bluuebunny/crossref_metadata_2025 huggingface dataset:
The Cancer Genome Atlas (TCGA) based m6A methylation-related genes predict prognosis in rectosigmoid cancer
Authors: Zhou Wei , Lin Junchao , Li Zeng , Li Min , Fan Daiming , Hong Liu
Published: December 2022

N6-methyladenosine (m6A) methylation plays an important role in the occurrence and development of tumors. This study aimed to explore the effects of m6A methylation regulatory genes on rectosigmoid cancer (RSC). RNA-seq data and related clinical information in The Cancer Genome Atlas database were analyzed. The Wilcoxon test was used to analyze the different expression levels of m6A methylation regulatory genes between the tumor and normal samples. Least absolute shrinkage and selection operator Cox regression analysis was used to construct a risk prognosis model between the m6A methylation regulatory genes and RSC. The median risk score was used to classify RSC patients into high and low-risk groups. Kaplan–Meier survival analysis and receiver operating characteristic curves were used to evaluate the sensitivity and specificity of the prediction model. The expression of m6A methylation regulation genes was different between the tumor and normal samples, 6 genes were overexpressed in tumor and 2 genes were down-regulated. Four m6A methylation regulatory genes, YTHDF3, KIAA1429, ALKBH5 and METTL3, were screened by least absolute shrinkage and selection operator Cox regression analysis. The overall survival of high-risk group was significantly lower than that of low-risk group (P = 4.681 × 10−4). The area under the curve value in the receiver operating characteristic curve was 0.935, indicating that the prediction model was effective. Univariate and multivariate Cox regression were used to test the effectiveness of the model. m6A methylation regulators YTHDF3, KIAA1429, ALKBH5, and METTL3 can be used to construct predictive models to predict overall survival in different clinical subgroups of RSC patients.
Anxiety, depression and post-traumatic stress disorder and related factors among Chinese population during the COVID-19 pandemic: A cross-sectional study
Authors: Liu Yang , Liu Yi-Fei , Liu Ke-Xian , Xie Yao-Jie , Li Wen-Gang , Kong Yue , Zhu Hai-Hua , Zhu Jie-Min , Mi Bai-Bing , Yang Jin-Qiu , Huang Zhuo , Du Ji-Wei , He Hong-Gu , Shen Qu
Published: December 2022

The sudden outbreak of coronavirus disease 2019 (COVID-19) has deep and wide negative mental impacts on the public, and studies on the impact of COVID-19 on social and mental well-being are necessary. This study aimed to evaluate mental distress, including anxiety, depression, and post-traumatic stress disorder (PTSD), and its related risk factors in Chinese adults in the early stages of the COVID-19 pandemic. This study used a large-scale cross-sectional design. A total of 2067 adult participants completed the online survey via REDcap from 1st to 15th of March 2020 during the COVID-19 outbreak in China. Anxiety, depression, PTSD, and related risk factors, including self-efficacy, coping style, and social support, were measured using valid and reliable instruments. The data were analyzed using multiple linear regression. We found that 201 (9.7%) participants reported moderate-to-severe anxiety, 669 (33.8%) reported depression, and 368 (17.8%) reported symptoms of PTSD. Self-efficacy, coping style, and social support significantly affected anxiety, depression, and PTSD symptoms. Participants’ sociodemographic characteristics, COVID-19 pandemic-related factors, low self-efficacy, low social support, and negative coping were predictors of mental distress during the COVID-19 pandemic. Our study will help healthcare professionals carry out early predictions and identification of high-risk groups and provide appropriate interventions to target groups during public health emergencies that plague the world.
The clinicopathological and prognostic significance of mTOR and p-mTOR expression in patients with non-small cell lung cancer: A meta-analysis
Authors: Qiu Weiwei , Ren Meiying , Wang Cuifeng , Fu Yuhua , Liu Yan
Published: December 2022

Background:

The mammalian target of rapamycin (mTOR) has a crucial role in carcinogenesis, angiogenesis, cellular proliferation, and metastasis; however, its significance in non-small cell lung cancer (NSCLC) remains contentious. Consequently, this study aims to assess the clinicopathological and prognostic importance of mTOR/p-mTOR expression in NSCLC.

Methods:

Literature retrieval was undertaken by searching English databases PubMed, EMBASE, Web of Science, and Cochrane Library as well as Chinese databases CNKI, Wan Fang, and VIP for full-text publications that satisfied our eligibility criteria up to November 2021. STATA 12.0 was used to conduct statistical analysis (STATA Corporation, College Station, TX).

Results:

This meta-analysis includes a total of 4683 patients from 28 primary publications. mTOR/p-mTOR expression was associated with sex (OR = 0.608, 95% CI: 0.442–0.836), lymph node metastasis (OR = 2.084, 95% CI: 1.437–3.182), and CEA (OR = 1.584, 95% CI: 1.135–2.209), but not with age, histological type, depth of tumor invasion, distant metastasis, TNM stage, differentiation degree, tumor size, or smoking. In addition, the expression of mTOR/p-mTOR is related to shorter overall survival in NSCLC patients (HR = 1.415, 95% CI: 1.051–1.905).

Conclusion:

Positive mTOR/p-mTOR expression was substantially correlated with unfavorable conditions on the sex, lymph node metastases, and CEA levels. mTOR/p-mTOR may indicate a bad prognosis for NSCLC. The current findings must be confirmed and changed by other high-quality research employing a multivariate analysis on bigger sample size.
Comparison of oblique lateral lumbar interbody fusion and transforaminal lumbar interbody fusion in the treatment of degenerative lumbar diseases: A protocol for systematic review and meta-analysis
Authors: Na Mengqi , Zhan Xinli
Published: December 2022

Background:

Degenerative lumbar diseases are common in the aging population, and is one of the most frequent causes of disability. Lumbar fusion is an effective surgical procedure for alleviating pain and improving function. A variety of fusion techniques applied where necessary are available and the optimal method remains controversial. We performed a protocol for systematic review and meta-analysis to compare the clinical efficacy of oblique lateral interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) in the treatment of degenerative lumbar diseases.

Methods:

This systematic review protocol will be reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P) 2015 Statement.

Following databases will be searched: PubMed, web of science, MEDLINE, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database, Wanfang data, and Chinese BioMedicine Literature Database. Only randomized controlled trials comparing OLIF and TLIF for treating degenerative lumbar diseases will be included. The meta-analysis will be performed with Review Manager Version 5.4 software (The Cochrane Collaboration, Copenhagen, Denmark).

Results:

The results of this systematic review will be published in a peer-reviewed journal.

Conclusion:

This study will elucidate the clinical outcomes of OLIF compared with TLIF in treating degenerative lumbar diseases.
Clinical efficacy and safety of Xuefu Zhuyu decoction in the treatment of diabetic kidney disease: A protocol for systematic review and meta-analysis
Authors: Song Chaoqun , Zhu Zhiyue , Liu Miao , Yang Wenbo , Bai Xiaotian , Nan Zheng
Published: December 2022

Background:

Diabetic kidney disease (DKD) is one of the common complications of diabetes, the most crucial cause of end-stage renal disease, and a significant cause of death in diabetes patients. In recent years, Xuefu Zhuyu decoction has also been widely used in treating diabetic nephropathy. However, there need to be more systematic reviews that comprehensively describe the effectiveness and safety of Xuefu Zhuyu decoction in treating DKD. Therefore, we will conduct a systematic review and meta-analysis to evaluate the indicators of Xuefu Zhuyu decoction in the treatment of DKD to provide evidence-based support.

Methods:

Eligible published randomized controlled trials from January 2005 to October 2022 will be obtained by searching PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, Wanfang, and VIP in Chinese and English. The Cochrane Collaboration Risk of bias tool will be used for methodological quality assessment and risk of bias. The meta-analysis will be performed using Cochrane RevMan 5.4 software.

Results:

This study will compare the following indicators: the primary outcomes: urinary albumin excretion rate and urea nitrogen. Secondary outcomes: blood creatinine; 24 hours urine protein quantification; glycosylated hemoglobin; fasting blood glucose; 2-hour postprandial blood glucose; total cholesterol; triglycerides; total effective rate; incidence of adverse events.

Conclusion:

The results of this systematic review will provide an objective, evidence-based basis for judging the efficacy and safety of Xuefu Zhuyu decoction in treating DKD.
Comparison of total intravenous anesthesia and inhalation anesthesia on postoperative quality of recovery after laparoscopic hysterectomy: A protocol for systematic review and meta-analysis
Authors: He Menglin , Chen Mingxue , Yu Feng
Published: December 2022

Background:

Postoperative recovery is a complex process and affected mainly by factors from patients, surgery and anesthesia. Although we have all kinds of sedatives and hypnotics now, the selection of an ideal medication for general anesthesia is still challenging. In this study, we perform a protocol for systematic review and meta-analysis to compare the effect of propofol-based total intravenous anesthesia and sevoflurane-based inhalation anesthesia on postoperative quality of recovery in patients undergoing laparoscopic hysterectomy.

Methods:

The protocol of this review was registered in PROSPERO (CRD42022379485). Meanwhile, it will be reported follow the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol. We will search 3 foreign electronic databases (Cochrane Library, Embase, Pubmed) and 4 Chinese electronic databases (China National Knowledge Infrastructure, WangFang Database, Chinese Biomedical Literature Database and Chinese Scientific Journal Database) to collect potential studies from their inceptions to December 2022. Only randomized controlled trials will be included. Two reviewers will independently perform study selection, data extraction and risk of bias assessment. Data synthesis and statistical analysis will be performed using the RevMan 5.4 (The Cochrane Collaboration, Copenhagen, Denmark) software.

Results:

The results of this systematic review and meta-analysis will be publicly available and published in a peer-reviewed journal.

Conclusion:

This study may provide the evidence regarding the efficacy and safety of total intravenous anesthesia and inhalation anesthesia on postoperative quality of recovery after laparoscopic hysterectomy.
Association between the participation of the plastic surgery department and qualitative prognoses in severe trauma patients: A retrospective observational study
Authors: Lim Nam Kyu , Kim Sungyeon , Hee Yoon Jae , Choi Kyung-Hwa
Published: December 2022

Catastrophic incidents would necessitate the intervention of multiple specializations with plastic surgery (PS) as an indispensable area of expertise. In view of PS, prognostic assessment of trauma patients should be focused on the qualitative value rather than mortality because plastic surgeons rarely handled patients’ vital signs in actual. Thus, we explored the association between the involvement of the PS department and qualitative prognoses for severe trauma patients. From November 2014 to December 2019, we enrolled total 529 trauma patients with an injury severity score (ISS) over 15 points. We set the prognostic factors that the rate of admission in intensive care unit (ICU), total or ICU duration of hospitalization, post-discharge progress and disability diagnosis which were regarded as qualitative prognoses. The analysis was performed with logistic regression analysis or regression analysis adjusted for age, sex, past medical history, cause of trauma, and frequency of operation. Among total of 529 patients, 290 patients in PS group and 239 patients in non-PS group were analyzed. In both groups, the under-65-year ages and male patients were significantly predominant. The rate of going home showed 2.082 times higher in PS group than non-PS group after adjusting for covariates, while there was no significant difference in diagnosis of disability. Meanwhile, overall prognoses were highly correlated with either higher ISS or lower Glasgow Coma Scale (GCS). In conclusion, higher severity generally affected to the severe trauma patient’s prognoses, and the PS treatment only contributes to discharge disposition to home.
Characteristics of patients with meningitis after lumbar epidural steroid injection
Authors: Kang You-Ri , Nam Tai-Seung , Kim Byeong C. , Kim Jae-Myung , Cho Soo Hyun , Kang Kyung Wook , Choi Kang-Ho , Kim Joon-Tae , Choi Seong-Min , Lee Seung-Han , Park Man-Seok , Kim Myeong-Kyu
Published: December 2022

To investigate the clinical, laboratory, and radiological features of meningitis after lumbar epidural steroid injection (M-ESI) without accompanying spinal infection, data of patients with meningitis admitted between January 2014 and December 2021 in a single center were retrospectively reviewed. Among them, patients with a recent history of lumbar ESI were identified, and their medical records were collected. Patients with concomitant infections other than meningitis, including spinal epidural abscess, were excluded. Seven patients with M-ESI were identified. All patients presented with headache and fever without focal neurological deficits, and headache developed shortly after a procedure (median, 4 hours). Cerebrospinal fluid (CSF) analysis showed neutrophilic pleocytosis (median, 6729/μL), elevated protein level (median, 379.1 mg/dL), decreased ratio of CSF glucose to serum glucose (median, 0.29), and elevated lactate level (median, 8.64 mmol/L). Serum level of C-reactive protein was elevated in 6, but serum procalcitonin level was within normal range. No causative pathogen was identified in the microbiological studies. The most frequent radiologic feature was sulcal hyperintensity on fluid-attenuated inversion recovery images (57%), followed by pneumocephalus (43%). Symptoms subsided in a short period (median, 1 day) after initiating treatment with antibiotics and adjuvant intravenous corticosteroids. None of the patients experienced neurological sequelae. Though the cardinal symptoms and CSF findings of M-ESI were comparable to those of bacterial meningitis, M-ESI seems to have distinctive characteristics regarding the clinical course, laboratory parameters, and pneumocephalus.
Baseline electrolyte disorders predict disease severity and mortality in patients with COVID-19
Authors: Taci Hoca Nevin , Berktaş Bahadir M.
Published: December 2022

Distinguishing critical laboratory biomarkers for disease severity at the time of hospital presentation is important for early identification of patients who are most likely to have poor outcomes and effective use of health resources. This study aimed to evaluate whether electrolyte imbalances on hospital admission predict severe disease and mortality in patients with coronavirus disease 2019 (COVID-19). We retrospectively collected data on the blood electrolyte concentrations of 286 COVID-19 patients at admission. The correlations between electrolyte imbalances, inflammation, and thrombosis markers in COVID-19 patients were also evaluated. We assessed the predictive performance of baseline blood electrolyte concentrations for severe disease and death using receiver operating characteristic curve analysis and multivariate logistic regression methods. Abnormalities in serum sodium, calcium, and potassium levels at admission were found at 20.6%, 14%, and 4.2%, respectively in this study. In the receiver operating characteristic curve analyses, hypocalcemia and hyponatremia effectively predicted disease progression to hospitalization (area under the curve 0.82, P < .001 and 0.81, P < .001, respectively) and 30-day mortality (area under the curve 0.85, P < .001 and 0.91, P < .001, respectively). In the multivariate logistic regression analysis, baseline hypocalcemia was identified as an independent risk factor associated with the risk of hospitalization (β = 2.019, P = .01; odds ratio: 7.53). Baseline hypocalcemia and hyponatremia effectively predicted disease progression toward hospitalization and 30-day mortality in patients with COVID-19. Clinicians should closely follow up or reevaluate COVID-19 patients with baseline electrolyte disorders.
Metformin combined with endoscopic therapy in patients with familial polyposis associated with carcinoma: A case report
Authors: Sun Dong-Jie , He Xiao-Jian , Li Hai-Tao , Luo Bao-Xiang , Zhou Lin-Xin , Zeng Xiang-Peng , Li Da-Zhou , Wang Wen
Published: December 2022

Rationale:

Familial adenomatous polyposis (FAP) is an autosomal dominant genetic disease, with a very high cancer rate. At present, endoscopic resection of polyps ≥ 1 cm is often chosen for patients with non-cancerous polyps who are unwilling to undergo surgery, and regular review is conducted. Once the polyps are pathologically confirmed to be cancerous, surgical resection of the diseased large intestine is generally recommended, but surgery often leads to a series of complications. So what do you do with cancer patients who don’t want surgery?

Patient concerns:

A 19-year-old woman presented with intermittent hematochezia with abdominal pain. A colonoscopy revealed hundreds of intestinal polyps.

Diagnoses:

The patient had a family history of FAP, and there were hundreds of polyps in the intestine. The pathology was adenomatous, and some polyps became cancerous, which met the diagnostic criteria of FAP.

Interventions:

Endoscopic examination was arranged for the patient, the resection of intestinal polyps ≥ 1 cm was given priority, and other polyps were removed as far as possible. After that, metformin 500 mg orally was given twice a day, and endoscopic follow-up was conducted every 6 months. During each endoscopic follow-up, intestinal polyps ≥ 1 cm were preferred to be removed, and other polyps were removed as far as possible.

Outcomes:

The patient’s abdominal pain and blood in the stool disappeared after endoscopic treatment. Cancerous polyps were found at the second and third follow-up visits, but the patient always refused surgical treatment. After 4 years of follow-up, polyp load was significantly reduced, abdominal pain and bloody stool symptoms did not appear again, and imaging examination showed no tumor recurrence and metastasis.

Lessons:

Endoscopic polyp resection is an important method to treat the clinical symptoms of FAP. Metformin combined with endoscopic therapy is a good alternative for patients with familial polyposis who do not want surgery. When the polyp is cancerous and the polyp is radically resected by the endoscope, if the patient refuses additional surgery, oral metformin combined with endoscopic follow-up can be considered.
Ultrasound-guided pulsed radiofrequency for neuromyelitis optica spectrum disorder-associated neuropathic pain: A case report
Authors: Yang Fei , Lin Liheng , Xia Yu , Wu Changxue
Published: December 2022

Background:

Neuropathic pain (NP) is one of the most prevalent and troublesome symptoms of neuromyelitis optica spectrum disorder (NMOSD), seriously affecting the patient’s life. At present, effective treatment for NP induced by NMOSD does not exist. Pulsed radiofrequency (PRF), an emerging microinvasive therapy, alleviates pain and is widely used to treat various types of NP. This is the first report describing a patient with NMOSD-associated NP treated with PRF on the left cervical 6 nerve root.

Methods:

A 49-year-old female with NMOSD-associated severe NP in the left upper limb and left shoulder tried several medications, but none were effective. She was diagnosed with NP caused by NMOSD.To alleviate severe pain, we performed PRF on the left cervical nerve root under the guidance of ultrasound. This treatment was repeated 3 times.

Results:

The patient’s pain was significantly relieved, with a visual analog scale score decreasing from 7-8/10 to 2-3/10, which was maintained during the 3-month follow-up period, without complications.

Conclusion:

PRF might be effective for the management of intractable neuropathic pain caused by NMOSD.
Elucidation of the mechanism of action of Runyan Mixture in the treatment of pharyngitis using a network pharmacological approach
Authors: Zhang Huihui , Tong Yingpeng , Jin Yinzhi , Cai Guoyun , Li Zhenxin , Pan Xinling
Published: December 2022

This study aimed to elucidate the mechanism of action of Runyan Mixture in treating pharyngitis using a network pharmacological approach. The active components of the Runyan Mixture were obtained from the traditional chinese medicine systems pharmacology database and evaluated using Lipinski’s rules. The SwissTargetPrediction database was used to predict the action targets of the Runyan Mixture, and a protein-protein interaction network was constructed using the STRING database. Moreover, the anti-inflammatory effect of Runyan Mixture was validated in vitro using the lipopolysaccharide induced inflammation in macrophages. The Runyan Mixture was the liquid preparation from 8 traditional Chinese medicine. A total of 89 types of active components, 53 core targets, and 98 signaling pathways (P < .001) were identified for the Runyan Mixture. The main action targets were EGFR, MAPK1, AKT1, PIK3CA, NFKB1, SRC, TNF, MAPK8, MET, and PTGS2. Among the identified signaling pathways, 20 were associated with microbial infection and 24 were related to the immune-inflammatory response. Experimental results in vitro showed that Runyan Mixture could significantly inhibit the expression of interleukin-1, interleukin-6, and tumor necrosis factor-α (P < .05) in macrophages by lipopolysaccharide stimulation. Based on the results of the protein-protein interaction network analysis and the anti-inflammatory effect in vitro, the efficiency of the Runyan Mixture in pharyngitis treatment could be attributed to the inhibition of the inflammatory response.
The independent risk factors for abnormal head computed tomography in patients with hepatic encephalopathy
Authors: Basak Bayram , Ersin Aksay , Sefer Ozgur , Gucluhan Ucar , Sebnem Sakar , Colak Nese
Published: December 2022

It’s known that head computed tomography (CT) is used excessively to exclude intracranial hemorrhage in patients with hepatic encephalopathy (HE) in the emergency department. However, the independent risk factors for abnormal head CT in patients with HE have not been studied extensively to date. In this retrospective study, patients with an ammonia level of >90 U/L who were clinically considered HE and had head CT were included. The characteristics of patients with abnormal head CT and independent risk factors for abnormal CT were investigated. Three hundred seventy-eight patients were included in the study. CT findings of 18 (4.8%) of the patients were abnormal: 12 had intracranial hemorrhage, 1 had an ischemic stroke, and 5 had an intracranial mass. Intracranial hemorrhage (odds ratio [OR] 12.5), history of recent trauma (OR 23.4), history of active malignancy (OR 10.3), thrombocyte count <100.000/μL (OR 4.3), and international normalized ratio ≥1.5 (OR 3.2) were found to be independent risk factors for abnormal head CT. Head CT scan may be considered in patients with HE if any of the following are present: intracranial bleeding history, recent trauma history, active malignancy, platelet count <100,000/μL, and international normalized ratio >1.5.
A review of autoimmunity and immune profiles in patients with primary ovarian insufficiency
Authors: Chen Junyu , Wu Shan , Wang Mengqi , Zhang Haoxian , Cui Manhua
Published: December 2022

Primary ovarian insufficiency (POI) is a complicated clinical syndrome characterized by progressive deterioration of ovarian function. Autoimmunity is one of the main pathogenic factors affecting approximately 10% to 55% of POI cases. This review mainly focuses on the role of autoimmunity in the pathophysiology of POI and the potential therapies for autoimmunity-related POI. This review concluded that various markers of ovarian reserve, principally anti-Müllerian hormone, could be negatively affected by autoimmune diseases. The presence of lymphocytic oophoritis, anti-ovarian autoantibodies, and concurrent autoimmune diseases, are the main characteristics of autoimmune POI. T lymphocytes play the most important role in the immune pathogenesis of POI, followed by disorders of other immune cells and the imbalance between pro-inflammatory and anti-inflammatory cytokines. A comprehensive understanding of immune characteristics of patients with autoimmune POI and the underlying mechanisms is essential for novel approaches of treatment and intervention for autoimmune POI.
Streptococcus gordonii finger infection: Case report and a review of the literature
Authors: Kang Cheng-Wei , Pu Xiao-Bing , Tan Gang , Dong Chang-Chao , Yan Zhao-Kui , Wu Li-Xue
Published: December 2022

Rationale:

Streptococcus gordonii is a rare cause of finger suppurative infection. Very few cases have been reported of its treatment.

Patient concerns:

A 68-year-old male of severe finger infection. Bacterial culture of synovial fluid revealed S gordonii.According to the patient’s history and auxiliary examination, the patient was diagnosed with S gordonii infection. Here, we review the diagnosis and treatment of this patient and describe the clinical and epidemiological characteristics of the patient.

Diagnoses:

Streptococcus gordonii finger infection.

Interventions: In the case of ineffective oral antibiotics, this patient chose to pursue an abscess incision, but in the course of treatment,the flexor digitorum tendon dissolved and eventually ruptured.

Outcomes:

The infection was controlled after intravenous injection of vancomycin. The incision was sutured 2 weeks later. No recurrence of infection was found after 3 months of follow-up.

Lessons:

The treatment included antibacterial and abscess treatments. In the absence of drug sensitivity results, antibiotics can be used empirically. If empirical anti-microbial treatment fails, the antibiotic regimen should be changed in a timely manner, Vancomycin may be an antibiotic choice
Increased risk of type 2 diabetes in patients with systemic lupus erythematosus: A nationwide cohort study in Taiwan
Authors: Lin Yeong-Jang , Chien Chih-Chiang , Ho Chung-Han , Chen Hung-An , Chen Chao-Yu
Published: December 2022

Data on the risk of developing diabetes in patients with systemic lupus erythematosus (SLE) are limited and have yielded mixed results. We conducted a nationwide cohort study to investigate the risk of subsequent type 2 diabetes in patients with SLE compared with matched non-SLE controls.

Data were collected from the Taiwan National Health Insurance Research Database. Adult patients newly diagnosed with SLE between 2003 to 2010 were identified as the study cohort. The non-SLE group was matched for age, gender, and date of initial diagnosis as the comparison cohort.

A total of 6159 SLE patients (87.90% female, mean age 38.79 years) were identified during this period. Of these, 206 (3.34%) developed type 2 diabetes. The 3-year incidence of type 2 diabetes was significantly higher in the SLE cohort than in the control group (130.26 vs 101.18 cases per 10,000 person-years), with an adjusted hazard ratio of 1.22 (95% confidence interval [CI] 1.04–1.44), after adjusting for age, gender, underlying comorbidities, and monthly income. Stratified analyses showed that women with SLE and low-income SLE patients (monthly income < 20,000 New Taiwan Dollar) had a higher risk of type 2 diabetes than non-SLE controls, with adjusted hazard ratios of 1.21 (95% CI 1.01–1.45) and 1.36 (95% CI 1.10–1.69), respectively.

Patients with newly diagnosed SLE had a 22% increased risk of developing type 2 diabetes during the 3-year follow-up period compared with matched controls.
The role of rectal endoscopic ultrasonography plus fine needle aspirartion and fine needle biopsy in pelvic masses
Authors: Auriemma Francesco , Dabizzi Emanuele , Facciorusso Antonio , Carrara Silvia , de Nucci Germana , Manes Giampiero , Lamonaca Laura , Paduano Danilo , Ofosu Andrew , Crinò Stefano Francesco , Repici Alessandro , Mangiavillano Benedetto
Published: December 2022

Background and aim

The diagnostic role of endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) and fine needle biopsy (FNB) of pelvic masses has not been well established. We aimed to evaluate the diagnostic accuracy of EUS plus FNA/FNB in suspected local recurrence of pelvic masses.

Materials and methods

All consecutive patients with a history of lower gastrointestinal and pelvic mass undergone EUS-FNA/FNB were included in the study.

Results

In total 34 patients who underwent EUS-guided FNA or FNB of a perirectal mass were enrolled. The sampled lesion was a mass in 22 patients (64.7%) and a lymph node in 10 patients (29.4%). The univariate logistic regression analysis for diagnostic accuracy showed lesion size as a significant predictor of diagnostic accuracy [odds ratio (OR), 1.61; 1.08–2.27; P = 0.02]. Diagnostic sensitivity was 100% (71.5–100%) with EUS-FNB and 75% (34.9–96.8%) with EUS-FNA (P = 0.12); specificity was 100% in both groups (P = 1.0). Sample adequacy was 94.1% in the whole cohort, with 20/20 adequacy rate (100%) in the EUS-FNB group and 12/14 (85.7%) in the EUS-FNA group (P = 0.28).

Conclusion

This is the first study demonstrating the diagnostic yield of EUS plus FNA/FNB in patients with pelvic masses comparing the two needles. Our results highlight the relevance of this technique, especially in undefined masses during oncological follow-up.
Multiple ligation-assisted endoscopic submucosal resection combined with endoscopic ultrasonography: a novel method to treat rectal neuroendocrine tumors
Authors: Xie Jiao , Hong Donggui , Li Dazhou , Jiang Chuanshen , Xu Binbin , Liu Meiyan , Wang Wen
Published: December 2022

Objective

The first choice of treatment for rectal neuroendocrine tumors (R-NETs) 10 mm in size is endoscopic resection, there is still controversy concerning the optimal endoscopic treatment for resecting R-NETs. This study evaluated the efficacy and safety of multiple ligation-assisted endoscopic submucosal resection combined with endoscopic ultrasonography (EMR-MLUS) for R-NETs.

Methods

We retrospectively analyzed the data of 62 patients with R-NETs ≤10 mm in size who underwent EMR-MLUS or ligation-assisted endoscopic submucosal resection combined with endoscopic ultrasonography (EMR-LUS) between May 2019 and April 2022, including tumor characteristics, endoscopic complete resection, pathological complete resection, the procedure time, adverse events, and follow-up were compared between the two groups of patients.

Results

Of the 62 patients, 19 underwent EMR-MLUS and 43 underwent EMR-LUS. The endoscopic morphology of lesions was statistically different between group EMR-MLUS and group EMR-LUS (P = 0.015), and most of them were flat and slightly raised lesions in group EMR-MLUS. Although the pathological complete resection rate was slightly higher in the EMR-MLUS group than in the EMR-LUS group (94.74% vs. 90.70%; P = 0.290), the endoscopic complete resection rate was high in both groups. Involvement of the lateral resection margin was found four cases in the ESMR-LUS group; one case of deep resection margin involvement in the EMR-MLUS group. The mean procedure time was longer in the EMR-MLUS group than in the EMR-LUS group (12.79 ± 1.01 min vs. 11.08 ± 1.89 min; P = 0.041). In group EMR-LUS, there were two cases of immediate bleeding; in group EMR-MLUS, one case of perforation, all of them were successfully treated by endoscopy. No recurrence, progression, or metastasis was found in all patients.

Conclusion

EMR-MLUS is a safe and effective technique that could be considered when removing small rectal NETs, especially flat and slightly raised lesions.
Effect of Caffeine on Colonic Manometry in Children
Authors: Mehta Vijay , Hopson Puanani , Irastorza Laura , Rizvi Syed Ahsan , Fernandez Jenelle , Thomas Jessina , Nabar Shruti , Safder Shaista
Published: December 2022

Objectives:

Coffee and caffeinated products have been widely consumed for many centuries. Previous adult studies have suggested that both coffee and decaffeinated beverages induce colonic motility. However, no study has been conducted in pediatrics, and the role of caffeine alone in pediatric colonic motility needs to be explored.

Methods:

A prospective study of pediatric patients undergoing standard colonic motility testing that were able to consume caffeinated coffee, decaffeinated coffee, and caffeine tablet during colonic manometry. Patients who had a gastrocolonic reflex and high amplitude propagated contractions (HAPCs) in response to intraluminal administration of bisacodyl in the colon were included in the final analyses.

Results:

Thirty‐eight patients were recruited, 22 of which were excluded, 11 due to abnormal studies (no HAPC seen in response to intraluminal response to bisacodyl), and 11 due to inability to consume all study agents or complete the study. Sixteen patients met criteria for final analyses. Intracolonic bisacodyl produced a larger area under the curve (AUC) compared to all other agents. Caffeinated coffee resulted in a higher AUC, motility index (MI), and time to HAPC compared with decaffeinated coffee (P < 0.05). There was no significant difference between caffeinated coffee and caffeine tablet, or caffeine tablet and decaffeinated coffee.

Conclusions:

Caffeine is indeed a colonic stimulant; however, other components of caffeinated and non‐caffeinated beverages likely induce colonic response and require further evaluation for possible use as a colonic stimulant.
The Association of Corticosteroids and Pediatric Sepsis Biomarker Risk Model (PERSEVERE)-II Biomarker Risk Stratification With Mortality in Pediatric Septic Shock*
Authors: Klowak Jennifer A. , Bijelić Vid , Barrowman Nick , Menon Kusum ,   for the Genomics of Pediatric Septic Shock Investigators
Published: December 2022

OBJECTIVES:

Mortality risk stratification may identify a subset of children who benefit from or are harmed by corticosteroid administration. The Pediatric Sepsis Biomarker Risk Model (PERSEVERE)-II score is a biomarker-based mortality risk stratification tool for pediatric sepsis. Our objective was to assess the association of corticosteroid administration with 28-day mortality within different levels of baseline mortality risk (PERSEVERE-II) in a cohort of children with septic shock.

DESIGN:

We performed a secondary analysis using prospectively collected data (January 2015 to December 2018).

SETTING:

PICUs in 13 tertiary care, academic centers in the United States.

PATIENTS:

Children with septic shock.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

We assessed the association of corticosteroid administration within PERSEVERE-II risk score categories and 28-day mortality, ICU-free days, and maximum failed organs in children with septic shock. We analyzed a total of 461 patients (215 with corticosteroids exposure, 246 without corticosteroid exposure) with an average age of 7.1 years (interquartile range, 2.2–13.6 yr). In the subgroup of patients with a high PERSEVERE-II score, corticosteroid administration was associated with an increased adjusted risk of 28-day mortality (odds ratio [OR] 4.10 [95% CI 1.70–9.86]; p = 0.002), but not in the low risk group (OR 0.20 [95% CI 0.02–1.73]; p = 0.15). A significant interaction between PERSEVERE-II score and corticosteroids was seen for both secondary outcomes complicated course (p = 0.01) and maximum failed organs (p < 0.001). Corticosteroid exposure was associated with fewer ICU-free days (p < 0.0001).

CONCLUSIONS:

In our multicenter observational study, corticosteroid administration was associated with increased mortality in a subgroup of children with a high PERSEVERE-II risk score.
Liver T1 Relaxation Quantification Using a 3-Dimensional Interleaved Look-Locker Acquisition With T2 Preparation Pulse Sequence (3D-QALAS): Comparison With Conventional 2-Dimensional MOLLI
Authors: Gandhi Deep B. , Pednekar Amol , Wang Hui , Tkach Jean A. , Dudley Jonathan A. , Manhard Mary Kate , Trout Andrew T. , Dillman Jonathan R.
Published: December 2022

Background

Changes in liver magnetic resonance imaging T1 relaxation times are associated with histologic inflammation and fibrosis.

Objective

To compare liver T1 measurements obtained using a novel single-breath-hold 3-dimensional (3D) whole-liver T1 estimation method (3D-QALAS) to standard-of-care 2-dimensional (2D) modified Look-Locker (2D-MOLLI) measurements.

Methods

With institutional review board approval, research magnetic resonance imaging examinations were performed in 19 participants at 1.5 T. T1 relaxometry of the liver was performed using a novel 3D whole-liver T1 estimation method (3D-QALAS) as well as a 2D modified Look-Locker (2D-MOLLI) method. The 3D method covered the entire liver in a single breath hold, whereas 2D imaging was performed at 4 anatomic levels in 4 consecutive breath holds. T1 measurements from parametric maps were obtained by a single operator, and region-of-interest area-weighted mean T1 values were calculated. Pearson correlation (r) was used to assess correlation between T1 estimation methods, and the paired t test and Bland-Altman analysis were used to compare agreement in T1 measurements.

Results

In 18 participants (1 participant was excluded from analysis because of respiratory motion artifacts on 3D-QALAS images), 2D-MOLLI and 3D-QALAS mean T1 measurements were strongly correlated (r = 0.95, [95% CI: 0.87–0.98]; P < 0.0001). 2D-MOLLI T1 values were significantly longer than 3D-QALAS values (647.2 ± 87.3 milliseconds vs. 554.7 ± 75.8 milliseconds; P < 0.0001) with mean bias = 92.5 milliseconds (95% limits of agreement, 36.8, 148.2 milliseconds).

Conclusion

Whole-liver T1 measurements obtained using a novel single-breath-hold 3D T1 estimation method correlate with a standard-of-care multiple consecutive-breath-hold 2D single-slice method but demonstrate systematic bias that should be considered or corrected when used in a clinical or research setting.
Contribution of quality improvement initiative in strengthening laboratory services in Primary Healthcare Facilities in Tanzania: findings from 2017/2018 Star Rating Assessment
Authors: Kinyenje Erick , Ngowi Ruth R. , Msigwa Yohanes S. , Hokororo Joseph C. , Yahya Talhiya A. , German Chrisogone C. , Mawazo Akili , Mohamed Mohamed A. , Nassoro Omary A. , Degeh Mbwana M. , Bahegwa Radenta P. , Marandu Laura E. , Mwaisengela Syabo M. , Mwanginde Lutengano W. , Makala Robert , Eliakimu Eliudi S.
Published: December 2022

Background

Accurate and reliable diagnosis is the cornerstone of disease management and control. A reliable and properly organized laboratory system not only generates information critical to individual case management but also to disease surveillance, control, and outbreak management. This study presents the status of quality of laboratory services in Tanzania after a nationwide quality assessment, Star Rating Assessment (SRA) of PHC facilities conducted in 2017/18.

Methods

This was a cross-sectional study using secondary data from SRA dataset. Eight indicators were used to measure quality of laboratory services; of which together with facility characteristics are considered independent variables. Dependent variable is the general scores for laboratory services during SRA. Firstly, proportions of facilities for the indicators was calculated. Then, multiple linear regression was employed to determine impact of each variable on quality of laboratory services. P-value of < 0.05 was considered significant.

Results

Approximately one-quarter of 6,663 PHC facilities included, i.e., 1,773(26.6%) had appropriate staffing level for qualified health laboratory personnel. The situation was better in private facilities compared to public facilities (63% vs 19%, p<0.001); and in urban-based facilities compared to rural-based facilities (62% vs 16%, p<0.001). None of the indicators was complied with at least half of the facilities. Three indicators were the strongest positive predictor of laboratory quality scores: having a laboratory safety system (Beta = 3.403), availability of essential laboratory tests with SOPs available and adhered (Beta = 2.739), and appropriate staffing level for laboratory personnel (Beta = 1.498). The scores were likely to be low if the facility was a dispensary (Beta = -1.325), located in a rural area (Beta = -0.068) or publicly owned (Beta = -0.048).

Conclusion

There is a critical shortage of qualified laboratory personnel in PHC facilities, especially in public facilities that are based in rural areas. There is a need to further strengthen laboratory services in PHC facilities to ensure quality of laboratory test results, since none of the indicators was complied with at least half of the facilities.
STrack: A tool to Simply Track bacterial cells in microscopy time-lapse images
Authors: Todorov Helena , Miguel Trabajo Tania , van der Meer Jan Roelof
Published: December 2022

Bacterial growth can be studied at the single cell-level through time-lapse microscopy imaging. Technical advances in microscopy lead to increasing image quality, which in turn allows to visualize larger areas of growth, containing more and more cells. In this context, the use of automated computational tools becomes essential.

In this paper, we present STrack, a tool that allows to track cells in time-lapse images in a fast and efficient way. We compared it to three recently published tracking tools on images ranging over six different bacterial strains, and STrack showed to be the most consistent tracking tool, returning more than 80% of correct cell lineages on average.

The python implementation of STrack, a docker structure, and a tutorial on how to download and use the tool can be found on the following github page:https://github.com/Helena-todd/STrack
Clinical validation of novel second-trimester preterm preeclampsia risk predictors combining clinical variables and serum protein biomarkers
Authors: Laurent Louise C. , Saade George R. , Markenson Glenn R. , Heyborne Kent D. , Schoen Corina N. , Baxter Jason K. , Longo Sherri A. , Pereira Leonardo M. , Su Emily J. , Hoffman Matthew K. , Lam Garrett K. , Fox Angela C. , Polpitiya Ashoka D. , Badsha Md. Bahadur , Fleischer Tracey C. , Garite Thomas J. , Boniface J. Jay , Kearney Paul E.
Published: December 2022

Objective

To develop and validate mid-trimester preterm preeclampsia (PE) risk predictors combining clinical factors and serum protein analytes, and to compare their performance with those of widely used clinical and risk assessment algorithms endorsed by professional societies.

Methods

This was a secondary analysis of data from two large, multicenter studies in pregnant individuals (PAPR,NCT01371019; TREETOP,NCT02787213), originally conducted to discover, verify, and validate a serum proteomic predictor of preterm birth risk. Serum protein abundances were determined by mass spectrometry. Classifier models combined one or two novel protein ratio(s) with a composite clinical variable, denoted as ClinRisk3, which included prior PE, pre-existing hypertension, or pregestational diabetes. Predictive performance was assessed for the full validation cohort and for a subset that had early gestational age (GA) dating via ultrasound. Classifier performance was compared directly to the U.S. Preventive Services Task Force (USPSTF) algorithm for identification of pregnancies that should receive low-dose aspirin (LDASA) for PE prevention.

Results

Nine of nine prespecified classifier models were validated for risk of preterm PE with delivery <37 weeks’ gestation. Areas under the receiver operating characteristic curve ranged from 0.72-0.78 in the full validation cohort, compared to 0.68 for both ClinRisk3 alone and for the USPSTF algorithm. In the early GA dating subcohort, an exemplar predictor, ClinRisk3 + inhibin subunit beta C chain/sex hormone binding globulin (ClinRisk3+INHBC/SHBG) showed a markedly lower screen positive rate (11.1% vs 43.3%) and higher positive predictive value (13.0% vs 5.0%) and odds ratio (9.93 vs 5.24) than USPSTF. Its performance was similar in nulliparas and all parities.

Conclusion

Nine preterm PE risk predictors were identified, validated in an independent cohort, and shown to be more predictive than the USPSTF-endorsed algorithm. Our results indicate that a single blood test performed in the first half of pregnancy can be used for personalized PE risk assessment, particularly for pregnancies with minimal or no identified clinical risk factors, including nulliparas. Results can be used to guide personalized pregnancy management, including but not restricted to LDASA for PE prophylaxis, and serve as a basis for developing new prevention strategies.

Funding Source

Sera Prognostics, Inc.

Précis

Combining novel serum protein biomarkers and selected clinical variables for preterm preeclampsia prediction outperforms widely used clinical risk assessment algorithms currently recommended by practice guidelines.