bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic Accuracy of Magnetic Resonance Cholangiopancreatography Versus Endoscopic Retrograde Cholangiopancreatography Findings in the Postorthotopic Liver Transplant Population
Authors: Shiani Ashok , Lipka Seth , Wolk Benjamin , Pinkas Haim , Kumar Ambuj , Alsi-na Angel , Kemmer Nyingi , Kemmer Nyingi , Turner Alexandra , Brady Patrick
Published: November 2022

Introduction: Magnetic resonance cholangiopancreatography (MRCP) is an important diagnostic tool in evaluating patients with biliary laboratory abnormalities after orthotopic liver transplant (OLT) to determine the need for more invasive procedures, such as endoscopic retrograde cholangiopancreatography (ERCP), which can deliver therapeutic interventions. The aim of this study was to determine the diagnostic accuracy of MRCP findings using ERCP as the gold standard in a group of post-OLT patients.

Methods: A retrospective review of 273 patients who underwent OLT at the University of South Florida and Tampa General Hospital, Tampa, Florida, USA, from January 2012–April 2015 was performed. A total of 52 patients who had a MRCP and underwent a subsequent ERCP were studied. Presence of anastomotic stricture, common bile duct dilation >0.7 mm, bile leak, stone, intrahepatic stricture, or extrahepatic stricture on either modality was recorded. SPSS statistical analysis software (version 22 for Windows, SPSS Inc., Chicago, Illinois, USA) was used to calculate diagnostic accuracy.

Results: The mean age of the population examined was 54.5±10.5 years; 73% of the patients were male (38 of 52). Overall agreement between the two procedures ranged from 71–96%. The sensitivity, specificity, and positive and negative predictive values of MRCP for anastomotic strictures were 77%, 59%, 79%, and 56%, respectively. The sensitivity, specificity, and positive and negative predictive values of MRCP for common bile duct dilation of >0.7 mm were 64%, 95%, 82%, and 88%, respectively.

Conclusion: Despite significant improvement in the technology to better visualise the biliary system on MRCP, this study found that MRCP does not appear to be sensitive or specific in this chosen population. ERCP should be considered to confirm all positive MRCP findings, and in normal MRCP cases if there are other clinical data suggesting biliary abnormalities.
Anti-Tumour Necrosis Factor in Inflammatory Bowel Disease: Inventory and Outlook
Authors: Bella Laura , Ford Phil
Published: November 2022

Biosimilars have contributed substantially to the evolving therapeutic landscape for inflammatory bowel disease (IBD), enabling healthcare systems to offer access to a broader range of therapies at an affordable price. Despite the increasing confidence healthcare practitioners (HCP) place in the safety and efficacy of biosimilars, uncertainty remains around best practice when switching a patient from a reference product to a biosimilar. This symposium aimed to uncover the importance of a managed switch programme by exploring real-world data from the University Hospital Southampton NHS Foundation Trust, Southampton, UK, and University Hospital Erlangen, Erlangen, Germany. The roles of therapeutic drug monitoring and predictive outcome scoring were discussed based on evidence from the SECURE and the CREOLE studies, respectively. Finally, in light of the recent European Union (EU) approval of adalimumab biosimilars, the future therapeutic landscape and how physicians and patients can make well-informed decisions when multiple versions of the same biologic are available were discussed.
Editor’s Pick: Pyruvate Kinase and Gastric Cancer: A Potential Marker
Authors: Macedo Filipa , Ladeira Kátia , Longatto-Filho Adhemar , Martins Sandra F.
Published: November 2022

Gastric cancer is the second most common cause of cancer-related deaths worldwide, and the 5-year overall survival rate for advanced gastric cancer is ≤25%. Metabolism is a critical process for maintaining growth and other functions in cancer cells; in these cells, the metabolic process shifts from oxidative phosphorylation to aerobic glycolysis and the expression of pyruvate kinase (PK) splice isoform M2 (PKM2) is upregulated. A PubMed search focussing on PK in gastric cancer was conducted and 32 articles were initially collected; 12 articles were subsequently excluded from this review. PKM2 is responsible for tumour growth and invasion and correlates with short survival times and cancer differentiation. Pyruvate dehydrogenase kinase 1 is associated with cell proliferation, lymph node metastasis, and invasion. Measurement of PKM2 or pyruvate dehydrogenase kinase 1 in the blood or stools could be a good marker for gastric cancer in combination with the glycoprotein CA72-4. The review arose from the need for new biomarkers in the management of gastric cancer and had the primary objective of determining whether PK could be used as a marker to diagnose and monitor gastric cancer.
Individualised Care for Crohn’s Disease: Evolving Approaches for a Progressive Disease
Authors: Williams Chris
Published: November 2022

Crohn’s disease (CD) is a chronic, progressive, relapsing-remitting disorder characterised by periods of inflammatory activity occurring most commonly in the terminal ileum and colon, resulting in worsening bowel damage and increasing disability, which in turn are associated with significant impairment in quality of life (QoL). The recognition of CD as a progressive disease has shifted the goal of treatment from symptom management towards a focus on slowing disease progression, with the aim of reducing subsequent disability and mitigating impacts on QoL. This symposium focusses on understanding the advantages and limitations of current management strategies. It addresses the full spectrum of the complexity of CD, ranging from biologic therapy for moderately-to-severely active luminal CD, to new treatment options for complex perianal fistula based on innovative stem cell approaches.
Efektivitas Ekstrak Daun Kopi Robusta (Coffea canephora) Sebagai Repelan Terhadap Aedes aegypti
Authors: Alimin Laurencia , Setyaningrum Endah , Angraini Dian Isti
Published: November 2022

Dengue Hemorrhagic Fever (DHF) is an endemic disease in various tropical countries that is transmitted through the bite of  Aedes aegypti. One of the prevention of DHF transmission is by using repellent. Repellents that are usually used in the community have high side effects. So we need to find a replacement made from natural components. Flavonoid is one of the compounds in robusta coffee leaves that has a repellent effect. This study used analytical research with a pure experimental research design namely the Posttest Only Control Group Design in the form of a Complete Randomized Design (CRD) conducted from November 2019 to January 2020, consisting of five treatments (negative control, concentration of 10%, 25%, 50% and positive control) and repeated five times. Data were analyzed with One Way Anova, Post Hoc Bonferroni and Probit analysis. The results of study of robusta coffee leaf extract as repellent at a concentration of 10%, 25% and 50% gave protection power to 41.21%, 68.69% and 81.46% with ED50 concentration was 16.834% and ED99 contained at a concentration of 49.788%. The conclusion is the higher the concentration of robusta coffee leaves extract, the higher its protective power as repellent against Aedes aegypti.Keywords:Aedes aegypti, Robusta Coffee Leaves, Repellent AbstrakDemam Berdarah Dengue (DBD) merupakan penyakit endemis diberbagai negara beriklim tropis yang ditularkan melalui gigitan nyamuk Aedes aegypti. Salah satu pencegahan penularan penyakit DBD adalah dengan menggunakan repelan. Repelan yang digunakan di masyarakat umumnya memiliki efek samping yang tinggi sehingga upaya pencarian repelan berbahan alami lebih diutamakan. Flavonoid merupakan salah satu senyawa yang terdapat di dalam daun kopi robusta memiliki efek sebagai repelan. Penelitian ini menggunakan jenis penelitian analitik dengan desain penelitian eksperimental murni yaitu Posttest Only Control Group Design yang berupa Rancangan Acak Lengkap (RAL) dilakukan dari bulan November hingga Januari 2020, terdiri dari lima perlakuan (kontrol negatif, konsentrasi 10%, 25%, 50% dan kontrol positif) dan diulang sebanyak lima kali. Data yang didapatkan dianalisis dengan menggunakan One Way Anova, Post Hoc Bonferroni dan analisis Probit. Hasil penelitian didapatkan bahwa ekstrak daun kopi robusta sebagai repelan pada konsentrasi 10%, 25% dan 50% memberikan daya proteksi sebesar 41,21%, 68,69% dan 81,46% dengan ED50 adalah konsentrasi 16,834% dan ED99 terdapat pada konsentrasi 49,788%. Kesimpulannya semakin tinggi konsentrasi ekstrak daun kopi robusta semakin tinggi daya proteksi sebagai repelan terhadap Aedes aegypti. Kata kunci: Aedes aegypti, Daun Kopi Robusta, Repelan.
Pengaruh Pemberian Buku Saku terhadap Motivasi dan Kepatuhan Ibu Melakukan Senam Hamil
Authors: Murni Ni Nengah Arini Murni , Wahyuni I Gusti Ayu Putu Sri Wahyuni , Anggraeni Ni Putu Dian Ayu
Published: November 2022

Introduction: Pregnancy exercise aims to prepare physically and mentally to face and prepare for childbirth. Motivation is still needed to do pregnancy exercise. The choice of method when providing health education is very important to understand the content of the material. Objective: To determine the effect of giving a pocket book on the motivation and compliance of pregnant women doing pregnancy exercise. Methods: Quasi-experimental-group pre and post-test design with control group. The research sample was pregnant women by purposive sampling with each group of 30 respondents. Measurement of motivation and compliance variables before and after the intervention with a questionnaire through the results of observations and monitoring cards. Data were analyzed by univariate and bivariate using Chi square test. Results: In the intervention group, there was a significant difference in maternal motivation (p-value=0.001) and pregnant women's adherence to exercise during pregnancy (p-value=0.042). While in the control group there was no difference in maternal motivation (p-value = 0.214), but there was a significant difference in the compliance of pregnant women in doing pregnancy exercise (p-value=0.000). Conclusion: Provision of pocket books is effective in increasing the motivation and compliance of mothers in doing pregnancy exercise. Future research can design tools that are more practical and effective to monitor compliance and evaluate the effectiveness of pregnancy exercise on the delivery process.
Synthetic materials in craniofacial regenerative medicine: A comprehensive overview
Authors: Yazdanian Mohsen , Alam Mostafa , Abbasi Kamyar , Rahbar Mahdi , Farjood Amin , Tahmasebi Elahe , Tebyaniyan Hamid , Ranjbar Reza , Hesam Arefi Arian
Published: November 2022

The state-of-the-art approach to regenerating different tissues and organs is tissue engineering which includes the three parts of stem cells (SCs), scaffolds, and growth factors. Cellular behaviors such as propagation, differentiation, and assembling the extracellular matrix (ECM) are influenced by the cell’s microenvironment. Imitating the cell’s natural environment, such as scaffolds, is vital to create appropriate tissue. Craniofacial tissue engineering refers to regenerating tissues found in the brain and the face parts such as bone, muscle, and artery. More biocompatible and biodegradable scaffolds are more commensurate with tissue remodeling and more appropriate for cell culture, signaling, and adhesion. Synthetic materials play significant roles and have become more prevalent in medical applications. They have also been used in different forms for producing a microenvironment as ECM for cells. Synthetic scaffolds may be comprised of polymers, bioceramics, or hybrids of natural/synthetic materials. Synthetic scaffolds have produced ECM-like materials that can properly mimic and regulate the tissue microenvironment’s physical, mechanical, chemical, and biological properties, manage adherence of biomolecules and adjust the material’s degradability. The present review article is focused on synthetic materials used in craniofacial tissue engineering in recent decades.
Biomimetic nanoparticles for tumor immunotherapy
Authors: Yu Hanqing , Wu Meng , Chen Siyu , Song Mingming , Yue Yulin
Published: November 2022

Currently, tumor treatment research still focuses on the cancer cells themselves, but the fact that the immune system plays an important role in inhibiting tumor development cannot be ignored. The activation of the immune system depends on the difference between self and non-self. Unfortunately, cancer is characterized by genetic changes in the host cells that lead to uncontrolled cell proliferation and evade immune surveillance. Cancer immunotherapy aims to coordinate a patient’s immune system to target, fight, and destroy cancer cells without destroying the normal cells. Nevertheless, antitumor immunity driven by the autoimmune system alone may be inadequate for treatment. The development of drug delivery systems (DDS) based on nanoparticles can not only promote immunotherapy but also improve the immunosuppressive tumor microenvironment (ITM), which provides promising strategies for cancer treatment. However, conventional nano drug delivery systems (NDDS) are subject to several limitations in clinical transformation, such as immunogenicity and the potential toxicity risks of the carrier materials, premature drug leakage at off-target sites during circulation and drug load content. In order to address these limitations, this paper reviews the trends and progress of biomimetic NDDS and discusses the applications of each biomimetic system in tumor immunotherapy. Furthermore, we review the various combination immunotherapies based on biomimetic NDDS and key considerations for clinical transformation.
The Sall2 transcription factor promotes cell migration regulating focal adhesion turnover and integrin β1 expression
Authors: Riffo Elizabeth , Palma Mario , Hepp Matías I. , Benítez-Riquelme Diego , Torres Vicente A. , Castro Ariel F. , Pincheira Roxana
Published: November 2022

SALL2/Sall2 is a transcription factor associated with development, neuronal differentiation, and cancer. Interestingly, SALL2/Sall2 deficiency leads to failure of the optic fissure closure and neurite outgrowth, suggesting a positive role for SALL2/Sall2 in cell migration. However, in some cancer cells, SALL2 deficiency is associated with increased cell migration. To further investigate the role of Sall2 in the cell migration process, we used immortalized Sall2 knockout (Sall2−/−) and Sall2 wild-type (Sall2+/+) mouse embryonic fibroblasts (iMEFs). Our results indicated that Sall2 positively regulates cell migration, promoting cell detachment and focal adhesions turnover. Sall2 deficiency decreased cell motility and altered focal adhesion dynamics. Accordingly, restoring Sall2 expression in the Sall2−/− iMEFs by using a doxycycline-inducible Tet-On system recovered cell migratory capabilities and focal adhesion dynamics. In addition, Sall2 promoted the autophosphorylation of Focal Adhesion Kinase (FAK) at Y397 and increased integrin β1 mRNA and its protein expression at the cell surface. We demonstrated that SALL2 increases ITGB1 promoter activity and binds to conserved SALL2-binding sites at the proximal region of the ITGB1 promoter, validated by ChIP experiments. Furthermore, the overexpression of integrin β1 or its blockade generates a cell migration phenotype similar to that of Sall2+/+ or Sall2−/− cells, respectively. Altogether, our data showed that Sall2 promotes cell migration by modulating focal adhesion dynamics, and this phenotype is associated with SALL2/Sall2-transcriptional regulation of integrin β1 expression and FAK autophosphorylation. Since deregulation of cell migration promotes congenital abnormalities, tumor formation, and spread to other tissues, our findings suggest that the SALL2/Sall2-integrin β1 axis could be relevant for those processes.
Demonstration of a three compartment solar electrolyser with gas phase cathode producing formic acid from CO2 and water using Earth abundant metals
Authors: Thijs Barbara , Hanssens Lucas , Heremans Gino , Wangermez Wauter , Rongé Jan , Martens Johan A.
Published: November 2022

A three compartment solar formic acid generator was built using a Sn on Cu foam cathode and NiFe anode. A bipolar combination of a Fumasep FAD-PET-75 and Nafion 117 membrane was mounted between anode and middle compartment, which was filled with Amberlyst 15H ion exchanger beads. A Fumasep FAD-PET-75 membrane separated the middle compartment from the cathode. The generator was powered with a photovoltaic panel and fed with gaseous CO2 and water. Diluted formic acid solution was produced by flowing water through the middle compartment. Common PV-EC devices are operated using aqueous electrolyte and produce aqueous formate. In our PV-EC device, formic acid is produced straight away, avoiding the need for downstream operations to convert formate to formic acid. The electrolyser was matched with solar photovoltaic cells achieving a coupling efficiency as high as 95%. Our device produces formic acid at a faradaic efficiency of ca. 31% and solar-to-formic acid efficiency of ca. 2%. By producing formic acid from CO2 and water without any need of additional chemicals this electrolyser concept is attractive for use at remote locations with abundant solar energy. Formic acid serves as a liquid renewable fuel or chemical building block.
Synergistic and antibiofilm potential of Curcuma aromatica derived silver nanoparticles in combination with antibiotics against multidrug-resistant pathogens
Authors: Tawre Madhumita S. , Shiledar Aishwarya , Satpute Surekha K. , Ahire Kedar , Ghosh Sougata , Pardesi Karishma
Published: November 2022

Hospital acquired infections caused due to ESKAPE pathogens pose a challenge for treatment due to their growing antimicrobial resistance. Curcuma aromatica (CA) is traditionally known for its antibacterial, wound healing and anti-inflammatory properties. The present study highlights the biogenic synthesis of silver nanoparticles (CAAgNPs) capped and stabilized by the compounds from CA rhizome extract, also further demonstrating their antibacterial, antibiofilm and synergistic effects against multidrug-resistant (MDR) pathogens. CAAgNPs were synthesized using aqueous rhizome extract of CA (5 mg/ml) and AgNO3 (0.8 mM) incubated at 60°C up to 144 h. UV-vis spectroscopy, field emission scanning electron microscopy (FESEM), transmission electron microscopy (TEM), energy dispersive spectroscopy (EDS) and X-ray diffraction (XRD) revealed CAAgNPs with characteristic peak at 430 nm, 13 ± 5 nm size of spherical shape, showing presence of silver and crystalline nature, respectively. Dynamic light scattering (DLS) and zeta potential confirmed their monodispersed nature with average diameter of 77.88 ± 48.60 nm and stability. Fourier transform infrared spectroscopic (FTIR) analysis demonstrated the presence of phenolic -OH and carbonyl groups possibly involved in the reduction and stabilization of CAAgNPs. The minimum inhibitory concentrations (MICs), minimum bactericidal concentrations (MBCs) and minimum biofilm inhibitory concentrations (MBICs) of CAAgNPs against Pseudomonas aeruginosa, NCIM 5029 and PAW1, and, Staphylococcus aureus, NCIM 5021 and S8 were in range from 8 to 128 μg/ml. Almost 50% disruption of pre-formed biofilms at concentrations 8–1,024 μg/ml was observed. Fluorescence microscopy and FESEM analysis confirmed cell death and disruption of pre-formed biofilms of P. aeruginosa PAW1 and S. aureus S8. Checkerboard assay demonstrated the synergistic effect of CAAgNPs (0.125–4 μg/ml) in combination with various antibiotics (0.063–1,024 μg/ml) against planktonic and biofilm forms of P. aeruginosa PAW1. The study confirms the antibacterial and antibiofilm activity of CAAgNPs alone and in combination with antibiotics against MDR pathogens, thus, reducing the dose as well as toxicity of both. CAAgNPs have the potential to be used in wound dressings and ointments, and to improve the performances of medical devices and surgical implants. In vivo toxicity of CAAgNPs however needs to be tested further using mice models.
Multifunctional phototheranostic agent ZnO@Ag for anti-infection through photothermal/photodynamic therapy
Authors: Obeng Enoch , Feng Jiayao , Wang Danyan , Zheng Dongyang , Xiang Bailin , Shen Jianliang
Published: November 2022

To overcome the limitations of traditional therapeutics, nanotechnology offers a synergistic therapeutic approach for the treatment of bacterial infection and biofilms that has attracted attention. Herein, we report on a ZnO@Ag nanocomposite with good biocompatibility synthesized by doping ZnO NPs with silver nanoparticles (Ag NPs). ZnO@Ag nanocomposites were synthesized with varying ratios of Ag NPs (0.5%, 2%, 8%). Under the same experimental conditions, ZnO@8%Ag exhibited outstanding properties compared to the other nanocomposites and the pristine ZnO NPs. ZnO@8%Ag demonstrated excellent photothermal and photodynamic properties. Also, ZnO@8%Ag demonstrated over 99% inhibition of Staphylococcus aureus (S. aureus) under photothermal therapy (PTT) or photodynamics therapy (PDT) as a result of the excessive generation of reactive oxygen species (ROS) by the Ag+ released, while the pristine ZnO showed an insignificant inhibition rate compared to the PBS group (control). Furthermore, ZnO@8%Ag completely disrupted S. aureus biofilm under a combined PTT/PDT treatment, a synergetic trimodal therapy, although the molecular mechanism of biofilm inhibition remains unclear. Hence, the excellent photothermal, photodynamic, biocompatibility, and bactericidal properties of ZnO@8%Ag present it as an appropriate platform for bacterial and biofilm treatment or other biomedically related applications.
Molecular Rubies in Photoredox Catalysis
Authors: Sittel Steven , Naumann Robert , Heinze Katja
Published: November 2022

The molecular ruby [Cr(tpe)2]3+ and the tris(bipyridine) chromium(III) complex [Cr(dmcbpy)3]3+ as well as the tris(bipyrazine)ruthenium(II) complex [Ru(bpz)3]2+ were employed in the visible light-induced radical cation [4+2] cycloaddition (tpe = 1,1,1-tris(pyrid-2-yl)ethane, dmcbpy = 4,4′-dimethoxycarbonyl-2,2′-bipyridine, bpz = 2,2′-bipyrazine), while [Cr(ddpd)2]3+ serves as a control system (ddpd = N,N′-dimethyl-N,N′-dipyridin-2-ylpyridine-2,6-diamine). Along with an updated mechanistic proposal for the CrIII driven catalytic cycle based on redox chemistry, Stern-Volmer analyses, UV/Vis/NIR spectroscopic and nanosecond laser flash photolysis studies, we demonstrate that the very weakly absorbing photocatalyst [Cr(tpe)2]3+ outcompetes [Cr(dmcbpy)3]3+ and even [Ru(bpz)3]2+ in particular at low catalyst loadings, which appears contradictory at first sight. The high photostability, the reversible redoxchemistry and the very long excited state lifetime account for the exceptional performance and even reusability of [Cr(tpe)2]3+ in this photoredox catalytic system.
Dietary sugars modulate bacterial-fungal interactions in saliva and inter-kingdom biofilm formation on apatitic surface
Authors: Negrini Thais de Cássia , Ren Zhi , Miao Yilan , Kim Dongyeop , Simon-Soro Áurea , Liu Yuan , Koo Hyun , Arthur Rodrigo Alex
Published: November 2022

Bacteria and fungi can interact to form inter-kingdom biofilms in the oral cavity. Streptococcus mutans and Candida albicans are frequently detected in saliva and in dental biofilms associated with early childhood caries (tooth-decay), a prevalent oral disease induced by dietary sugars. However, how different sugars influence this bacterial-fungal interaction remains unclear. Here, we investigate whether specific sugars affect the inter-kingdom interaction in saliva and subsequent biofilm formation on tooth-mimetic surfaces. The microbes were incubated in saliva containing common dietary sugars (glucose and fructose, sucrose, starch, and combinations) and analyzed via fluorescence imaging and quantitative computational analyses. The bacterial and fungal cells in saliva were then transferred to hydroxyapatite discs (tooth mimic) to allow microbial binding and biofilm development. We found diverse bacterial-fungal aggregates which varied in size, structure, and spatial organization depending on the type of sugars. Sucrose and starch+sucrose induced the formation of large mixed-species aggregates characterized by bacterial clusters co-bound with fungal cells, whereas mostly single-cells were found in the absence of sugar or in the presence of glucose and fructose. Notably, both colonization and further growth on the apatitic surface were dependent on sugar-mediated aggregation, leading to biofilms with distinctive spatial organizations and 3D architectures. Starch+sucrose and sucrose-mediated aggregates developed into large and highly acidogenic biofilms with complex network of bacterial and fungal cells (yeast and hyphae) surrounded by an intricate matrix of extracellular glucans. In contrast, biofilms originated from glucose and fructose-mediated consortia (or without sugar) were sparsely distributed on the surface without structural integration, growing predominantly as individual species with reduced acidogenicity. These findings reveal the impact of dietary sugars on inter-kingdom interactions in saliva and how they mediate biofilm formation with distinctive structural organization and varying acidogenicity implicated with human tooth-decay.
First-in-man application of Liwen RF™ ablation system in the treatment of drug-resistant hypertrophic obstructive cardiomyopathy
Authors: Wang Zihao , Zhao Rong , Sievert Horst , Ta Shengjun , Li Jing , Bertog Stefan , Piayda Kerstin , Zhou Mengyao , Lei Changhui , Li Xiaojuan , Liu Jiani , Xu Bo , Feng Bo , Hu Rui , Liu Liwen
Published: November 2022

Objectives

This study sought to evaluate the clinical applicability of the Liwen Liu RF™ ablation system for percutaneous intramyocardial septal radiofrequency ablation (PIMSRA).

Background

Data on new cardiac radiofrequency ablation devices for the treatment of hypertrophic obstructive cardiomyopathy (HOCM) are limited.

Materials and methods

From July 2019 to July 2020, a total of 68 patients with drug-resistant HOCM, who underwent PIMSRA with the Liwen RF™ ablation system, which has an ablation electrode of stepless adjustable length, were prospectively enrolled. Safety endpoints included, amongst others, the occurrence of pericardial effusion and/or hemorrhage, cardiac arrhythmias, device failure and procedural death. The reduction in left ventricular outflow tract (LVOT) gradients at 12 months follow-up were used as a surrogate marker for device efficacy.

Results

All procedures were technically successful. The total energy output time of the system was 75.8 (IQR: 30.0) min, and the average power was 43.61 ± 13.34 watts. No ablation system error occurred. The incidence of pericardial effusion or hemorrhage, transient arrhythmia and resuscitation was 8.8, 39.7, and 1.5% during procedure, respectively. None of the patients died. During 30-day follow-up, there were no complications with the exception of a pericardial effusion in one patient (1.5%). No further complications were reported after 30 days. The patients’ resting [baseline: 75 (IQR: 48) vs. 12-months: 12 (IQR: 19) mmHg, p < 0.001] and provoked [baseline: 122 (IQR: 53) vs. 12-months: 41 (IQR: 59) mmHg, p < 0.001] LVOT gradients decreased significantly during follow-up.

Conclusion

In this study, we demonstrate the safety and feasibility of the Liwen RF™ ablation system to treat HOCM. The system allows for significant and sustainable LVOT gradient reduction during 12-months of follow-up. Hence, the Liwen RF™ ablation system is a promising new device that has the potential to become an alternative to existing septal reduction concepts in HOCM patients.
Cardiac magnetic resonance follow-up of COVID-19 vaccine associated acute myocarditis
Authors: Kravchenko Dmitrij , Isaak Alexander , Mesropyan Narine , Bischoff Leon M. , Pieper Claus C. , Attenberger Ulrike , Kuetting Daniel , Zimmer Sebastian , Hart Christopher , Luetkens Julian A.
Published: November 2022

Background

Mass COVID-19 vaccination campaigns have helped impede the COVID-19 pandemic. In rare cases, some vaccines have led to vaccine associated myocarditis in a specific subset of the population, usually young males. Cardiac magnetic resonance (CMR) can reliably diagnose vaccine associated myocarditis, but follow-up data of CMR proven acute myocarditis is scarce.

Materials and methods

Nine patients with acute vaccine associated myocarditis underwent baseline and follow-up CMR examinations and were compared to baseline parameters at initial presentation and to a group of 20 healthy controls. CMR protocol included functional assessment, T1 and T2 mapping, T2 signal intensity ratio, strain feature tracking, and late gadolinium enhancement (LGE).

Results

Myocarditis patients (n = 9, aged 24 ± 6 years, 8 males) underwent CMR follow-up after an average of 5.8 ± 4.3 months. All patients showed a complete resolution of visual myocardial edema while also demonstrating a reduction in overall LGE extent from baseline to follow-up (4.2 ± 2.1 vs. 0.9 ± 0.8%, p < 0.001), although visual LGE was still noted in all patients. Left ventricular ejection fraction was normal at baseline and at follow-up (58 ± 6 vs. 62 ± 4%, p = 0.10) as well as compared to a healthy control group (60 ± 4%, p = 0.24). T1 (1024 ± 77 vs. 971 ± 34 ms, p = 0.05) and T2 relaxations times (57 ± 6 vs. 51 ± 3 ms, p = 0.03) normalized at follow-up. Most patients reported a resolution of clinical symptoms, while two (22%) reported new onset of exertional dyspnea.

Conclusion

Patients with COVID-19 vaccine associated acute myocarditis showed a complete, uncomplicated resolution of myocardial inflammation on follow-up CMR, which was associated with a near complete resolution of symptoms. Minor, residual myocardial scarring was present on follow-up LGE imaging. The long-term implications of the remaining myocardial scar-tissue after vaccine associated myocarditis remain unknown warranting further studies.
Stress hyperglycemia ratio and neutrophil to lymphocyte ratio are reliable predictors of new-onset atrial fibrillation in patients with acute myocardial infarction
Authors: Pan Lifei , Li Zhitong , Li Chenglin , Dong Xiaopeng , Hidru Tesfaldet H. , Liu Fei , Xia Yunlong , Yang Xiaolei , Zhong Lei , Liu Ying
Published: November 2022

Background

The occurrence of new-onset atrial fibrillation (NOAF) post-acute myocardial infarction (AMI) is associated with worse outcomes. In this study, we sought to assess the predictive effect of stress hyperglycemia ratio (SHR) and neutrophil to lymphocyte ratio (NLR) to predict NOAF in patients with AMI.

Materials and methods

We recruited 3,194 individuals with AMI but free of atrial fibrillation (AF). AMI cases were stratified into groups according to SHR and NLR quartiles and were further categorized based on diabetes status. High SHR and high NLR were defined as the highest quartile of SHR and NLR. A nomogram incorporating risk factors for NOAF was constructed using multivariate logistic regression analyses. The performance of the novel nomogram was tested for predictive performance, agreement between the actual and predicted probability, and clinical utility using area under the curve (AUC), bootstrapped calibration curves, and decision curve analysis, respectively.

Result

A total of 245 (7.67%) patients developed NOAF post-AMI. The NOAF cases had higher values of SHR and NLR than non-NOAF patients after AMI regardless of diabetes status. After adjusting for potential confounders, high SHR and NLR were independently associated with NOAF post-AMI. Moreover, the novel nomogram incorporating high NLR and high SHR for NOAF risk estimation in patients with AMI showed satisfactory performance assessed by the AUC, calibration curves, decision curve analysis.

Conclusion

SHR and NLR were independently associated with NOAF in AMI patients. The constructed novel nomogram that incorporates SHR and NLR might assist in NOAF risk stratification post-AMI.
Ultra-high-resolution assessment of lesion extension after cryoballoon ablation for pulmonary vein isolation
Authors: Spera Francesco , Narducci Maria Lucia , Bencardino Gianluigi , Perna Francesco , Bisignani Antonio , Pinnacchio Gaetano , Tondo Claudio , Maggio Ruggero , Stabile Giuseppe , Iacopino Saverio , Tundo Fabrizio , Ferraro Anna , De Simone Antonio , Malacrida Maurizio , Pintus Federico , Crea Filippo , Pelargonio Gemma
Published: November 2022

Introduction

Unrecognized incomplete pulmonary vein (PV) isolation during the index procedure, can be a major cause of clinical recurrences of atrial fibrillation (AF) after cryoballoon (CB) ablation. We aimed to characterize the extension of the lesions produced by CB ablation and to assess the value of using an ultra-high resolution electroanatomic mapping (UHDM) system to detect incomplete CB lesions.

Materials and methods

Twenty-nine consecutive patients from the CHARISMA registry undergoing AF ablation at four Italian centers were prospectively evaluated. The Rhythmia™ mapping system and the Orion™ (Boston Scientific) mapping catheter were used to systematically map the left atrium and PVs before and after cryoablation.

Results

A total of 116 PVs were targeted and isolated. Quantitative assessment of the lesions revealed a significant reduction of the antral surface area of the PV, resulting in an ablated area of 5.7 ± 0.7 cm2 and 5.1 ± 0.8 cm2 for the left PV pair and right PV pair, respectively (p = 0.0068). The mean posterior wall (PW) area was 22.9 ± 2 cm2 and, following PV isolation, 44.8 ± 6% of the PW area was ablated. After CB ablation, complete isolation of each PV was documented by the POLARMap™ catheter in all patients. By contrast, confirmatory UHDM and the Lumipoint™ tool unveiled PV signals in 1 out of 114 of the PVs (0.9%). Over 30-day follow-up, no major procedure-related adverse events were reported. After a mean follow-up of 333 days, 89.7% of patients were free from arrhythmia recurrence.

Conclusion

The lesion extension achieved by the new CB ablation system involved the PV antrum, with less than 50% of the PW remaining untouched. The new system, with short tip and circular mapping catheter, failed to achieve PV isolation in only 0.9% of all PVs treated.

Clinical trial registration

[http://clinicaltrials.gov/], identifier [NCT03793998].
The efficacy and safety of different endovascular modalities for infrapopliteal arteries lesions: A network meta-analysis of randomized controlled trials
Authors: Guo Julong , Ning Yachan , Wang Hui , Li Yu , Su Zhixiang , Zhang Fan , Wu Sensen , Guo Lianrui , Gu Yongquan
Published: November 2022

Background

Endovascular treatment has become the first-line therapy for infrapopliteal artery occlusive disease (IPOD), while the optimal endovascular method remains to be determined. We performed a network meta-analysis (NWM) of randomized controlled trials (RCTs) to simultaneously compare the outcomes of different endovascular modalities for IPOD.

Methods and results

The Pubmed, Embase, and Cochrane databases were used as data sources. The NWM approach used random-effects models based on the frequentist framework. In total, 22 eligible RCTs (44 study arms; 1,348 patients) involving nine endovascular modalities or combinations [balloon angioplasty (BA), drug-coated balloon (DCB), drug-eluting stent (DES), atherectomy device + BA (AD + BA), AD + DCB, balloon-expandable bare metal stent (BMS), self-expanding stent (SES), absorbable metal stents (AMS), and inorganics-coated stent (ICS)] were included. BA had a lower 12-month primary patency rate than DCB (RR 0.50, CI 0.27, 0.93) and AD + DCB (RR 0.34, CI 0.12, 0.93). AD + DCB decreased 6-month TLR compared with AMS (RR 0.15, CI 0.03, 0.90), and DES decreased it compared with BMS (RR 0.25, CI 0.09, 0.71). DCB had a lower 6-month TLR rate than AMS (RR 0.26, CI 0.08, 0.86) and BA (RR 0.51, CI 0.30, 0.89). BA had a higher 12-month TLR rate than DCB (RR 1.76, CI 1.07, 2.90). According to the value of the surface under the cumulative ranking curve (SUCRA), AD + DCB was considered the best treatment in terms of primary patency at 6 months (SUCRA = 87.5) and 12 months (SURCA = 91). AD + BA was considered the best treatment in terms of 6-month TLR (SUCRA = 83.1), 12-month TLR (SURCA = 75.8), and 12-month all-cause mortality (SUCRA = 92.5). In terms of 12-month major amputation, DES was considered the best treatment (SUCRA = 78.6), while AD + DCB was considered the worst treatment (SUCRA = 28.8). Moreover, AD + BA always ranks higher than AD + DCB in the comparison including these two combinations. Subgroup analyses of modalities without stenting did not significantly change the primary outcomes.

Conclusion

ADs showed noteworthy advantages in multiple terms for IPOD except for 12-month major amputation. AD + BA may be a better method for IPOD than AD + DCB. The efficacy and safety of ADs are worthy of further investigation.

Systematic review registration

[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022331626].
Multi-dimensional patient acuity estimation with longitudinal EHR tokenization and flexible transformer networks
Authors: Shickel Benjamin , Silva Brandon , Ozrazgat-Baslanti Tezcan , Ren Yuanfang , Khezeli Kia , Guan Ziyuan , Tighe Patrick J. , Bihorac Azra , Rashidi Parisa
Published: November 2022

Transformer model architectures have revolutionized the natural language processing (NLP) domain and continue to produce state-of-the-art results in text-based applications. Prior to the emergence of transformers, traditional NLP models such as recurrent and convolutional neural networks demonstrated promising utility for patient-level predictions and health forecasting from longitudinal datasets. However, to our knowledge only few studies have explored transformers for predicting clinical outcomes from electronic health record (EHR) data, and in our estimation, none have adequately derived a health-specific tokenization scheme to fully capture the heterogeneity of EHR systems. In this study, we propose a dynamic method for tokenizing both discrete and continuous patient data, and present a transformer-based classifier utilizing a joint embedding space for integrating disparate temporal patient measurements. We demonstrate the feasibility of our clinical AI framework through multi-task ICU patient acuity estimation, where we simultaneously predict six mortality and readmission outcomes. Our longitudinal EHR tokenization and transformer modeling approaches resulted in more accurate predictions compared with baseline machine learning models, which suggest opportunities for future multimodal data integrations and algorithmic support tools using clinical transformer networks.
Self-managed weight loss by smart body fat scales ameliorates obesity-related body composition during the COVID-19 pandemic: A follow-up study in Chinese population
Authors: Huang Xinru , Li Mingjie , Shi Yefei , Yao Hongyun , Lei Zhijun , Kou Wenxin , Li Bo , Shi Jiayun , Zhang Weiwei , Jian Weixia
Published: November 2022

Background

Since 2020, longer stay-at-home time in response to the coronavirus disease 2019 (COVID-19) pandemic has changed the weight-related behaviors of Chinese population.

Objectives

To explore the demographic and basic characteristics of body fat scale users and to investigate the changes in obesity-related body composition of overweight and obese users during COVID-19. Further, we analyzed the factors associated with successful weight loss and improved body composition changes in overweight and obese people.

Methods

The study included 107,419 Chinese adults registered in the smart app connecting to the body fat scale in 2020 to describe the demographic characteristics of body fat scale users by Unpaired Student’s t-test and Chi-Square test. Subsequently, overweight and obese participants with body mass index (BMI) of more than 24 kg/m2 were screened to investigate the independent factors associated with effective weight loss and improved body composition changes by multivariable logistic regression analyses.

Results

During the pandemic, the number of body fat scale users increased markedly compared with pre-pandemic. Over half of the participants were women and with normal baseline BMI. Based on BMI classification, multivariable logistic regressions showed that age, gender, measurement frequency classification, baseline BMI, visceral adipose index and skeletal muscle rate were associated with weight loss and fat loss in the overweight and obese population, with the high-frequency measurement being the most important factor for effective weight and fat loss. In the population with normal BMI obesity, younger age was the most significant factor for effective fat loss.

Conclusion

During the COVID-19 pandemic, participation in self-monitored weight loss increased markedly compared with pre-pandemic, and women accounted for the majority. We found that many overweight and obese participants achieved weight loss goals by smart body fat scales, and the effectiveness of weight and fat loss was greater in obese participants than in overweight participants, both based on BMI and PBF classification. In addition, promoting the usage of smart body fat scales could contribute to more effective weight and fat loss in the overweight and obese population based on BMI classification. However, in the population with normal BMI obesity, young subjects might be easier to successfully lose fat compared with the elder. Digital self-management by smart body fat scales could become a promising approach for the obese population with high BMI to lose weight and keep healthy.
Experimental study of the adsorption of 2-Chloroacetophenone at the air-environmental water interface
Authors: Hao Shangpeng , Liu Xuefeng , Sun Chao , Zhang Yuanpeng , Gao Runli , Wang Haitao , Wang Xiaolu
Published: November 2022

The widespread surface of the air-water interface plays a crucial role in the partitioning processes between the atmosphere and the hydrosphere. As one of the prime CWAs (Chemical Warfare Agents) abandoned by Japanese, the unfound 2-Chloroacetophenone posed a severe threat to the Chinese people. In this study, the interface partition constant of 2-Chloroacetophenone was obtained by measuring the mass uptake vapor on different environmental water films with various thicknesses. The surface tension, dissolved organic matter, and salinity of the environmental samples were analyzed. The partition constant of 2-Chloroacetophenone in pure water, river water and sea water samples at 288 K were 1182.2 ± 49.9, 1606.6 ± 101.3 and 408.9 ± 18.3, respectively. Surface adsorption is the predominant mechanism. The results also indicate that the adsorption partitioning ability of 2-Chloroacetophenone at the air/water interface was negatively correlated with surface tension. 2-Chloroacetophenone is more likely to adsorb at the gas/water interface with lower surface tension.
Juvenile hormone modulates hydrocarbon expression and reproduction in the german wasp Vespula germanica
Authors: da Silva Rafael Carvalho , do Nascimento Fabio Santos , Wenseleers Tom , Oi Cintia Akemi
Published: November 2022

Juvenile hormone (JH) affects multiple physiological traits in insects. In social insects, besides development, JH has been demonstrated to influence caste determination and the production of chemical compounds. In social wasps, JH triggers behavioral maturation, gonadotropic effects, and hydrocarbon modulation. Here, we investigated whether JH displays the same function in fertility and fertility cue production in females of the German wasp Vespula germanica, previously shown in the related species Vespula vulgaris. By experimentally treating workers with JH-analog, an anti-JH, and acetone solvent control, we tested whether JH modulates the cuticular chemical expression (CHCs), the Dufour’s gland chemical composition, and hence the compounds found over the egg’s surface. Additionally, we explored whether JH has a gonadotropic effect on workers. Workers treated with the JH-analog acquired a chemical profile that was intermediate between the queen and other treated workers. Interestingly, the same pattern was also seen in the Dufour’s glands and eggs, although more subtle. Furthermore, workers treated with the JH-analog were more fertile when compared to the controls, supporting the fact that JH acts as a gonadotropic hormone. Our results indicate a similar function of JH in societies of related wasp species V. germanica and V. vulgaris.
The role of costimulatory molecules in glioma biology and immune microenvironment
Authors: Wang Ji , Wang Zi , Jia Wenxue , Gong Wei , Dong Bokai , Wang Zhuangzhuang , Zhou Meng , Tian Chunlei
Published: November 2022

Background: Extensive research showed costimulatory molecules regulate tumor progression. Nevertheless, a small amount of literature has concentrated on the potential prognostic and therapeutic effects of costimulatory molecules in patients with glioma.

Methods: The data were downloaded from The Cancer Genome Atlas (TCGA) database, Chinese Glioma Genome Atlas (CGGA) database, and Gene Expression Omnibus (GEO) database for bioinformatics analysis. R software was applied for statistical analysis. Using the FigureYa and Xiantao online tools (https://www.xiantao.love/) for mapping.

Results: The Least absolute shrinkage and selection operator (LASSO) and Cox regression analysis were utilized to identify the signature consisting of five costimulatory molecules. Multivariate regression analysis revealed that the prognosis of glioma could be independently predicted by the riskscore. Furthermore, we explored clinical and genomic feature differences between the two groups. The level of tumor mutational burden (TMB) was higher in the high-risk group, while more mutation of IDH1 was observed in the low-risk group. Results of Tumor Immune Dysfunction and Exclusion (TIDE) analysis showed that high-risk patients were more prone to be responded to immunotherapy. In addition, subclass mapping analysis was performed to validate our findings and the results revealed that a significantly higher percentage of immunotherapy response rate was observed in the high-risk group.

Conclusion: A novel signature with a good independent predictive capacity of prognosis was successfully identified. And our findings reveal that patients with high-risk scores were more likely to be responded to immunotherapy.
Congenital absence of the vas deferens with hypospadias or without hypospadias: Phenotypic findings and genetic considerations
Authors: Fang Jianzheng , Wang Xiaoyi , Sun Xueping , Cui Yugui , Diao Feiyang , Yang Xiaoyu
Published: November 2022

Congenital absence of the vas deferens (CAVD) is a major cause of obstructive azoospermia. Mutations of CFTR and ADGRG2 cause the majority of CAVD. Despite this, 10%–20% of CAVD patients remain without a clear genetic diagnosis. Herein, the CFTR and ADGRG2 genes were first sequenced using Sanger sequencing in 50 CAVD patients. Whole-exome sequencing (WES) was used to further identify potential novel genetic causes in CAVD with hypospadias. In total, 29 of 50 CAVD patients carried at least one CFTR mutation, but no ADGRG2 mutation was found. 5T was found to be the most frequent variant in our CAVD populations. Seven CAVD patients with hypospadias were further analyzed using WES. No homozygous or compound heterozygous mutations related to disorders of sex development (DSDs) or male infertility were identified by WES. CAVD with hypospadias presented lower testicular volume (9.71 ± 2.14 ml vs. 14.45 ± 2.93 ml, p < 0.001) and higher FSH level (FSH: 7.28 ± 3.91 IU/L vs. 4.24 ± 1.96 IU/L, p = 0.027) than CAVD without hypospadias. It is worth noting that neither CFTR or ADGRG2 mutation nor homozygous or compound heterozygous gene mutations were identified in seven CAVD cases with hypospadias. However, nine heterozygous or hemizygous mutations were selected as potential pathogenic genes in CAVD with hypospadias. In conclusion, CFTR variants, especially 5T, play a major role in the Chinese CAVD population. CAVD with hypospadias shows relatively lower testicular spermatogenesis, suggesting a different genetic basis or pathogenic factor from cystic fibrosis/CAVD or unilateral renal agenesis/CAVD.