bluuebunny/crossref_metadata_2025 huggingface dataset:
Peripartum Hysterectomy: Is There Any Difference Between Emergency and Planned Surgeries?
Authors: Oge Tufan , Tokgoz Vehbi Yavuz , Cakmak Yusuf , Velipasaoglu Melih
Published: January 2022

Objective To compare the outcomes of emergency and planned peripartum hysterectomies.

Methods The present retrospective cross-sectional study was conducted in two hospitals. Maternal and neonatal outcomes were compared according to emergency and planned peripartum hysterectomies.

Results A total of 34,020 deliveries were evaluated retrospectively, and 66 cases of peripartum hysterectomy were analyzed. Of these, 31 were cases of planned surgery, and 35 were cases of emergency surgery. The patients who underwent planned peripartum hysterectomy had a lower rate of blood transfusion (83.9% versus 100%; p = 0.014), and higher postoperative hemoglobin levels (9.9 ± 1.3 versus 8.3 ± 1.3; p < 0.001) compared with the emergency hysterectomy group. The birth weight was lower, although the appearance, pulse, grimace, activity, and respiration (Apgar) scores were higher in the planned surgery group compared with the emergency cases.

Conclusion Planned peripartum hysterectomy with an experienced team results in less need for transfusion and improved neonatal outcomes compared with emergency peripartum hysterectomy.
Is There Any Effect of the Physician Performing Embryo Transfer in IVF-ICSI Treatment: A Prospective Cohort Study
Authors: Inal Zeynep Ozturk , Inal Hasan Ali , Aksoy Emine , Mermer Sultan
Published: January 2022

Objective To evaluate whether there is an effect of the physician who transfers the embryos on pregnancy rates in in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) treatment.

Methods A total of 757 participants were analyzed between 2012 and 2017. Participants were classified according to 3 physicians who transferred the embryos: ([group 1 = 164 patients]; [group 2 = 233 patients]; [group 3 = 360 patients]). Baseline parameters and IVF-ICSI outcomes were compared between the groups.

Results No differences were determined between the groups regarding the baseline parameters (age, age subgroups [20–29, 30–39, and ≥ 40 years old)], body mass index (BMI), smoking status, infertility period, cause of infertility, baseline follicle stimulating hormone, luteinizing hormone, estradiol (E2), thyroid stimulating hormone, prolactin levels, antral follicle count, duration of stimulation, stimulation protocol, gonadotropin dose required, maximum E2 levels, progesterone levels, endometrial thickness on human chorionic gonadotropin (hCG) administration and transfer days (p > 0.05). The numbers of oocytes retrieved, metaphase II (MII), 2 pronucleus (2PN), , transferred embryo, fertilization rate, day of embryo transfer, the catheter effect and embryo transfer technique, and clinical pregnancy rates (CPRs) were also comparable between the groups (p > 0.05).

Conclusion Our data suggests that the physician who transfers the embryos has no impact on CPRs in patients who have undergone IVF-ICSI, but further studies with more participants are required to elucidate this situation.
Assistance to Victims of Sexual Violence in a Referral Service: A 10-Year Experience
Authors: de Jesus Gabriel Ramalho , Rodrigues Natália Pavoni , Braga Giordana Campos , Abduch Renata , Melli Patricia Pereira dos Santos , Duarte Geraldo , Quintana Silvana Maria
Published: January 2022

Objective To evaluate the assistance provided to women victims of sexual violence and their participation in the follow-up treatment after the traumatic event, presenting a sociodemographic profile, gynecological background, and circumstances of the event, and reporting the results, acceptance, and side effects of prophylaxis for sexually transmitted infections (STIs) and pregnancy.

Methods A retrospective cohort study comprising the period between 2007 and 2016. All women receiving medical care and clinical follow-up after a severe episode of sexual violence were included. Records of domestic violence, male victims, children, and adolescents who reported consensual sexual activity were excluded. The present study included descriptive statistics as frequencies and percentages.

Results A total of 867 medical records were reviewed and 444 cases of sexual violence were included. The age of the victims ranged from 10 to 77 years old, most of them self-declared white, with between 4 and 8 years of education, and denying having a sexual partner. Sexual violence occurred predominantly at night, on public thoroughfare, being committed by an unknown offender. Most victims were assisted at the referral service center within 72 hours after the violence, enabling the recommended prophylaxis. There was high acceptance of antiretroviral therapy (ART), although half of the users reported side effects. Seroconversion to human immunodeficiency virus (HIV) or to hepatitis B virus (HBV) was not detected in women undergoing prophylaxis.

Conclusion In the present cohort, the profile of victims of sexual violence was low-educated, young, white women. The traumatic event occurred predominantly at night, on public thoroughfare, being committed by an unknown offender. Assistance within the first 72 hours after sexual violence enables the healthcare center to provide prophylactic interventions against STIs and unwanted pregnancies.
Efficacy of Transversus Abdominis Plane Block in the Reduction of Pain and Opioid Requirement in Laparoscopic and Robot-assisted Hysterectomy: A Systematic Review and Meta-analysis
Authors: López-Ruiz Claudia , Orjuela Jerutsa Catalina , Rojas-Gualdrón Diego Fernando , Jimenez-Arango Marcela , Ríos José Fernando de los , Vásquez-Trespalacios Elsa Maria , Vargas Claudia
Published: January 2022

Objective To summarize the available evidence of TAP Block in efficacy in laparoscopic or robotic hysterectomy.

Data Sources We searched databases and gray literature for randomized controlled trials in which transversus abdominis plane (TAP) block was compared with placebo or with no treatment in patients who underwent laparoscopic or robot-assisted hysterectomy.

Method of Study Selection Two researchers independently evaluated the eligibility of the selected articles.

Tabulation, Integration, and Results Seven studies were selected, involving 518 patients. Early postoperative pain showed a difference in the mean mean difference (MD): - 1.17 (95% confidence interval [CI]: - 1.87–0.46) in pain scale scores (I2 = 68%), which was statistically significant in favor of using TAP block, but without clinical relevance; late postoperative pain: DM 0.001 (95%CI: - 0.43–0.44; I2 = 69%); opioid requirement: DM 0.36 (95%CI: - 0.94–1.68; I2 = 80%); and incidence of nausea and vomiting with a difference of 95%CI = - 0.11 (- 0.215–0.006) in favor of TAP.

Conclusion With moderate strength of evidence, due to the high heterogeneity and imbalance in baseline characteristics among studies, the results indicate that TAP block should not be considered as a clinically relevant analgesic technique to improve postoperative pain in laparoscopic or robotic hysterectomy, despite statistical significance in early postoperative pain scale scores.

Clinical Trial Number and Registry: PROSPERO ID - CRD42018103573.
Perinatal Outcomes after Fetal Endoscopic Tracheal Occlusion for Isolated Congenital Diaphragmatic Hernia: Rapid Review
Authors: da-Costa-Santos Juliana , Bennini João Renato
Published: January 2022

Objective To compare the perinatal outcomes of fetuses with isolated congenital diaphragmatic hernia after fetal endoscopic tracheal occlusion (FETO) and antenatal expectant management.

Data sources In this rapid review, searches were conducted in the MEDLINE, PMC, EMBASE and CENTRAL databases between August 10th and September 4th, 2020. Randomized controlled trials (RCTs), quasi-RCTs or cluster-RCTs published in English in the past ten years were included.

Study selection We retrieved 203 publications; 180 studies were screened by abstract. Full-text selection was performed for eight studies, and 1 single center RCT met the inclusion criteria (41 randomized women; 20 in the FETO group, and 21 in the control group).

Data collection Data collection was performed independently, by both authors, in two steps (title and abstract and full-text reading).

Data synthesis There were no cases of maternal mortality. The mean gestational age at delivery was of 35.6 ±  2.4 weeks in the intervention group, and of 37.4 ±  1.9 weeks among the controls (p < 0.01). Survival until 6 months of age was reported in 50% of the intervention group, and in 5.8% of the controls (p < 0.01; relative risk: 10.5; 95% confidence interval [95%CI]: 1.5–74.7). Severe postnatal pulmonary hypertension was found in 50% of the infants in the intervention group, and in 85.7% of controls (p = 0.02; relative risk: 0.6; 95%CI: 0.4–0.9). An analysis of the study indicated some concerns of risk of bias. The quality of evidence was considered moderate to low.

Conclusion Current evidence is limited but suggests that FETO may be an effective intervention to improve perinatal outcomes.
Analysis of the Excess of Papanicolaou Tests in Brazil from 2006 to 2015
Authors: Fischer Ana Carolina Pereira , Fischer Eduardo Augusto Pereira , Vaz Fernanda Brião , Hoffmann Júlia
Published: January 2022

Objective To analyze the quantity of cervical smears, also designated Papanicolaou tests, between 2006 and 2015 in all the Federal units of Brazil, as well as to verify the quantity of exams collected outside the recommended age range and the economic impact of such excess.

Methods The data was collected from the Ministry of Health's database called Sistema de Informação do Câncer do Colo de Útero (SISCOLO), which contains all the test results collected nationwide by the Unified Health System (SUS, in the Portuguese acronym). From that, the number of exams and the age range of the women who underwent them were analyzed; besides, these numbers were stratified according to the state of where the exam was performed. The quantity of exams collected outside the recommended age range was verified, and, so, the economic impact generated was noted.

Results Between 2006 and 2015, 87,425,549 Papanicolaou tests were collected in Brazil. Of these, 20,215,052 tests were collected outside the age range recommended by the Brazilian Ministry of Health; this number corresponded to 23.12% of all exams. From such data, considering that each Pap smear collected by SUS generates a cost of BRL 7.30 to the government, according to the information in the Tabela SUS dated September 2018, there was a total charge of BRL 147,569,880 for tests collected outside the protocol.

Conclusion In Brazil, according to the Ministry of Health's protocol about the recommended practices on collecting Pap smears, whose newest edition dates of 2016, it is recommended that Pap smears are collected in women from a specific age range, in whom the potential diagnosing advantages overcome the onus of overdiagnosis or of a lesion with great regression potential. However, such protocols have not been correctly followed, promoting more than 20 million tests in excess, and an exorbitant cost for the Brazilian public health system. It is relevant to take measures to correctly use the official protocol, reducing the patients risks, as well as the economic impact for SUS.
Underestimation Rate in the Percutaneous Diagnosis of Radial Scar/Complex Sclerosing Lesion of the Breast: Systematic Review
Authors: Zanon Ana Beatrice Bonganha , Maesaka Jonathan Yugo , Chequin Bruna Bello , Santos Ana Gabriela de Siqueira , Baracat Edmund Chada , Filassi José Roberto
Published: January 2022

Objective To evaluate the underestimation rate in breast surgical biopsy after the diagnosis of radial scar/complex sclerosing lesion through percutaneous biopsy.

Data Sources A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The PubMed, SciELO, Cochrane, and Embase databases were consulted, with searches conducted through November 2020, using specific keywords (radial scar OR complex sclerosing lesion, breast cancer, anatomopathological percutaneous biopsy AND/OR surgical biopsy).

Data collection Study selection was conducted by two researchers experienced in preparing systematic reviews. The eight selected articles were fully read, and a comparative analysis was performed.

Study selection A total of 584 studies was extracted, 8 of which were selected. One of them included women who had undergone a percutaneous biopsy with a histological diagnosis of radial scar/complex sclerosing lesion and subsequently underwent surgical excision; the results were used to assess the underestimation rate of atypical and malignant lesions.

Data synthesis The overall underestimation rate in the 8 studies ranged from 1.3 to 40% and the invasive lesion underestimation rate varied from 0 to 10.5%.

Conclusion The histopathological diagnosis of a radial scar/complex sclerosing lesion on the breast is not definitive, and it may underestimate atypical and malignant lesions, which require a different treatment, making surgical excision an important step in diagnostic evaluation.
Numerical confirmations of joint spike transitions in G
2 cosmologies
Authors: Lim W C
Published: January 2022

We produce numerical evidence that the joint spike transitions between Kasner eras of G
2 cosmologies are described by the non-orthogonally transitive G
2 spike solution. A new matching procedure is developed for this purpose.
Template lattices for a cross-correlation search for gravitational waves from Scorpius X-1
Authors: Wagner Katelyn J , Whelan John T , Wofford Jared K , Wette Karl
Published: January 2022

We describe the application of the lattice covering problem to the placement of templates in a search for continuous gravitational waves from the low-mass x-ray binary Scorpius X-1. Efficient placement of templates to cover the parameter space at a given maximum mismatch is an application of the sphere covering problem, for which an implementation is available in the LatticeTiling software library. In the case of Sco X-1, potential correlations, in both the prior uncertainty and the mismatch metric, between the orbital period and orbital phase, lead to complications in the efficient construction of the lattice. We define a shearing coordinate transformation which simultaneously minimizes both of these sources of correlation, and allows us to take advantage of the small prior orbital period uncertainty. The resulting lattices have a factor of about three fewer templates than the corresponding parameter space grids constructed by the prior straightforward method, allowing a more sensitive search at the same computing cost and maximum mismatch.
Method for full magnetic gradient tensor detection from a single HTS gradiometer
Authors: Keenan S T , Clark D A , Leslie K E
Published: January 2022

A new method to measure the full magnetic gradient tensor (FMGT) using a single rotating high-temperature superconducting planar first-order gradiometer is described. Determining the FMGT provides valuable additional information about magnetic sources and their anomalies and, critically, the location of magnetic targets with less ambiguity and with fewer survey lines required. This paper presents both a theoretical description and experimental demonstration of the single sensor system that can, in principle, extract all the magnetic gradient tensor components, with suitable referencing and/or field cancellation procedures. The technique involves rotating the planar gradiometer mounted on an angled plinth about the vertical axis of the sensor package. The technique works by shifting gradient terms to harmonics of the rotating frequency, above the 1/f noise of the device, and allows extraction of all the components in the frequency domain. Additional referencing enables compensation for the non-ideal gradiometer response and provides a more accurate measurement of contaminated gradient components. Laboratory results show tracking of a moving dipole target and these are compared to a modelled response, both with and without field compensation.
Investigation of self-generated magnetic field and dynamics of a pulsed plasma flow
Authors: TAZHEN Aigerim , DOSBOLAYEV Merlan , RAMAZANOV Tlekkabul
Published: January 2022

Due to the growing interest in studying the compression and disruption of the plasma filament in magnetic fusion devices and Z-pinches, this work may be important for new developments in the field of controlled thermonuclear fusion. Recently, on a coaxial plasma accelerator, we managed to obtain the relatively long-lived (∼300 μs) plasma filaments with its self-magnetic field. This was achieved after modification of the experimental setup by using high-capacitive and low-inductive energy storage capacitor banks, as well as electrical cables with low reactive impedance. Furthermore, we were able to avoid the reverse reflection of the plasma flux from the end of the plasma accelerator by installing a special plasma-absorbing target. Thus, these constructive changes of the experimental setup allowed us to investigate the physical properties of the plasma filament by using the comprehensive diagnostics including Rogowski coil, magnetic probes, and Faraday cup. As a result, such important plasma parameters as density of ions and temperature of electrons in plasma flux, time dependent plasma filament’s azimuthal magnetic field were measured in discharge gap and at a distance of 23.5 cm from the tip of the cathode. In addition, the current oscillograms and I–V characteristics of the plasma accelerator were obtained. In the experiments, we also observed the charge separation during the acceleration of plasma flow via oscillograms of electron and ion beam currents.
Evaluation of a Beta-Blocker–Edema–Loop Diuretic Prescribing Cascade: A Prescription Sequence Symmetry Analysis
Authors: Vouri Scott Martin , Morris Earl J , Jiang Xinyi , Hofer Ann-Kathrin , Schmidt Stephan , Pepine Carl , Winterstein Almut G , Smith Steven M
Published: January 2022

BACKGROUND

Drug-related adverse events associated with antihypertensive therapy may result in subsequent prescribing of other potentially harmful medications, known as prescribing cascades. The aim of this study was to assess the magnitude and characteristics of a beta-blocker–edema–loop diuretic prescribing cascade.

METHODS

A prescription sequence symmetry analysis was used to assess loop diuretic initiation before and after initiation of beta-blockers among patients 20 years or older without heart failure, atrial fibrillation, other arrythmias, or use of calcium channel blocker within a U.S. private insurance claims database (2005–2018). The temporality of loop diuretic initiation relative to a beta-blocker or negative control (renin-angiotensin system blocker) initiation was tabulated. Secular trend-adjusted sequence ratios (aSRs) with 95% confidence intervals (CIs) compared the initiation of loop diuretic 90 days before and after initiation of beta-blockers.

RESULTS

Among 988,675 beta-blocker initiators, 9,489 patients initiated a new loop diuretic prescription 90 days after and 5,245 patients before beta-blocker initiation, resulting in an aSR of 1.78 (95% CI, 1.72–1.84). An estimated 1.72 beta-blocker initiators per 100 patient-years experienced the prescribing cascade in the first 90 days. The aSR was disproportionately higher among older adults (aSR 1.97), men (aSR 2.25), and patients who initiated metoprolol tartrate (aSR 2.48), labetalol (aSR 2.18), or metoprolol succinate (aSR 2.11). Negative control results (aSR 1.09, 95% CI, 1.05–1.13) generally corroborated our findings, but suggested modest within-person time-varying confounding.

CONCLUSIONS

We observed excess use of loop diuretics following beta-blocker initiation that was only partially explained by secular trends or hypertension progression.
A fungal protease named AsES triggers antiviral immune responses and effectively restricts virus infection in arabidopsis andNicotiana benthamianaplants
Authors: Caro Maria Del Pilar , Venturuzzi Andrea Laura , Moschen Sebastian , Salazar Sergio Miguel , Díaz-Ricci Juan Carlos , Asurmendi Sebastian
Published: January 2022

Background and Aims

Plants have evolved complex mechanisms to fight against pathogens. Among these mechanisms, pattern-triggered immunity (PTI) relies on the recognition of conserved microbe- or pathogen-associated molecular patterns (MAMPs or PAMPs, respectively) by membrane-bound receptors. Indeed, PTI restricts virus infection in plants and, in addition, BRI1-associated kinase 1 (BAK1), a central regulator of PTI, plays a role in antiviral resistance. However, the compounds that trigger antiviral defences, along with their molecular mechanisms of action, remain mostly elusive. Herein, we explore the role of a fungal extracellular subtilase named AsES in its capacity to trigger antiviral responses.

Methods

In this study, we obtained AsES by recombinant expression, and evaluated and characterized its capacity to trigger antiviral responses against Tobacco mosaic virus (TMV) by performing time course experiments, analysing gene expression, virus movement and callose deposition.

Key Results

The results of this study provide direct evidence that exogenous treatment with recombinant AsES increases a state of resistance against TMV infection, in both arabidopsis and Nicotiana benthamiana plants. Also, the antiviral PTI response exhibited by AsES in arabidopsis is mediated by the BAK1/SERK3 and BKK1/SERK4 co-receptors. Moreover, AsES requires a fully active salicylic acid (SA) signalling pathway to restrict the TMV movement by inducing callose deposition. Additionally, treatment with PSP1, a biostimulant based on AsES as the active compound, showed an increased resistance against TMV in N. benthamiana and tobacco plants.

Conclusions

AsES is a fungal serine protease which triggers antiviral responses relying on a conserved mechanism by means of the SA signalling pathway and could be exploited as an effective and sustainable biotechnology strategy for viral disease management in plants.
Effect of high-dose 290 nm UV-B on resveratrol content in grape skins
Authors: Tsurumoto Tomohiro , Fujikawa Yasuo , Onoda Yushi , Kamimori Masahiro , Hiramatsu Kazuya , Tanimoto Hideo , Ohta Daisaku , Okazawa Atsushi
Published: January 2022

UV-C irradiation increases resveratrol content in grape skins, but it reaches a maximum at a certain UV-C dose. In contrast, UV-B has a weak resveratrol-enhancing effect at low doses, but it has not been investigated at high doses. In this study, we investigated the effect of high-dose UV-B on resveratrol contents in grape skins. Irradiation of Muscat Bailey A with 290 nm UV-B LED at 22 500 and 225 000 µmol m−2 increased the resveratrol contents in the grape skins by 2.1- and 9.0-fold, respectively, without significant increases in other phenolic compounds. The effect was also confirmed for 2 other cultivars: Shine Muscat and Delaware. Transcriptome analysis of the grape skins of Muscat Bailey A immediately after irradiation with UV-B at 225 000 µmol m−2 showed that genes related to biotic and abiotic stresses were upregulated. Hence, it was suggested that high-dose UV-B irradiation induces a stress response and specifically activates resveratrol biosynthesis.
Crystal structures of glycoside hydrolase family 136 lacto-N-biosidases from monkey gut- and human adult gut bacteria
Authors: Yamada Chihaya , Katayama Takane , Fushinobu Shinya
Published: January 2022

Glycoside hydrolase family 136 (GH136) was established after the discovery and structural analysis of lacto-N-biosidase (LNBase) from the infant gut bacterium Bifidobacterium longum subsp. longum JCM1217 (BlLnbX). Homologous genes of BlLnbX are widely distributed in the genomes of human gut bacteria and monkey Bifidobacterium spp., although only 2 crystal structures were reported in the GH136 family. Cell suspensions of Bifidobacterium saguini, Tyzzerella nexilis, and Ruminococcus lactaris exhibited the LNBase activity. Recombinant LNBases of these 3 species were functionally expressed with their specific chaperones in Escherichia coli, and their kinetic parameters against p-nitrophenol substrates were determined. The crystal structures of the LNBases from B. saguini and T. nexilis in complex with lacto-N-biose I were determined at 2.51 and 1.92 Å resolutions, respectively. These structures conserve a β-helix fold characteristic of GH136 and the catalytic residues, but they lack the metal ions that were present in BlLnbX.
Habitat determines convergent evolution of cephalic horns in vipers
Authors: Busschau Theo , Boissinot Stephane
Published: January 2022

Phenotypic convergence of traits in similar environments can provide insights into the evolutionary processes shaping trait evolution. Among squamate reptiles, horn-like cephalic appendages have evolved under various selective pressures, including selection for defence, crypsis or sexual selection. Yet, among snakes, particularly vipers, the functional and evolutionary significance of horns are unknown. We used a comparative phylogenetic approach with habitat and diet data on 263 viper taxa to shed light on the selective pressures underlying horn evolution in vipers. We detected significant correlations with habitat but not diet. The relative positions of horns are ecologically divergent in that supranasal horns are positively correlated with terrestrial forest habitats while supraocular horns are negatively correlated with terrestrial forest habitats and are instead associated with arboreal or sparsely vegetated habitats. Multiple independent origins of supranasal or supraocular horns in similar habitats provide evidence of adaptive convergence. Comparisons with other snake lineages suggest that cephalic appendages may have evolved under selection for crypsis in ambush foraging snakes.
Pathological response following neoadjuvant immunotherapy in mismatch repair-deficient/microsatellite instability-high locally advanced, non-metastatic colorectal cancer
Authors: Kothari Anai , White Michael G , Peacock Oliver , Kaur Harmeet , Palmquist Sarah M , You Nancy , Taggart Melissa , Salem Usama , Overman Michael , Kopetz Scott , Chang George J
Published: January 2022

This case series demonstrates an excellent pathological response to neoadjuvant checkpoint inhibitor (CPI) therapy in patients with mismatch repair-deficient (dMMR) colorectal cancer, which has translated into exemplary short-term oncological outcomes. As well as validating the utility of neoadjuvant CPI therapy in dMMR colorectal cancer, it also opens the door to future study of limited resection in patients with tumours that would otherwise require multivisceral resection.
Effect of the learning curve on survival after laparoscopic liver resection for colorectal metastases
Authors: Shanti Hiba , Raman Rakesh , Chakravartty Saurav , Belgaumkar Ajay P. , Patel Ameet G.
Published: January 2022

Background

Laparoscopic liver resection (LLR) is a highly demanding procedure with great variability. Previously published randomized trials have proven oncological safety of laparoscopic liver resection (LLR) as compared to open surgery. However, these were started after the learning curve (LC) was established. This leaves the question of whether the LC of LLR in the early laparoscopic era has affected the survival of patients with colorectal liver metastasis (CRLM).

Methods

All consecutive LLRs performed by a single surgeon between 2000 and 2019 were retrospectively analysed. A risk-adjusted cumulative sum (RA-CUSUM) chart for conversion rate and the log regression analysis of the blood loss identified two phases in the LC. This was then applied to patients with CRLM, and the two subgroups were compared for recurrence-free (RFS) and overall survival (OS). The analysis was repeated with propensity score-matched (PSM) groups

Results

A total of 286 patients were included in the LC analysis, which identified two distinct phases, the early (EP; 68 patients) and the late (LP; 218 patients) phases. The LC was applied to 192 patients with colorectal liver metastasis (EPc, 45 patients; LPc, 147 patients). For patients with CRLM, R0 resection was achieved in 93 per cent: 100 per cent in the EPc group and 90 per cent in the LPc group (P = 0.026). Median OS and RFS were 60 and 16 months, respectively. The 5-year OS and RFS were 51 per cent and 32.7 per cent, respectively. OS (hazard ratio (h.r.) 0.78, 95 per cent confidence interval (c.i.) 0.51 to 1.2; P = 0.286) and RFS (h.r. 0.94, 95 per cent c.i. 0.64 to 1.37; P = 0.760) were not compromised by the learning curve. The results were replicated after PSM.

Conclusion

In our experience, the development of a laparoscopic liver resection programme can be achieved without adverse effects on the long-term survival of patients with CRLM.
Coffee consumption and its interaction with the genetic variant AhR rs2066853 in colorectal cancer risk: a case–control study in Korea
Authors: Lu Y-Thanh , Gunathilake Madhawa , Lee Jeonghee , Kim Youngyo , Oh Jae Hwan , Chang Hee Jin , Sohn Dae Kyung , Shin Aesun , Kim Jeongseon
Published: January 2022

The bioactive compounds in coffee have several antioxidant properties that may beneficially impact colorectal cancer (CRC) development. The aryl hydrocarbon receptor (AhR) is an important transcription factor that regulates an enzyme related to the caffeine metabolism pathway. We investigated the modification effect on coffee of AhR gene polymorphism in the risk of CRC. A case–control study was conducted with 699 cases and 1393 controls to investigate the interaction between coffee intake and the AhR rs2066853 variant in CRC risk. The odds ratios (ORs) and 95% confidence intervals (CIs) were assessed using multiple logistic regression analyses. We observed a significant protective effect of coffee against CRC in the overall and male populations. Consuming three or more cups of coffee per day may significantly lower CRC risk in all subjects by 77% and in men by 83% (OR = 0.23, 95% CI: 0.14–0.39 and OR = 0.17, 95% CI: 0.09–0.34, respectively, P-trends < 0.001). No association between AhR rs2066853 and CRC risk was found. In the dominant model, the G/G genotype had a strongest synergistic effect with coffee on protection against CRC (OR = 0.12, 95% CI: 0.06–0.26, P-interaction = 0.014). The interaction remained significant in men and the distal colon cancer subgroup. In the additive model, the interaction was clearly shown strongest in G/G carriers (OR = 0.12, 95% CI: 0.06–0.27, P-interaction = 0.039), followed by A/A and G/A carriers. The interaction remained significant in men and the rectal cancer subgroup. In conclusion, the protective effect of coffee on CRC risk might interact with the genetic variant AhR rs2066853, and this joint effect was determined by sex and site-specific cancer.
Prefrontal cortical distribution of muscarinic M2 and cannabinoid-1 (CB1) receptors in adult male mice with or without chronic adolescent exposure to Δ9-tetrahydrocannabinol
Authors: Garzón Miguel , Chan June , Mackie Ken , Pickel Virginia M
Published: January 2022

Chronic adolescent administration of marijuana’s major psychoactive compound, ∆9-tetrahydrocannabinol (Δ9-THC), produces adaptive changes in adult social and cognitive functions sustained by prelimbic prefrontal cortex (PL-PFC). Memory and learning processes in PL-PFC neurons can be regulated through cholinergic muscarinic-2 receptors (M2R) and modulated by activation of cannabinoid-1 receptors (CB1Rs) targeted by Δ9-THC. Thus, chronic exposure to Δ9-THC during adolescence may alter the expression and/or distribution of M2Rs in PL-PFC neurons receiving CB1R terminals. We tested this hypothesis by using electron microscopic dual CB1R and M2R immunolabeling in adult C57BL/6 J male mice that had received vehicle or escalating dose of Δ9-THC through adolescence. In vehicle controls, CB1R immunolabeling was mainly localized to axonal profiles virtually devoid of M2R but often apposing M2R-immunoreactive dendrites and dendritic spines. The dendrites received inputs from CB1R-labeled or unlabeled terminals, whereas spines received asymmetric synapses exclusively from axon terminals lacking CB1Rs. Adolescent Δ9-THC significantly increased plasmalemmal M2R-immunogold density exclusively in large dendrites receiving input from CB1R-labeled terminals. In contrast, cytoplasmic M2R-immunogold density decreased in small spines of the Δ9-THC-treated adult mice. We conclude that Δ9-THC engagement of CB1Rs during adolescence increases M2R plasmalemmal accumulation in large proximal dendrites and decreases M2R cytoplasmic expression in small spines of PL-PFC.
Is a Mummy a Person or a Property: The Classification and Choice of Law of Cultural Objects in Private International Law
Authors: Chen Zhen
Published: January 2022

In the Buddha Mummy Statue case, the Chinese village committees sued the Dutch defendants for the return of a stolen golden statue that contains a mummified Buddha. The parties had different opinions on the legal nature of the mummy contained in the statue. The Chinese court classified the statue as a cultural property and applied the choice of law over movable properties provided in Article 37 of the Chinese Private International Law Act (lex rei sitae). Based on a comparative study, this article argues that a mummy does not fall within the traditional dichotomy between a person and a property. Instead, a mummy should be classified as a transitional existence between a person and a property. If the classification of a mummy has to be confined to the traditional dichotomy, a mummy can be regarded as a quasi-person or a special kind of property. Following this new classification, a new choice-of-law rule should be established. In this regard, the Belgian Private International Law Act, which adopts the lex originis rule, supplemented by the lex rei sitae rule, is a forerunner. This article advocates that the adoption of the lex originis rule may help to stop the vicious circle of illegal possession of stolen cultural objects and facilitate the return of stolen cultural objects, especially those containing human remains, to their country of origin.
Contributing factors to lymph node recovery with esophagectomy by thoracic surgeons: an analysis of the Society of Thoracic Surgeons General Thoracic Surgery Database
Authors: Sachdeva Uma M , Axtell Andrea L , Kroese Tiuri E , Chang David C , Mathisen Douglas J , Morse Christopher R
Published: January 2022

Given the association between lymphadenectomy and survival after esophagectomy, and the ongoing development of effective adjuvant protocols for identified residual disease, we determined factors contributing to lymph node yield and effects on postoperative morbidity following esophagectomy by thoracic surgeons. Using the Society of Thoracic Surgeons General Thoracic Surgery Database, all patients who underwent esophagectomy for primary esophageal cancer with gastric conduit reconstruction from 2012 to 2016 were identified. Patient demographics, technical factors, and tumor characteristics associated with lymph node yield were determined using a multivariable multilevel mixed-effects regression model. Associations between lymph node yield and perioperative morbidity and mortality were similarly assessed. A total of 8480 patients were included. The median number of nodes harvested was 16 [Interquartile Range 11–22]. Factors associated with fewer nodes included female gender (b=−0.53, P=0.032), body mass index <18.5 (b=−1.46, P=0.012), prior cardiothoracic surgery (b=−0.73, P=0.015), intraoperative blood transfusion (b=−1.43, P<0.001), squamous cell histology (b=−0.86, P=0.006), and neoadjuvant treatment (b=−1.41, P<0.001). Operative approach significantly affected lymph node yield, with minimally invasive approaches demonstrating higher lymph node counts, and open transhiatal esophagectomy recovering the fewest nodes. Findings were independent of clinical center. There was no association of higher lymph node yield with 30-day mortality, with only slightly increased risk for chyle leak (odds ratio [OR] 1.02, P=0.012). In conclusion, several patient and tumor factors affect lymph node recovery with esophagectomy, independent of hospital center. Technical aspects, specifically minimally invasive approach, play a significant role in quantified lymph node yield. Higher operative lymph node yield was associated with minimal increased morbidity.
Estimating the SARS-CoV-2 infection fatality rate by data combination: the case of Germany’s first wave
Authors: Dimpfl Thomas , Sönksen Jantje , Bechmann Ingo , Grammig Joachim
Published: January 2022

Assessing the infection fatality rate (IFR) of SARS-CoV-2 in a population is a controversial issue. Due to asymptomatic courses of COVID-19, many infections remain undetected. Reported case fatality rates are therefore poor estimates of the IFR. We propose a strategy to estimate the IFR that combines official data on cases and fatalities with data from seroepidemiological studies in infection hotspots. The application of the method yields an estimate of the IFR of wild-type SARS-CoV-2 in Germany during the first wave of the pandemic of 0.83% (95% CI: [0.69%; 0.98%]), notably higher than the estimate reported in the prominent study by Streeck et al. (2020) (0.36% [0.17%; 0.77%]) and closer to that obtained from a world-wide meta analysis (0.68% [0.53%; 0.82%]), where the difference can be explained by Germany’s disadvantageous age structure. Provided that suitable data are available, the proposed method can be applied to estimate the IFR of virus variants and other regions.
Misclassification-robust semiparametric estimation of single-index binary-choice models
Authors: Čížek P , Sadıkoğlu S
Published: January 2022

In this paper, a new class of semiparametric estimators for single-index binary-choice models is introduced. The proposed estimators are based on the semiparametric indirect inference that identifies and estimates the parameters of the model via possibly misspecified auxiliary criteria. A large class of considered auxiliary criteria includes the ordinary least squares, nonlinear least squares, and nonlinear least absolute deviations estimators. Besides deriving the consistency and asymptotic normality of the proposed methods, we demonstrate that the proposed indirect inference methodology—at least for selected auxiliary criteria—combines weak distributional assumptions, good estimation precision, and robustness to misclassification of responses. We conduct Monte Carlo experiments and an application study to compare the finite-sample performance of the proposed and existing estimators.
Clinical outcomes of early closure versus conservative strategy after diagnosis with atrial septal defect: a nationwide population-based cohort study
Authors: Min Sun-Yang , Lee Ji Sung , Park Duk-Woo , Song Jong-Min
Published: January 2022

OBJECTIVES

The long-term clinical benefits of atrial septal defect (ASD) closure remain controversial. We aimed to compare long-term clinical outcomes between patients who underwent early surgical closure after ASD diagnosis and those who did not.

METHODS

Using the Korean National Health Insurance Service database, we identified patients with isolated ASDs diagnosed between 1 January 2003 and 31 December 2006. The ASD patients who underwent closure surgery within 6 months after diagnosis were allocated to the early-closure group and the rest were allocated to the conservative-strategy group. The primary outcome was all-cause mortality. Secondary outcomes were atrial flutter/fibrillation (AFF) and ischaemic stroke.

RESULTS

Among patients without a history of AFF or stroke, 1644 patients in the early-closure group were propensity score matched to 1644 patients in the conservative-strategy group and their median follow-up durations were 12.9 and 12.8 years, respectively. The early closure was associated with a significantly lower risk of mortality (hazard ratio, 0.55 [95% confidence interval, 0.43–0.70]). In an age-stratified analysis, significant mortality reductions in the early-closure group were found in patients aged 40 years or older. The risk of AFF was significantly higher in the early-closure group, which might be mainly ascribed to postoperative transient AFF, while there was no difference in ischaemic stroke between the 2 groups.

CONCLUSIONS

Our data suggest that timely ASD closure without delay is necessary for ASD patients without previous history of clinical events, especially in patients aged 40 years or older.
Impact of myocardial injury after coronary artery bypass grafting on long-term prognosis
Authors: Pölzl L , Thielmann M , Cymorek S , Nägele F , Hirsch J , Graber M , Sappler N , Eder J , Staggl S , Theurl F , Abfalterer H , Reinstadler S J , Holfeld J , Griesmacher A , Ulmer H , Grimm M , Bauer A , Ruttmann-Ulmer E , Ruhparwar A , Bonaros N , Gollmann-Tepeköylü C
Published: January 2022

Aims

The most appropriate definition of perioperative myocardial infarction (pMI) after coronary artery bypass grafting (CABG) and its impact on clinically relevant long-term events is controversial. We aimed to (i) analyse the incidence of pMI depending on various current definitions in a ‘real-life’ setting of CABG surgery and (ii) determine the long-term prognosis of patients with pMI depending on current definitions.

Methods and results

A consecutive cohort of 2829 coronary artery disease patients undergoing CABG from two tertiary university centres with the presence of serial perioperative cardiac biomarker measurements (cardiac troponin and creatine kinase-myocardial band) were retrospectively analysed. The incidence and prognostic impact of pMI were assessed according to (i) the 4th Universal Definition of Myocardial Infarction (4UD), (ii) the definition of the Society for Cardiovascular Angiography and Interventions (SCAI), and (iii) the Academic Research Consortium (ARC). The primary endpoint of this study was a composite of myocardial infarction, all-cause death, and repeat revascularization; secondary endpoints were mortality at 30 days and during 5-year follow-up. There was a significant difference in the occurrence of pMI (49.5% SCAI vs. 2.9% 4UD vs. 2.6% ARC). The 4th Universal Definition of Myocardial Infarction and ARC criteria remained strong independent predictors of all-cause mortality at 30 days [4UD: odds ratio (OR) 12.18; 95% confidence interval (CI) 5.00–29.67; P < 0.001; ARC: OR 13.16; 95% CI 5.41–32.00; P < 0.001] and 5 years [4UD: hazard ratio (HR) 2.13; 95% CI 1.19–3.81; P = 0.011; ARC: HR 2.23; 95% CI 1.21–4.09; P = 0.010]. Moreover, the occurrence of new perioperative electrocardiographic changes was prognostic of both primary and secondary endpoints.

Conclusion

Incidence and prognosis of pMI differ markedly depending on the underlying definition of myocardial infarction for patients undergoing CABG. Isolated biomarker release-based definitions (such as troponin) were not associated with pMI relevant to prognosis. Additional signs of ischaemia detected by new electrocardiographic abnormalities, regional wall motion abnormalities, or coronary angiography should result in rapid action in everyday clinical practice.
Self-reported changes in alcohol and tobacco use during COVID-19: findings from the eastern part of WHO European Region
Authors: Kilian Carolin , Neufeld Maria , Manthey Jakob , Alavidze Sophiko , Bobrova Anastacia , Baron-Epel Orna , Berisha Merita , Bilici Rabia , Davletov Kairat , Isajeva Laura , Kantaş Yılmaz Fatma , Karatkevich Tatsiana , Mereke Alibek , Musić Milanović Sanja , Galstyan Kristine , Muslić Ljiljana , Okoliyski Michail , Shabani Zana , Štelemėkas Mindaugas , Sturua Lela , Sznitman Sharon R , Ünübol Başak , Ferreira-Borges Carina , Rehm Jürgen
Published: January 2022

Background

The COVID-19 pandemic might impact substance use behaviours around the globe. In this study, we investigate changes in alcohol and tobacco use in the second half of 2020 in countries of the eastern part of the WHO European Region.

Methods

Self-reported changes in alcohol and tobacco use among 11 295 adults from 18 countries in the eastern part of the WHO European Region were collected between August 2020 and January 2021. The non-probabilistic sample was weighted for age, gender and education. For each country, proportions of respondents reporting a decrease, no change or increase in substance use over the past 3 months were examined, and multinomial regression models were used to test associations with age, gender and past-year alcohol use.

Results

In most countries, about half of the respondents indicating past-year alcohol or tobacco use reported no change in their substance use. Of those alcohol users who reported changes in their alcohol use, a larger proportion reported a decrease than an increase in most countries. The opposite was true for tobacco use. Women, young adults and past-year harmful alcohol users were identified as being more likely to change their substance use behaviour.

Conclusion

We found diverging overall trends for alcohol and tobacco use in the second half of 2020. The patterns of change vary according to age, gender and past-year substance use. Individuals at risk to increase their substance use during the COVID-19 pandemic require most policy considerations.
Arginine induces the resistance of postharvest jujube fruit against Alternaria rot
Authors: Chang Lulu , Yu Youwei , Zhang Lele , Wang Xiaojia , Zhang Shaoying
Published: January 2022

In order to explore the effects of arginine (Arg) treatment on postharvest rot of jujube caused by Alternaria alternata (A. alternata), winter jujube was treated with different concentrations of Arg (0, 20, 200, and 1000 μmol/L). Results showed that Arg treatment substantially inhibited the expansion of lesion diameter, and jujubes treated with 200 μmol/L Arg had the smallest lesion diameter. In vitro experiments demonstrated that Arg could not inhibit spore germination and mycelial growth of A. alternata. Further experimental results showed that Arg treatment reduced the production rate of O2–. and H2O2 content and improved the activities of superoxide dismutase, catalase, peroxidase, and ascorbate peroxidase in comparison with the control; Arg treatment enhanced the activities of chitinase and β-1,3-glucanase. Furthermore, Arg treatment significantly increased the activity of phenylalamine ammonia lyase and the contents of flavonoids, phenolics, and lignin. Results indicated that, although Arg could not directly inhibit the growth of pathogenic fungi as a fungicide, it can induce resistance to Alternaria rot by maintaining the balance of reactive oxygen species, increasing the activities of pathogenesis-related protein, and promoting the phenylpropane metabolism in jujube fruit tissue. Therefore, Arg treatment can be a novel measure for inducing the resistance of jujube to postharvest Alternaria rot.