.030) than patients with TTS ≤ 5 weeks. Conclusions: Prolonged TTS had no impact on the prognosis of T1a RCC while surgery delayed for over 5 weeks may lead to worse survival in T1b RCC.