bluuebunny/crossref_metadata_2025 huggingface dataset:
Network meta-analysis of transcriptome expression changes in different manifestations of dengue virus infection
Authors: Winter Christine , Camarão António A. R. , Steffen Imke , Jung Klaus
Published: February 2022

Background

Several studies have been performed to study transcriptome profiles after dengue virus infections with partly different results. Due to slightly different settings of the individual studies, different genes and enriched gene sets are reported in these studies. The main aim of this network meta-analysis was to aggregate a selection of these studies to identify genes and gene sets that are more generally associated with dengue virus infection, i.e. with less dependence on the individual study settings.

Methods

We performed network meta-analysis by different approaches using publicly available gene expression data of five selected studies from the Gene Expression Omnibus database. The study network includes dengue fever (DF), hemorrhagic fever (DHF), shock syndrome (DSS) patients as well as convalescent and healthy control individuals. After data merging and missing value imputation, study-specific batch effects were removed. Pairwise differential expression analysis and subsequent gene-set enrichment analysis were performed between the five study groups. Furthermore, mutual information networks were derived from the top genes of each group comparison, and the separability between the three patient groups was studied by machine learning models.

Results

From the 10 possible pairwise group comparisons in the study network, six genes (IFI27, TPX2, CDT1, DTL, KCTD14 and CDCA3) occur with a noticeable frequency among the top listed genes of each comparison. Thus, there is an increased evidence that these genes play a general role in dengue virus infections. IFI27 and TPX2 have also been highlighted in the context of dengue virus infection by other studies. A few of the identified gene sets from the network meta-analysis overlap with findings from the original studies. Mutual information networks yield additional genes for which the observed pairwise correlation is different between the patient groups. Machine learning analysis shows a moderate separability of samples from the DF, DHF and DSS groups (accuracy about 80%).

Conclusions

Due to an increased sample size, the network meta-analysis could reveal additional genes which are called differentially expressed between the studied groups and that may help to better understand the molecular basis of this disease.
Interchangeability and optimization of heart rate methods for estimating oxygen uptake in ergometer cycling, level treadmill walking and running
Authors: Olsson Karin Sofia Elisabeth , Rosdahl Hans , Schantz Peter
Published: February 2022

Background

The heart rate (HR) method enables estimating oxygen uptake (V̇O2) in physical activities. However, there is a paucity in knowledge about the interchangeability of this method when applied to cycling, walking and running. Furthermore, with the aim of optimization, there is a need to compare different models for establishing HR-V̇O2relationships.

Methods

Twenty-four physically active individuals (12 males and 12 females) participated. For each participant, two models of HR-V̇O2relationships were individually established in ergometer cycling, level treadmill walking and running. Model 1 consisted of five submaximal workloads, whereas model 2 included also a maximal workload. Linear regression equations were used to estimate V̇O2at seven intensity levels ranging between 25 and 85% of heart rate reserve (HRR). The estimated V̇O2levels were compared between the exercise modalities and models, as well as with data from a previous study.

Results

A high level of resemblance in estimated V̇O2was noted between running and cycling as well as between running and walking, with both model 1 and model 2. When comparing walking and cycling, the V̇O2levels for given intensities of %HRR were frequently slightly higher in walking with both models (range of significant differences: 5–12%). The variations of the estimated individual V̇O2values were reduced when using model 2 compared to model 1, both between and within the exercise modalities.

Conclusion

The HR method is optimized by more workloads and wider ranges. This leads to overall high levels of interchangeability when HR methods are applied in ergometer cycling, level treadmill walking and running.
Comparative analysis of explainable machine learning prediction models for hospital mortality
Authors: Stenwig Eline , Salvi Giampiero , Rossi Pierluigi Salvo , Skjærvold Nils Kristian
Published: February 2022

Background

Machine learning (ML) holds the promise of becoming an essential tool for utilising the increasing amount of clinical data available for analysis and clinical decision support. However, the lack of trust in the models has limited the acceptance of this technology in healthcare. This mistrust is often credited to the shortage of model explainability and interpretability, where the relationship between the input and output of the models is unclear. Improving trust requires the development of more transparent ML methods.

Methods

In this paper, we use the publicly available eICU database to construct a number of ML models before examining their internal behaviour with SHapley Additive exPlanations (SHAP) values. Our four models predicted hospital mortality in ICU patients using a selection of the same features used to calculate the APACHE IV score and were based on random forest, logistic regression, naive Bayes, and adaptive boosting algorithms.

Results

The results showed the models had similar discriminative abilities and mostly agreed on feature importance while calibration and impact of individual features differed considerably and did in multiple cases not correspond to common medical theory.

Conclusions

We already know that ML models treat data differently depending on the underlying algorithm. Our comparative analysis visualises implications of these differences and their importance in a healthcare setting. SHAP value analysis is a promising method for incorporating explainability in model development and usage and might yield better and more trustworthy ML models in the future.
Total polyp number may be more important than size and histology of polyps for prediction of metachronous high-risk colorectal neoplasms
Authors: Yoon Hyuk , Shin Cheol Min , Park Young Soo , Kim Nayoung , Lee Dong Ho
Published: March 2022

Background

To evaluate whether the risk of metachronous high-risk colorectal neoplasm (HR-CRN) differs according to the indication for surveillance colonoscopy.

Methods

Patients who underwent polypectomy or endoscopic resection of colorectal neoplasms were enrolled and classified into three groups according to the indication for surveillance colonoscopy: advanced colorectal neoplasm (ACRN: adenoma ≥ 10 mm, adenoma with high-degree dysplasia and/or villous component), advanced serrated polyps (ASP: hyperplastic polyp or sessile serrated lesion ≥ 10 mm, traditional serrated polyp), and high-risk polyps (HRP: 3 or more adenomas or serrated polyps). The primary outcome was the development of metachronous HR-CRN, defined as ACRN, ASP, or HRP at the first follow-up colonoscopy.

Results

In total, 367 patients were enrolled (ACRN group: N = 264; ASP group: N = 33; HRP group: N = 70). Among the 160 patients who underwent follow-up colonoscopy, 28 (18%) had HR-CRN. In univariable analysis, indication for surveillance colonoscopy was not found to be associated with the development of metachronous HR-CRN. Instead, the total polyp number at index colonoscopy showed a positive association with the risk of metachronous HR-CRN in trend analysis (p = 0.001). In multivariable analysis, the presence of 5 or more polyps at index colonoscopy was found to be associated with the risk of metachronous HR-CRN (OR, 2.575, p = 0.049) after adjusting for risk factors, such as obesity, diabetes, and smoking.

Conclusions

The risk of metachronous HR-CRN did not differ according to the main indications for surveillance colonoscopy. The presence of 5 or more polyps at index colonoscopy was the only risk factor for metachronous HR-CRN.
Efficacy of sigmoidoscopy for evaluating disease activity in patients with ulcerative colitis
Authors: Park Su Bum , Kim Seong-Jung , Lee Jun , Lee Yoo Jin , Baek Dong Hoon , Seo Geom Seog , Kim Eun Soo , Kim Sang-Wook , Kim So Yeong
Published: February 2022

Background

Endoscopic assessment of disease activity is a key parameter in the management of ulcerative colitis. Whether sigmoidoscopy alone is sufficient to evaluate the disease activity in ulcerative colitis lacks studies.

Methods

We retrospectively analyzed the medical records and endoscopic results of patients with ulcerative colitis followed by colonoscopy in seven tertiary hospitals between January 2012 and December 2018. Endoscopic disease activity was scored using the Mayo endoscopic subscore (MES) and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) for each segment from the colonoscopy images. Concordance was evaluated by comparing the highest MES and UCEIS in the rectosigmoid and proximal regions to confirm the usefulness of sigmoidoscopy.

Results

A total of 500 colonoscopic examinations from 333 patients were enrolled. Only in 7.6% [k(kappa): 0.893, r(Spearman): 0.906, p < 0.001] and 8.6% [k(kappa): 0.890, r(Spearman): 0.914; p < 0.001] of cases, MES and UCEIS scored more severely in the proximal colon. Comparison of active disease (MES ≥ 2) in the rectosigmoid area and the entire colon showed a high concordance rate [k(kappa): 0.899, r(Spearman): 0.904, p < 0.001]. Endoscopic healing (MES = 0) also showed a high concordance rate [k(kappa): 0.882, r(Spearman): 0.887, p < 0.001]. In 38 cases (7.6%) of patients with a higher MES in the proximal area, it was significantly higher in patients with previous extensive colitis.

Conclusions

Sigmoidoscopy and colonoscopy showed a high concordance rate. Therefore, sigmoidoscopy is considered a sufficient substitute for colonoscopy. However, colonoscopy should be considered in patients with previous extensive colitis.
Machine learning-based survival rate prediction of Korean hepatocellular carcinoma patients using multi-center data
Authors: Noh Byeonggwan , Park Young Mok , Kwon Yujin , Choi Chang In , Choi Byung Kwan , Seo Kwang il , Park Yo-Han , Yang Kwangho , Lee Sunju , Ha Taeyoung , Hyon YunKyong , Yoon Myunghee
Published: February 2022

Aim

To predict survival time of Korean hepatocellular carcinoma (HCC) patients using multi-center data as a foundation for the development of a predictive artificial intelligence model according to treatment methods based on machine learning.

Methods

Data of patients who underwent treatment for HCC from 2008 to 2015 was provided by Korean Liver Cancer Study Group and Korea Central Cancer Registry. A total of 10,742 patients with HCC were divided into two groups, with Group I (2920 patients) confirmed on biopsy and Group II (5562 patients) diagnosed as HCC according to HCC diagnostic criteria as outlined in Korean Liver Cancer Association guidelines. The data were modeled according to features of patient clinical characteristics. Features effective in predicting survival rate were analyzed retrospectively. Various machine learning methods were used.

Results

Target was overall survival time, which divided into approximately 60 months (= /< 60 m, > 60 m). Target distribution in Group I (total 514 samples) was 28.8%: (148 samples) less than 60 months, 71.2% (366 samples) greater than 60 months, and in Group II (total 757 samples) was 66.6% (504 samples) less than 60 months, 33.4% (253 samples) greater than 60 months. Using NG Boost method, its accuracy was 83%, precision 84%, sensitivity 95%, and F1 score 89% for more than 60 months survival time in Group I with surgical resection. Moreover, its accuracy was 79%, precision 82%, sensitivity 87%, and F1 score 84% for less than 60 months survival time in Group II with TACE. The feature importance with gain criterion indicated that pathology, portal vein invasion, surgery, metastasis, and needle biopsy features could be explained as important factors for prediction in case of biopsy (Group I).

Conclusion

By developing a predictive model using machine learning algorithms to predict prognosis of HCC patients, it is possible to project optimized treatment by case according to liver function and tumor status.
Tropheryma whipplei in the stool samples of children with acute diarrhea: a study from Tehran, Iran
Authors: Sayyahfar Shirin , Latifian Mina , Esmaeili Parisa , Baseri Neda , Bagheri Amiri Fahimeh , Bakhshi Bita , Esteghamati Abdoulreza , Esmaeili Saber
Published: February 2022

Background

Recently, Tropheryma whipplei has been suggested as one of the causative agents of diarrhea among children worldwide. Limited data is available on the prevalence of T. whipplei among children with diarrhea in most countries such as Iran. This study was conducted to evaluate the prevalence of T. whipplei in children with acute diarrhea in Iran.

Methods

In this study, the stool samples were collected from 130 children under 10 years old with acute diarrhea from children's hospitals in Tehran city. Genomic DNA was extracted from stool samples and was tested for the presence of DNA of T. whipplei using the SYBR Green Real-time PCR method. Positive T. whipplei samples were finally confirmed by PCR Product sequencing.

Results

The mean age of participants was 32.5 months, and 54.6% of children were female. Using the SYBR Green Real-time PCR, 9.23% (12/130) of samples were positive for T. whipplei, which were confirmed by sequencing. 66.67% of positive cases were males. The duration of diarrhea in infected children with T. whipplei (83.3%) was significantly longer (OR: 5.93, 95% CI 1.24–28.22) compared to children with negative results (45.8%). Other demographic factors and clinical signs had not a statistically significant relationship with T. whipplei infection.

Conclusions

In this study, T. whipplei was detected in stool samples of children with acute diarrhea. The results indicated that T. whipplei could be associated with childhood diarrhea in Iran. The health care system and physicians should be aware of the presence of T. whipplei infection in Iran, especially in childhood diarrhea.
Grayscale medical image segmentation method based on 2D&3D object detection with deep learning
Authors: Ge Yunfei , Zhang Qing , Sun Yuantao , Shen Yidong , Wang Xijiong
Published: February 2022

Background

Grayscale medical image segmentation is the key step in clinical computer-aided diagnosis. Model-driven and data-driven image segmentation methods are widely used for their less computational complexity and more accurate feature extraction. However, model-driven methods like thresholding usually suffer from wrong segmentation and noises regions because different grayscale images have distinct intensity distribution property thus pre-processing is always demanded. While data-driven methods with deep learning like encoder-decoder networks always are always accompanied by complex architectures which require amounts of training data.

Methods

Combining thresholding method and deep learning, this paper presents a novel method by using 2D&3D object detection technologies. First, interest regions contain segmented object are determined with fine-tuning 2D object detection network. Then, pixels in cropped images are turned as point cloud according to their positions and grayscale values. Finally, 3D object detection network is applied to obtain bounding boxes with target points and boxes’ bottoms and tops represent thresholding values for segmentation. After projecting to 2D images, these target points could composite the segmented object.

Results

Three groups of grayscale medical images are used to evaluate the proposed image segmentation method. We obtain the IoU (DSC) scores of 0.92 (0.96), 0.88 (0.94) and 0.94 (0.94) for segmentation accuracy on different datasets respectively. Also, compared with five state of the arts and clinically performed well models, our method achieves higher scores and better performance.

Conclusions

The prominent segmentation results demonstrate that the built method based on 2D&3D object detection with deep learning is workable and promising for segmentation task of grayscale medical images.
Clinical value of resting cardiac dual-energy CT in patients suspected of coronary artery disease
Authors: Li Wenhuan , Yu Fangfang , Liu Mingxi , Yan Chengxi
Published: February 2022

Background

Rest/stress myocardial CT perfusion (CTP) has high diagnostic value for coronary artery disease (CAD), but the additional value of resting CTP especially dual-energy CTP (DE-CTP) beyond coronary CT angiography (CCTA) in chest pain triage remains unclear. We aimed to evaluate the diagnostic accuracy of resting myocardial DE-CTP, and additional value in detecting CAD beyond CCTA (obstructive stenosis: ≥ 50%) in patients suspected of CAD.

Methods

In this prespecified subanalysis of 54 patients, we included patients suspected of CAD referred to invasive coronary angiography (ICA). Diagnostic accuracy of resting myocardial DE-CTP in detecting myocardial perfusion defects was assessed using resting13N-ammonia positron emission tomography (PET) as the gold standard. Diagnostic accuracy of cardiac dual-energy CT in detecting flow-limiting stenoses (justifying revascularization) by CCTA combined with resting myocardial DE-CTP, using ICA plus resting13N-ammonia PET as the gold standard. The CCTA and DE-CTP datasets derived from a single-phase scan performed with dual-energy mode.

Results

For detecting myocardial perfusion defects, DE-CTP demonstrated high diagnostic accuracy with a sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) of 95.52%, 85.93%, and 0.907 on a per-segment basis. For detecting flow-limiting stenoses by CCTA alone, sensitivity, specificity, and AUC were 100%, 56.47%, and 0.777 respectively on a per-vessel basis. For detecting flow-limiting stenoses by CCTA combined with resting myocardial DE-CTP, sensitivity, specificity, and AUC were 96.10%, 95.29% and 0.956 respectively on a per-vessel basis. Additionally, CCTA combined with resting myocardial DE-CTP detected five patients (9%) with no obstructive stenosis but with myocardial perfusion defects confirmed by ICA plus13N-ammonia PET.

Conclusions

Resting cardiac DE-CTP demonstrates a high diagnostic accuracy in detecting myocardial perfusion defects and provides an additional clinical value by reducing rates of false-positive and false-negative patients beyond CCTA in patients suspected of CAD.
Food consumption in the Canary Islands: nutritional implications of food imports and local production
Authors: Godenau Dirk , Martin-Rodriguez Gloria , Gonzalez-Gomez Jose Ignacio , Caceres-Hernandez Jose Juan
Published: February 2022

Background

The composition of the average diet for the Canary Islands’ population has been the subject of concern for the region’s authorities and nutrition specialists. In this study, the composition of the average diet in the Canary Islands is estimated.

Method

The approach is based on secondary data on local production and external trade. The breakdown of the total volume of apparent food consumption into specific product categories marketed to the consumers is achieved by applying hypotheses about losses in the distribution process. The estimation of food intake is obtained by making assumptions about the rates of food wastage in the final stage of consumption. This consumption is expressed not only in terms of edible weight and the market value associated with different food groups according to their local or imported origin, but also in terms of their energy and nutrient content.

Results

The results obtained suggest a high-calorie diet, close to three thousand kilocalories per person per day, with an average cost of around eight euros per person per day. Imported products, with a lower average cost per unit of energy, provide most of the carbohydrates and fats.

Conclusion

This study provides a complementary approach to survey-based evidence and also offers the possibility of evaluating the contributions of local or imported food to the diet.
Interstitial lung disease in Primary Sjögren's syndrome
Authors: Lin Wei , Xin Zhifei , Zhang Jianlong , Liu Ning , Ren Xiuying , Liu Meilu , Su Yashuang , Liu Yixuan , Yang Liu , Guo Shaoying , Yang Yupeng , Li Yang , Cao Jingjing , Ning Xiaoran , Li Jingjing , Xue He , Niu Nannan , Chen Yingmin , Li Fang , Sun Lijun , Zhang Xiaopeng , Zhang Fengxiao , Zhang Wen
Published: February 2022

Background

Interstitial lung disease (ILD) may cause life-threatening complications of primary Sjogren’s syndrome (pSS), and has a poor prognosis in terms of survival and quality of life. To date, few studies have investigated the risk factors for ILD detected by high-resolution computed tomography (HRCT) in pSS patients with or without respiratory symptoms.

Methods

Data of 333 patients with newly diagnosed pSS were retrospectively analysed. Interstitial lung disease involvement was defined as typical abnormalities on HRCT and/or pulmonary function tests. Multivariate regression model was used to evaluate the association between interstitial lung disease and pSS characteristics.

Results

Sixty-six patients (19.82%) were diagnosed with pSS-ILD. Ground glass opacities (87.88%) and septal/sub pleural lines (81.82%) were most frequent. Based on pulmonary high-resolution computed tomography, patients were divided into nonspecific (n = 42), usual (n = 20), lymphocytic interstitial pneumonia (n = 3) and cryptogenic organising pneumonia (n = 1) groups. There was a strong association between erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP) and the HRCT-score. Pulmonary function tests revealed impaired diffusion capacity for carbon monoxide and total lung capacity, and coexistence of small airway lesions in pSS-interstitial lung disease. On logistic regression analysis, age, Raynaud’s phenomenon, lymphopenia, cough, dyspnoea and rampant dental caries were risk factors associated with pSS-interstitial lung disease.

Conclusions

Interstitial lung disease involvement in pSS is a common clinical occurrence. The clinical manifestation is nonspecific and variable; Raynaud’s phenomenon and lymphopenia may predict its onset. pSS patients with advanced age, dry cough and dyspnoea should be systematically evaluated for ILD involvement and managed according to their symptoms.
Evaluation of the antimalarial activity and toxicity of Mahanil-Tang-Thong formulation and its plant ingredients
Authors: Chaniad Prapaporn , Phuwajaroanpong Arisara , Techarang Tachpon , Horata Natharinee , Chukaew Arnon , Punsawad Chuchard
Published: February 2022

Background

Novel potent antimalarial agents are urgently needed to overcome the problem of drug-resistant malaria. Herbal treatments are of interest because plants are the source of many pharmaceutical compounds. The Mahanil-Tang-Thong formulation is a Thai herbal formulation in the national list of essential medicines and is used for the treatment of fever. Therefore, this study aimed to evaluate the antimalarial activity of medicinal plants in the Mahanil-Tang-Thong formulation.

Methods

Nine medicinal plant ingredients of the Mahanil-Tang-Thong formulation were used in this study. Aqueous and ethanolic extracts of all the plants were analyzed for their phytochemical constituents. All the extracts were used to investigate the in vitro antimalarial activity against Plasmodium falciparum K1 (chloroquine-resistant strain) by using the lactate dehydrogenase (pLDH) method and cytotoxicity in Vero cells by using the 3-(4,5-dimethylthiazol2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Additionally, an extract with potent in vitro antimalarial activity and no toxicity was selected to determine the in vivo antimalarial activity with Peters’ 4-day suppressive test against the Plasmodium berghei ANKA strain. Acute toxicity was evaluated in mice for 14 days after the administration of a single oral dose of 2000 mg/kg.

Results

This study revealed that ethanolic extracts of Sapindus rarak DC., Tectona grandis L.f., Myristica fragrans Houtt. and Dracaena loureiri Gagnep. exhibited potent antimalarial activity, with half-maximal inhibitory concentration (IC50) values of 2.46, 3.21, 8.87 and 10.47 μg/ml, respectively, while the ethanolic of the formulation exhibited moderate activity with an IC50 value of 37.63 μg/ml and its aqueous extract had no activity (IC50 = 100.49 μg/ml). According to the in vitro study, the ethanolic wood extract of M. fragrans was selected for further investigation in an in vivo mouse model. M. fragrans extract at doses of 200, 400, and 600 mg/kg body weight produced a dose-dependent reduction in parasitemia by 8.59, 31.00, and 52.58%, respectively. No toxic effects were observed at a single oral dose of 2000 mg/kg body weight.

Conclusion

This study demonstrates that M. fragrans is a potential candidate for the development of antimalarial agents.
Characterisation, procedures and heritability of acute dietary intake in the Twins UK cohort: an observational study
Authors: Leeming Emily R. , Mompeo Olatz , Turk Pauline , Bowyer Ruth C. E. , Louca Panayiotis , Johnson Abigail J. , Spector Tim D. , Le Roy Caroline , Gibson Rachel
Published: February 2022

Background

Estimated food records (EFR) are a common dietary assessment method. This investigation aimed to; (1) define the reporting quality of the EFR, (2) characterise acute dietary intake and eating behaviours, (3) describe diet heritability.

Methods

A total of 1974 one-day EFR were collected from 1858 participants in the TwinsUK cohort between 2012 and 2017. EFR were assessed using a six-point scoring system to determine reporting quality. The frequency and co-occurrence of food items was examined using word clouds and co-occurrence networks. The impact of eating behaviours on weight, BMI and nutrient intake were explored using mixed-effect linear regression models. Finally, diet heritability was estimated using ACE modelling.

Results

We observed that 75% of EFR are of acceptable reporting quality (score > 5). Black tea and semi-skimmed milk were the most consumed items, on an individual basis (respectively 8.27, 6.25%) and paired (0.21%) as co-occurring items. Breakfast consumption had a significantly (p = 5.99 × 10− 7) greater impact on energy (kcal) (mean 1874.67 (±SD 532.42)) than skipping breakfast (1700.45 (±SD 620.98)), however only length of eating window was significantly associated with body weight (kg) (effect size 0.21 (±SD 0.10), p = 0.05) and BMI (effect size 0.08 (±SD 0.04), p = 0.04) after adjustment for relevant covariates. Lastly, we reported that both length of eating window (h2 = 33%, CI 0.24; 0.41), and breakfast consumption (h2 = 11%, CI 0.02; 0.21) were weakly heritable.

Conclusions

EFR describing acute dietary intake allow for eating behaviour characterisation and can supplement habitual diet intake assessments. Novel findings of heritability warrant further investigation.
Dietary intake of monounsaturated and polyunsaturated fatty acids is related to the reduced risk of esophageal squamous cell carcinoma
Authors: Tang Yu-Xuan , Zhao Wenjing , Li Jun , Xie Peng , Wang Shuyi , Yan Lubin , Xing Xiangbing , Lu Jiahai , Tse Lap-Ah , Wang Harry Hao-Xiang , Liu Xudong
Published: February 2022

Background

The relationship of consumption of dietary fat and fatty acids with esophageal squamous cell carcinoma (ESCC) risk remains unclear. This study aimed to explore the relationship of dietary fat and fatty acids intake with ESCC risk.

Methods

This case-control study included 879 incident cases and 892 community-based controls recruited from Southwest China. A food frequency questionnaire was adopted to collect information about dietary information, and intake of fat, saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), polyunsaturated fatty acid (PUFA), and total fatty acid (TFA) was calculated. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were estimated using the logistic regression model.

Results

When comparing the highest with lowest intake quintiles, MUFA (OR: 0.33, 95% CI: 0.21–0.51), PUFA (OR: 0.32, 95% CI: 0.20–0.51), and TFA (OR: 0.44, 95% CI: 0.28–0.70) were related to a reduced risk of ESCC after adjusting for confounders; for non-drinkers rather than drinkers, the intake of SFA was significantly related to a 61% (OR: 0.39, 95% CI: 0.19–0.81) reduced risk of ESCC when comparing the highest with the lowest intake quintiles. Dietary fat was not related to the risk of ESCC.

Conclusions

This study suggested that the more intake of MUFA and PUFA, the lower risk of ESCC, whereas the protective effect of TFA was only observed among non-drinkers. Strategic nutritional programs should consider food rich in unsaturated fatty acids to mitigate the occurrence of ESCC.
Blood lipid metabolism and the risk of gallstone disease: a multi-center study and meta-analysis
Authors: Zhang Min , Mao Min , Zhang Chi , Hu Fulan , Cui Ping , Li Guangcan , Shi Jia , Wang Xin , Shan Xuefeng
Published: March 2022

Background

Gallstone disease (GSD) is a common and costly biliary disorder. Multiple studies have investigated the associations between blood lipid metabolism and GSD risk; however, the results are inconsistent. This research aimed to comprehensively evaluate the relationships among serum total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides and GSD risk.

Methods

Firstly, a multi-center cross-sectional study was carried out. Subjects who participated in the health examination in three hospitals between January 2015 and May 2020 were recruited. Multivariable logistic regression was used to investigate blood lipid metabolism associated with GSD risk. Then, a meta-analysis was performed to verify the associations further. Medline and Embase databases were systematically searched before June 10, 2021. The DerSimonian and Laird random-effect model was utilized when the heterogeneity was high; otherwise, fixed-effect model was adopted.

Results

There were 548,934 eligible participants included in the multi-center study, and 45,392 of them were diagnosed with GSD. The results demonstrated that total cholesterol and HDL cholesterol were negatively associated with GSD risk in both high vs. low model and per mmol/L increase model, while triglyceride was positively associated with GSD risk in the per unit increase model. In the meta-analysis, 104 studies with approximately 3 million participants were finally included. The results verified that HDL cholesterol [odds ratio (OR) = 0.636, P = 5.97 × 10− 16 in high vs low model; OR = 0.974, P = 6.07 × 10− 05 in per unit model] and triglyceride (OR = 1.192, P = 3.47 × 10− 05 in high vs. low model; OR = 1.011, P = 5.12 × 10− 05 in per unit model) were related to GSD risk in the two models.

Conclusions

The findings indicated that low HDL cholesterol levels and high triglyceride levels were risk factors for GSD. This study provides a basis for identifying the population at high risk for GSD and implementing tertiary prevention strategies for GSD, thus contributing to GSD prevention as well as disease burden relief.
Association of tumor deposits with tumor-infiltrating lymphocytes and prognosis in gastric cancer
Authors: Li Xinyue , Yang Jing
Published: February 2022

Background

To investigate the relationship between tumor deposits (TDs) with the clinicopathological characteristics tumor-infiltrating lymphocytes (TILs) and prognosis of gastric cancer. Further analysis was done on the relationship between the number and maximum diameter of TDs with the clinicopathological characteristics and prognosis of gastric cancer.

Methods

The pathological findings of 369 patients with gastric cancer were retrospectively analyzed to observe the expression of TDs and the levels of stromal TILs. The relationship between TDs, clinicopathological characteristics, and levels of stromal TILs was compared using the chi-square test. Kaplan-Meier was used for survival analysis, and the log-rank test was used to determine the relationship between TDs and disease-free survival, cancer-specific survival, and overall survival. The prognostic value of TDs was assessed using multivariate Cox proportional hazards regression analysis. For further analysis, the optimal cutoff values for the number and maximum diameter of TDs were selected based on the receiver operating characteristic (ROC) curve.

Results

TDs were significantly associated with sex, lymphovascular invasion, perineural invasion, pathological T,N stage, and clinical stage (all P < 0.05). TILs levels are lower in TDs(+) group and higher in TDs(−) group. Compared with TDs(−) groups, TDs(+) group had poor disease-free survival, cancer-specific survival, and overall survival. TDs are negatively correlated with TILs, and TILs levels are lower in TDs(+) group and higher in TDs(−) group (P < 0.05). The samples are divided into the number of TDs (< 4 and ≥ 4) and the maximum diameter of TDs (< 7 mm and ≥ 7 mm). The number of TDs was significantly associated with pathological N stage (P < 0.05). The maximum diameter of TDs was significantly correlated with Lauren classification (P < 0.05) .TDs ≥ 4 had lower DFS, CSS, and OS (P < 0.05). The maximum diameter of TDs was not statistically significant with prognosis (P > 0.05).

Conclusion

TDs are independent prognosis predictors of gastric cancer. In the tumor microenvironment, TDs and TILs interact with each other to regulate the development of gastric cancer, thus affecting gastric cancer prognosis of patients. The number of TDs ≥ 4 has a worse prognosis compared to the number of TDs < 4.
Undifferentiated pleomorphic sarcoma of the pancreas: a rare case report and literature review
Authors: Liang Ze , Han Jingzhao , Tuo Hongfang , Xue Dongdong , Yu Hanxiang , Peng Yanhui
Published: February 2022

Background

Primary undifferentiated pleomorphic sarcoma (UPS) of the pancreas is an exceedingly rare malignant tumor, with only 15 cases have been reported in the medical literature. At present, clinicians have poor recognition of the tumor, the epidemiology, diagnosis, and treatment of this disease have yet not been established.

Case presentation

In this report, we depict the clinical and imaging characteristics of a 37-year-old man presenting with a primarily cystic UPS. The patient complained of epigastric pain and distention over 20 days. Abdominal CT and pancreatic magnetic resonance imaging revealed cystic and cystic solid masses in the pancreatic body and tail. An abdominal ultrasound echogram revealed the mass in the body of the pancreas to be cystic with separation echo inside, and the wall was thick, not smooth. Besides, a hypoechoic mass was seen in the tail area of the pancreas with an inhomogeneous echoic pattern, containing small patches of no echo zone in the central. Microscopically, spindle fibroblast-like cells are arranged in a characteristic storiform pattern with pleomorphic and multinucleated cells. Immunohistochemically, tumor cells were positive for CD68 and vimentin. Seven months postoperatively, he was diagnosed with pulmonary lymph node metastasis and died 5 months later. Combined with this case report, we also reviewed the literature regarding UPS of the pancreas.

Conclusions

As we know, this is the first report on ultrasonography findings of pancreatic UPS. Despite there are no distinctive manifestation of UPS, a solid cystic lesion on ultrasonography or a hypodense area in the lesion on T2-weighted imaging, should be considered for differential diagnosis with pancreatic UPS. We believe this article may add some ideas into the diagnosis and therapy of patients with this tumor.
Clinical characteristics and patient outcomes of molecular subtypes of small cell lung cancer (SCLC)
Authors: Ding Xiao-Long , Su Yi-Ge , Yu Liang , Bai Zhou-Lan , Bai Xue-Hong , Chen Xiao-Zhen , Yang Xia , Zhao Ren , He Jin-Xi , Wang Yan-Yang
Published: February 2022

Background

Recent studies have shown that according to the expression levels of achaete-scute homolog 1 (ASCL1), neurogenic differentiation factor 1 (NEUROD1), and POU class 2 homeobox 3 (POU2F3), small cell lung cancer (SCLC) can be divided into four subtypes: SCLC-A (ASCL1-dominant), SCLC-N (NEUROD1-dominant), SCLC-P (POU2F3-dominant), and SCLC-I (triple negative or SCLC-inflamed). However, there are limited data on the clinical characteristics and prognosis of molecular subtypes of SCLC.

Methods

Immunohistochemistry (IHC) was used to detect the expression levels of ASCL1, NEUROD1, and POU2F3 in 53 patient samples of resectable SCLC. The subtype was defined by the differential expression of the transcription factors for ASCL1, NEUROD1, and POU2F3 or the low expression of all three factors with an inflamed gene signature (SCLC-A, SCLC-N, SCLC-P, and SCLC-I, respectively). The clinicopathological characteristics, immunological features (programmed death ligand 1 [PD-L1] expression and CD8+ tumor infiltrating lymphocyte [TIL] density), and patient outcomes of the four subtypes of SCLC were analyzed.

Results

Positive ASCL1, NEUROD1, and POU2F3 staining was detected in 43 (79.2%), 27 (51.0%), and 17 (32.1%) SCLC specimens by IHC. According to the results of IHC analysis, SCLC was divided into four subtypes: SCLC-A (39.6%), SCLC-N (28.3%), SCLC-P (17.0%), and SCLC-I (15.1%). The 5-year overall survival (OS) rates of these four subtypes were 61.9%, 69.3%, 41.7%, and 85.7%, respectively (P=0.251). There were significant differences in smoking status among different subtypes of SCLC (P= 0.031). However, we did not confirm the correlation between subtypes of SCLC and other clinicopathological factors or immune profiles. Cox multivariate analysis showed that N stage (P=0.025), CD8+ TILs (P=0.024), Ki-67 level (P=0.040), and SCLC-P (P=0.023) were independent prognostic factors for resectable SCLC.

Conclusions

Our IHC-based study validated the proposed classification of SCLC using the expression patterns of key transcriptional regulatory factors. We found that SCLC-P was associated with smokers and was one of the poor prognostic factors of limited-stage SCLC. In addition, no correlation was found between PD-L1 expression or CD8+ TIL density and SCLC subtypes.
Evaluation of the SYNAPSE VINCENT for lateral lymph node dissection in rectal cancer with robotic surgery: a preliminary report
Authors: Matsuhashi Nobuhisa , Sato Yuta , Tajima Jesse Yu , Kiyama Shigeru , Takahashi Takao , Kuno Masashi , Endo Masahide , Fukada Masahiro , Mizutani Chika , Tokumaru Yoshihisa , Yasufuku Itaru , Suetsugu Tomonari , Tanaka Yoshihiro , Okumura Naoki , Murase Katsutoshi , Saiki Takuya , Yoshida Kazuhiro
Published: February 2022

Background

Even if 3D angiographic images of preoperative contrast-enhanced computed tomography (CT) are created, the coronal and axial sections can be unclear, and thus, it is difficult to achieve projection awareness similar to that of actual laparoscopic images. In recent years, the technology of analyzing and applying medical images has advanced, and surgical simulation and navigation have been widely used to improve the safety of surgical operations. It is important to understand pelvic anatomy in the area of rectal cancer, and use of the SYNAPSE VINCENT makes it possible to simulate the anatomy before surgery, which is very useful in educating surgeons and their assistants.

Materials and methods

An important objective in surgery is to understand the anatomy of the external/internal iliac arteries and lymph nodes in lateral lymph node dissection (LLD) for rectal cancer. In this study, we explored the accuracy and usefulness of SYNAPSE VINCENT images of pelvic anatomy (especially vascular anatomy) analyzed preoperatively in two cases of LLD for rectal cancer in our department.

Results

The patients were two men aged 73 and 57 years, respectively. Both patients underwent robotic abdominal perineal resection and LLD with neoadjuvant chemoradiotherapy. The operating times for LLD were 138 and 106 min, estimated blood loss was less than 10 mL and 20 mL, and the harvested lymph nodes were nos. 21 and 22, respectively. The SYNAPSE VINCENT could be used for simulation and navigation before and during surgery. For experienced surgeons, the system helped them carry out operations more accurately.

Conclusion

In the future, surgical support using virtual reality, augmented reality, and mixed reality based on medical images will be useful and is expected to improve the safety, accuracy, and efficiency of surgery, which is extremely useful for both young and skilled surgeons preparing for difficult operations.
Primary hemangioblastoma of the kidney with molecular analyses by next generation sequencing: a case report and review of the literature
Authors: Wang Xintong , Haines George K. , Mehrotra Meenakshi , Houldsworth Jane , Si Qiusheng
Published: February 2022

Background

Hemangioblastoma is an indolent mesenchymal tumor most frequently occurring in the central nervous system (CNS), but can also arise extraneuraxially, as part of Von Hippel-Lindau (VHL) disease or in sporadic tumors. Extraneuraxial hemangioblastomas occur outside the central nervous system. It includes tumors arising from the nervous paraneuraxial structures and visceral organs. Sporadic hemangioblastoma of the kidney, a rare subset of extraneuraxial hemangioblastomas, is an under-recognized renal neoplasm. There have been only 25 cases described to date in the English language literature. We report herein one additional sporadic tumor in a patient without VHL disease.

Case presentation

A 61 year old male presenting with gross hematuria was found to have a 3.5 cm renal mass at the lateral mid to lower pole of the left kidney on computed tomography urogram. The patient underwent a partial nephrectomy for the mass. Pathological examination showed a well-circumscribed non-encapsulated tumor composed of sheets of large polygonal cells traversed by a rich vascular network. The tumor cells showed clear to eosinophilic cytoplasm and overall bland nuclei. The diagnosis of hemangioblastoma was confirmed by positive immunostaining for alpha-inhibin, S100, neuron-specific enolase, and PAX8. No significant gene mutations, including VHL gene and copy number changes were detected in the tumor using next generation sequencing supporting the diagnosis of sporadic renal hemangioblastoma.

Conclusion

Sporadic renal hemangioblastoma is a rare subset of extraneuraxial hemangioblastomas. We report one such tumor in a patient without clinical or molecular evidence of VHL disease. The literature was reviewed to better understand the clinical, radiological, pathological, and molecular features of this neoplasm. The majority of renal hemangioblastomas showed positive immunostaining for PAX8, which supports the idea that the immunoprofiles of extraneuraxial hemangioblastomas can vary depending on sites of origin. Diagnosis of renal hemangioblastoma is challenging because of its rarity and overlapping microscopic and immunophenotypic features with other renal tumors, including clear cell renal cell carcinoma. In some cases, molecular or genetic studies may be necessary to obtain an accurate diagnosis. Since renal hemangioblastoma is clinically benign, recognition of this pathological entity is important to avoid unnecessary over-treatment.
Curative efficacy of surgical procedures for older patients with femoral neck fracture: a network meta-analysis and systematic review
Authors: Cui Lanxin , Zhao Shishun , Tian Heng , Guo Wenlai , Dong Xiaoming
Published: March 2022

Background

Femoral neck fractures have a higher incidence in older people with poor prognosis, inducing serious social problems. Common treatment methods include total hip arthroplasty, bipolar hemiarthroplasty, double-screw fixation, multiple-screw fixation, and dynamic hip system.

Methods

We searched through four electronic databases, including PubMed, Web of Science, Cochrane Library, and Embase databases, for articles regarding femoral neck fractures, bone screw, and hip prosthesis published up to February 11, 2020. All included articles were used for quality evaluation and data extraction. Extracted data were expressed as odds ratios or weighted mean differences, with 95% confidence intervals. We conducted a network meta-analysis for Harris hip score, complications, 1-year mortality rate, reoperation rate, intraoperative blood loss, and duration of operation using STATA version 16.0 software.

Results

Twenty-two randomized controlled trials and nine cohort studies included in this study involved 3861 patients. Total hip arthroplasty significantly improved the postoperative function of patients with femoral neck fractures. The surface under the cumulative ranking curve value of the Harris hip score for more than 1 year after total hip arthroplasty was 98.2.

Conclusions

This meta-analysis indicated no significant difference in mortality among different treatment groups. Total hip arthroplasty can provide satisfactory outcomes in hip joint function, and double-screw fixation results in the lowest intraoperative risk. In general, total hip arthroplasty results in a lower incidence of adverse events and is especially recommended for patients with femoral neck fractures. This article has been retrospectively registered on the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) on November 27, 2020. Registration number: INPLASY2020110123.
Bacterial community structure and diversity along the halocline of Tyro deep-sea hypersaline anoxic basin
Authors: Mapelli Francesca , Barbato Marta , Chouaia Bessem , Riva Valentina , Daffonchio Daniele , Borin Sara
Published: February 2022

Purpose

Tyro is a deep hypersaline anoxic basin (DHAB) located at the seafloor of the Eastern Mediterranean sea. Tyro hosts a stratified eukaryotic microbiome moving from seawater to the brine, but no reports are available on its prokaryotic community. We provide the first snapshot of the bacterial community structure in Tyro brine, seawater-brine interface, and the overlaying deep seawater.

Methods

In this study, we combined the use of molecular analyses, i.e., DNA fingerprinting and 16S rRNA pyrosequencing for the description of the bacterial community structure and taxonomy. PiCRUST2 was used to infer information on the prokaryotes functional diversity. A culture-dependent approach was applied to enrich bacteria of interest for marine biotechnology.

Results

Bacterial communities sharply clustered moving from the seawater to the Tyro brine, in agreement with the abrupt increase of salinity values. Moreover, specific taxonomic groups inhabited the seawater-brine interface compared to the overlaying seawater and their identification revealed converging taxonomy with other DHABs in the Eastern Mediterranean sea. Functional traits inferred from the prokaryote taxonomy in the upper interface and the overlaying seawater indicated metabolic pathways for the synthesis of osmoprotectants, likely involved in bacterial adaptation to the steep increasing salinity. Metabolic traits related to methane and methylated compounds and to hydrocarbon degradation were also revealed in the upper interface of Tyro. The overall capability of the Tyro microbiome for hydrocarbon metabolism was confirmed by the isolation of hydrocarbonoclastic bacteria in the sediments.

Conclusions

Our results suggest that Tyro seawater-brine interface hosts a specific microbiome adapted to the polyextreme condition typical of DHABs with potential metabolic features that could be further explored for the characterization of the metabolic network connecting the brine with the deep seawater through the chemocline. Moreover, Tyro could be a reservoir of culturable microbes endowed with functionalities of interest for biotechnological applications like hydrocarbon bioremediation.