bluuebunny/crossref_metadata_2025 huggingface dataset:
PS-P14-6: SALTCON FESTIVAL IN KYOTO 2022 BY SALT REDUCTION PROMOTION TEAM OF JAPANESE SOCIETY OF HYPERTENSION PRACTITIONERS SUBCOMMITTEE
Authors: Hatta Tsuguru , Noma Gentoku , Takase Hiroyuki , Ozono Ryoji , Tsuge Toshinao , Minowa Hitoshi , Ando Katsuyuki , Narumi Jun , Aoki Soichiro , Yoshiikawa Hiroyuki , Mizuta Einosuke , Kudo Hiroshi , Tana Takeshi , Tsuchihashi Takuya , Kusaka Miho
Published: January 2023

Background:

In September 2011, the United Nations and WHO, based on an article published in the Lancet, proposed five actions that the entire world should take to combat noncommunicable diseases (NCDs). In order of priority, they are: 1. Tobacco Control > 2. Salt Reduction > 3. Improved Diets and Physical Activity > 4. Essential Drugs and Technologies. However, looking back over the past decade, while Tobacco Control has made progress, Salt Reduction still has a ways to go. In fact, a Systematic Analysis published in the Lancet in 2019 places “salt” at the top of the list of dietary factors that negatively impact life expectancy and health span. Therefore, the Festival has identified “Salt Reduction” as a global issue to be addressed in the next decade, and will implement programs to accelerate Salt Reduction efforts.

*SOLCON: Abbreviated term for Salt Consious (visualize) and Salt Control (adjust).

Purpose:

Accelerate Salt Reduction efforts

(Involving people who have never had anything to do with salt before)

(1) Overview (three events will be held, each described in detail below)

(2) Forums for organizations (sharing Population Approach), held on the web

(3) Markets targeting individuals (practice of Individual Approach), holding Real

Public lectures for individuals, held on the web

Meeting Date:

(1) Forum: Thursday, November 24, 2022, 12:00 - 17:00

(2) Market: Sunday, November 13, 2022, 10:00–15:00

(3) Public Lecture: Saturday, November 19, 2022, 16:00–18:00

Reduce salt! is not enough to reach the health-unconcerned population, and to reduce salt consumption, we have planned an event like the Japanese version of CASH (the National Council on Salt and Health), a collaboration of industry, government, and academia. We hope that this project will be a catalyst for reducing salt consumption in Japan.
PS-P15-5: EFFECT OF SODIUM RESTRICTION ON LARGE ARTERY STIFFNESS AND DISTENSIBILITY OF SMALL ARTERIES IN HYPERTENSIVE PATIENTS: A RANDOMIZED TRIAL
Authors: Adolphi Camila Lumy , Gaeta Ludmila Nogueira Novaes , Lopes Heno Ferreira , Bortolotto Luiz Aparecido
Published: January 2023

Objective:

Arterial stiffness is characterized by a decrease in arterial distensibility, resulting from the interaction between the extracellular matrix and cellular elements. Large and small arteries can be differently influenced by extrinsic factors, such as excessive sodium intake. This study aim to evaluate the impact of sodium restriction on large artery stiffness and distensibility of small arteries in young adults diagnosed with arterial hypertension.

Methods:

Randomized controlled clinical trial, including 20 hypertensive patients, aged between 30 and 59 years, followed up at the hypertension outpatient clinic of a tertiary hospital. Subjects were randomized into two groups: group 1 - low-sodium diet (2 g sodium/day); group 2 - usual diet. To analyze the stiffness and distensibility of the arteries, it was measured aortic pulse wave velocity by Complior®, elasticity of small arteries and vascular resistance by HDI®, and also through the measurement of metalloproteinase-9. For nutritional assessment it were considered blood glucose levels, 24-h urinary sodium, body mass index (BMI) and other anthropometric measurements. For nutritional intake we analized the 24-hour dietary recall.

Results and Discussion:

In comparison with group 2, it was observed a significant (p < 0.05) reduction in office blood pressure (p = 0,037) and pulse wave velocity (p = 0,010) in group 1 subjects. Also, in group 1 it occurred reduction in blood glucose levels, BMI, waist and neck circumference. Sodium intake was significantly reduced in group 1, taking into account 24 hs urinary sodium and evaluated by dietary recall. It is worth mentioning that excessive sodium intake linked to arterial hypertension causes a remodeling process, increased oxidative stress, inflammation and fibrosis of the arteries, contributing to arterial stiffness. Regarding the distensibility of small arteries, no significant differences were found between the two groups, but the intervention period and the number of individuals in the study should be taken into account, since these factors may have influenced the results.

Conclusion:

Sodium restriction for a short period of time promoted reduction of arterial stiffness, in parallel to reduction in obesity parameters and blood pressure in adults diagnosed with systemic arterial hypertension.
PS-P15-7: EFFECT OF ESAXERENONE ON UNCONTROLLED NOCTURNAL HYPERTENSION FIRST EVALUATED BY 2 UPPER-ARM/WRIST HOME MONITORING DEVICES (EARLY-NH STUDY)
Authors: Kario Kazuomi , Nishizawa Masafumi , Kato Mitsutoshi , Ishii Hajime , Uchiyama Kazuaki , Nagai Michiaki , Takahashi Nobuo , Asakura Taro , Shiraiwa Toshihiko , Taguchi Takashi , Shiosakai Kazuhito , Sugimoto Kotaro
Published: January 2023

Objective:

Nocturnal hypertension is one of the phenotypes of masked hypertension, which affects 30–50% of hypertensive patients, and it cannot be adequately controlled with a single agent. The mineralocorticoid receptor (MR) is activated in an aldosterone-independent manner in diabetes, obesity, salt sensitivity, and excessive salt intake. As all of these conditions are associated with nocturnal hypertension, MR blockers which exert not only antihypertensive but also organ-protective effects are considered the optimal antihypertensive option.

Recently, we have developed 2 types (upper-arm and wrist) of nocturnal home blood pressure (BP) monitoring (HBPM) devices. Using these devices, we evaluated the effects of esaxerenone on nighttime home BP and organ damage (UACR and NT-proBNP) in uncontrolled nocturnal hypertensive patients on medication using one drug, either angiotensin receptor blocker (ARB) or calcium channel blocker (CCB).

Design and method:

EARLY-NH study (jRCTs031200364) was a multicenter, open-label, interventional study in nocturnal hypertensive patients. Nighttime BP was automatically measured at 2, 3, and 4AM with upper-arm (OMRON HEM-9700T), and wrist (OMRON HEM-9601T) HBPM devices. The BP data were electronically collected. Inclusion criteria were: 1) aged ≧ 20 years, 2) receiving one ARB or CCB, 3) nighttime home systolic BP (SBP) ≧ 120 mmHg. Over the 12-week study period, esaxerenone was started at the initial dose of 1.25 or 2.5 mg/day, and could be titrated up to 5 mg/day at weeks 4 and 8, based on the individual patient's condition. The primary efficacy endpoint was the change from baseline in nighttime home BP [SBP and diastolic BP (DBP)] measured by the upper-arm device at week 12. Secondary endpoints included changes in nighttime home BP measured by the wrist device, and levels and control rate of office and home BPs, %change in UACR and NT-proBNP, and safety variables including adverse events, eGFR, and serum potassium.

Results:

The 93 patients with uncontrolled nocturnal hypertension were successfully enrolled [age: 67.6 years; man: 50.5%; ARB/CCB: 48.4/51.6%; nighttime home SBP/DBP (upper-arm: 132.4/78.4 mmHg; wrist: 130.4/73.1 mmHg); morning home SBP/DBP: 143.8/86.7 mmHg; office SBP/DBP: 147.2/84.1 mmHg; UACR: 110.4 mg/gCr; NT-proBNP: 83.7 pg/mL; serum potassium: 4.0 mEq/L; eGFR: 69.7 mL/min/1.73m2]. Results for the efficacy, safety, and exploratory analysis will be presented.

Conclusions:

EARLY-NH study will provide the first clinical evidence of the efficacy and safety of esaxerenone on uncontrolled nocturnal hypertension evaluated by 2 newly developed different upper-arm and wrist HBPM and on organ damage. These results will contribute to digital management of hypertension using home BP.
PS-P16-1: INFLUENCE OF AGE AND SEX ON THE RELATIONSHIP BETWEEN MAP AND CENTRAL PULSE PRESSURE DURING YOUNG ADULTHOOD
Authors: Alfie Jose , Aparicio Lucas S
Published: January 2023

The present study evaluates the interplay between age and sex on the relationship between MAP and brachial and central PP in young to middle-aged hypertensive patients. This is a cross-sectional study of hypertensive patients referred for radial pulse wave evaluation (Sphygmocor device). A total of 312 patients (69% under antihypertensive treatment), mean age 35 ± 9 years (16–49 years) and 134 ± 14 /82 ± 10 mmHg, with operator index > 70% were included. As shown in the figure, increasing age was associated with a progressive dissociation of central PP between subgroups of MAP below and above the mean (100 mmHg), reaching statistical significance in women only (P = 0.01 for the interaction between age and MAP). Higher MAP significantly boosted the age-related increase in AP (p = 0.01 in men and 0.049 in women for the interaction between age and MAP). The strength of the correlation between MAP and central PP increased with age more steeply in women than in men (see the table). Multiple regression analyses including the agexMAP interaction term confirmed the interaction between age and MAP on central PP in both sexes. In conclusion, the association between distending pressure and PP increases in strength from early adulthood to midlife. Women are more vulnerable to the effect of MAP on central pulsatility.

JOURNAL/jhype/04.03/00004872-202301001-01311/figure1/v/2023-10-24T163949Z/r/image-jpeg
PS-P16-3: DIFFERENTIAL RISK FACTORS FOR WORSENING RENAL FUNCTION AND FOR PROGRESSION OF PROTEINURIA-DATA FROM SPECIFIC HEALTH SURVEYS OF TOYOOKA CITY
Authors: Kishimoto Ichiro
Published: January 2023

Objective:

To assess the difference between risk factors associated with a decline in renal function without a progression of proteinuria and those associated with a progression of proteinuria without a decline in renal function.

Design and method:

Retrospective longitudinal data from 2014–2017 specific health surveys among participants of National Health Insurance in Toyooka City were analyzed (n = 5,169 at baseline). Associations of risk factors at baseline and a ≧ 1.2-fold increase in creatinine or a progression of dip-stick proteinuria during follow-up were determined with a Cox proportional hazard analysis.

Results:

Multiple regression models revealed that a ≧ 1.2-fold increase in serum creatinine without a progression of proteinuria during 3-year follow-up was significantly associated with age, male gender (risk ratio (RR):2.2), proteinuria, and hypertension (RR:3.6), independently each other. After adjustments, qualitative tests for proteinuria revealed that, compared to (negative), (2 +) and (3 +) were associated with 7.7- (95% confidence interval (CI):1.2–25.8, p = 0.03) and 28- (95% CI:1.6–140, p = 0.03) fold increases in the risks for a worsening of renal function, respectively, while (±) or (1 +) did not show a significant difference. In addition, there was no significant association between a decline in renal function without a progression of proteinuria and body mass index (BMI), diabetes, or dyslipidemia. On the other hand, a progression of proteinuria to ≧ (1 +) without a decline in renal function was significantly associated with age, male gender (RR:1.8), higher BMI, hypertension (RR:1.6), dyslipidemia (RR:1.7) and diabetes (RR:1.7) at baseline after adjustments of baseline serum creatinine or proteinuria levels. Compared to the qualitative test proteinuria (negative), (±) and (1 +) were significantly associated with 4.3- (95% CI: 2.8–6.5, p < 0.0001) and 5.3- (95% CI: 2.8–9.4, p < 0.0001) fold increases in the risks for the further progression of proteinuria, respectively.

Conclusions:

Community data from specific health surveys among participants of National Health Insurance revealed differential risk factors associated with a worsening of chronic kidney diseases with respect to renal function and to proteinuria. Hypertension is one of the major risks for a decline in renal function, while a constellation of multiple risk factors was associated with a progression of proteinuria. In the present study, compared to (negative), even (±) of the qualitative test for proteinuria is associated with the 3-year risks not for a decline in renal function but for a further progression of proteinuria, while proteinuria ≧ (2 +) is significantly associated with a worsening of renal function.
PS-R06-1: A CASE OF PATIENT WITH END-STAGE KIDNEY DISEASE INTRODUCED HEMODIALYSIS AFTER CEREBRAL HEMORRHAGE.
Authors: Aso Mitsuhiro , Yamaguchi Shintaro , Yasuda Itaru , Nishioka Ken , Kaneko Kenji , Kanda Takeshi , Itoh Hiroshi
Published: January 2023

A 46-year-old male had been treated for end-stage kidney disease due to diabetic nephropathy and adaptive FSGS, and underwent surgery of arteriovenous fistula 3 weeks before the admission. He was scheduled to be introduced hemodialysis, but was urgently hospitalized due to cerebral hemorrhage. The head CT scan showed a subcutaneous hematoma of about 45 ml in the left frontal lobe, and the patient had impaired consciousness and worsening respiratory status. There were no surgical indications for cerebral hemorrhage, we initiated blood pressure control with nicardipine. Hyperkalemia was also seen, but urgent dialysis was not necessary, and we planned to introduce dialysis the next day or later. The next day hemodialysis was introduced, but soon after hemodialysis completed, worsening of respiratory condition and dilated pupil were observed. The head CT scan showed worsening cerebral edema compared to pre-dialysis CT scan on the same day. Thereafter, respiratory and general condition did not improve, and he died 11 days after the admission.

It is recommended that dialysis should be avoided within 24 hours of the onset of cerebral hemorrhage because of the high risk of hematoma expansion. In addition, in the acute phase of cerebral hemorrhage, it is considered to choose a dialysis method that causes less intracranial pressure increase, such as peritoneal dialysis or continuous hemodiafiltration dialysis, if possible. Administration of hypertonic glycerol may also be helpful. When a patient with end-stage kidney disease is introduced hemodialysis soon after cerebral hemorrhage, control of blood and intracranial pressure should be cared.
PS-R07-7: USE OF GADOLINIUM CONTRAST MEDIUM ENABLES ADRENAL VEIN SAMPLING IN A FLORID PRIMARY ALDOSTERONISM PATIENT WITH IODINE ALLERGY
Authors: Nagai Satoshi , Yoshida Yuichi , Shibuta Kanako , Miyamoto Shotaro , Ozeki Yoshinori , Okamoto Mitsuhiro , Gotoh Koro , Masaki Takayuki , Shibata Hirotaka
Published: January 2023

Case:

A 35-year-old woman was allergic to iodine contrast medium and was diagnosed with primary aldosteronism (PA) based on functional confirmatory tests. She was suspected to have unilateral PA because of marked hypertension, spontaneous hypokalemia, high plasma aldosterone, reduced plasma renin activity, and a right hypodense adrenal tumor. She wanted to become pregnant and requested adrenalectomy instead of medical treatment with mineralocorticoid receptor antagonists. Localization of PA by adrenal vein sampling (AVS) was necessary, but angiography with iodine contrast medium was not possible because of her allergy. AVS was performed using gadolinium contrast agent (gadoterate meglumine) instead of iodine, in combination with computed tomography angiography (CTA) because the American College of Radiology manual does not recommend prior steroid administration for high-risk patients who have already exhibited adverse reactions to iodine contrast medium. In AVS, before and after adrenocorticotropic hormone (ACTH) loading, 12 blood samples were drawn from the right adrenal vein, left adrenal central vein, left adrenal common duct, left and right renal veins, and the lower inferior vena cava with only 5 mL of gadolinium medium. There were no complications during AVS. Examination revealed an elevated aldosterone/cortisol ratio on the right side, lateralized ratio of 7.4, and contralateral ratio of 0.76; the patient was diagnosed with right unilateral PA. She underwent right adrenalectomy and showed improvements in aldosterone level from 312.4 pg/mL to 83.0 pg/mL, potassium from 3.0 mEq/L to 3.9 mEq/L, and systolic blood pressure from 138 mmHg to 117 mmHg. She is currently off her medications.

Conclusion:

In PA patients with iodine allergy, AVS can be performed safely and precisely using gadolinium contrast combined with CTA.
PS-R07-9: A CASE OF ADRENAL VEIN SAMPLING IN PRIMARY ALDOSTERONISM WITH DISCREPANT RESULTS OF ALDOSTERONE-OVERSECRETION-LATERALITY UNDER BASAL CONDITIONS AND COSYNTROPIN STIMULATION
Authors: Nozato Yoichi , Akasaka Hiroshi , Takami Yoichi , Yamamoto Koichi , Rakugi Hiromi
Published: January 2023

Background:

Adrenal venous sampling (AVS) is regarded as the gold standard for diagnosis of primary aldosteronism (PA) subtypes before surgery. Cosyntropin stimulation during AVS improves the success rate of bilaterally selective catheterization and outcome prediction for PA. However, in some cases cosyntropin stimulation may obscure the judgement of laterality of aldosterone oversecretion.

Case presentation:

A 66-year-old Japanese man was referred to our hospital for evaluation and management of hypertension and hypokalemia. His home blood pressure was 160/80 mmHg and poorly controlled with a calcium channel blocker, and a serum potassium level was 3.3 mEq/L under oral potassium administration. Plasma aldosterone concentration (PAC) was 249 pg/mL. Abdominal computed tomography scan revealed a 7 mm nodule on the left adrenal gland. Both captopril challenge test and saline infusion test revealed positive test results, which confirmed a diagnosis of PA. The AVS was performed both under basal conditions and during cosyntropin stimulation, which revealed discrepant results of laterality (Table 1). Since the absolute value of aldosterone secretion was significantly higher on the right adrenal gland, suggesting autonomous secretion from the right, AVS was performed again. The second procedure showed unilaterality in the right under basal AVS and bilaterality during cosyntropin stimulation (Table 2). Similarly, aldosterone levels were clearly higher on the right side, leading to the diagnosis of microadenoma of the right adrenal gland, and a laparoscopic right adrenalectomy was performed. Histopathology of the removed right adrenal gland revealed a diagnosis of a 2 mm adenoma. After adrenalectomy, his blood pressure control and hypokalemia improved.

Conclusions:

Cosyntropin stimulation during AVS is believed to increase the local diagnostic value of aldosterone oversecretion, but in rare cases, as in this case, basal and cosyntropin-stimulated AVS results yielded contrary findings. Cosyntropin-stimulated AVS should be interpreted with caution.
Anatomic Basis of Ankle Instability
Authors: Vega Jordi , Dalmau-Pastor Miki
Published: January 2023

The surgeon must have a thorough understanding of ankle ligamentous anatomy in order to grasp new concepts including ankle microinstability and rotational instability. The anterior talofibular ligament (ATFL) has 2 fascicles, a superior fascicle which is intra-articular and an inferior fascicle which is extra-articular. Located within the ankle joint but extrasonovial, the superior fascicle of the ATFL lacks the capacity to heal after a moderate ankle sprain. Because this fascicle controls talar internal rotation, any deficiency may lead to ankle microinstability, which in turn may lead to chronic overloading of the deltoid ligament’s most anterior fascicles and chronic rotational instability. The ATFL inferior fascicle, the calcaneofibular ligament and their connecting fibers form the lateral fibulotalocalcaneal ligament complex. An injury of the lateral fibulotalocalcaneal ligament complex will lead to classic chronic ankle instability. These new findings on the ankle ligaments have major implications for ankle instability.

Level of Evidence: Diagnostic Level V — expert opinion. See Instructions for Authors for a complete description of levels of evidence.
Analysis of 5-year Mortality following Lower Extremity Amputation due to Vascular Disease
Authors: Beeson Summer A. , Neubauer Daniel , Calvo Richard , Sise Michael , Martin Matthew , Kauvar David S. , Reid Chris M.
Published: January 2023

Background:

Mortality rates following major lower extremity amputations (LEAs) 30 days–365 days postoperative have decreased, but 5-year rates remain high at 40.4%–70%. These data may not reflect recent advances in peripheral arterial disease (PAD) care, and comorbidities of chronic PAD may lead to mortality more frequently than the amputation itself. Mortality rates between diabetic and nondiabetic patients were also analyzed.

Methods:

The California Office of Statewide Health Planning and Development hospital database was queried for patients admitted January 1, 2007–December 31, 2018. ICD-9-CM codes identified patients with vascular disease and an amputation procedure.

Results:

There were 26,669 patients. The 30-day, 90-day, 1-year, and 5-year major LEA mortality rates were 4.82%, 8.62%, 12.47%, and 18.11%, respectively. Weighted averages of 30-day, 90-day, 1-year, and 5-year major LEA mortality rates in the literature are 13%, 15.40%, 47.93%, and 60.60%, respectively. Mortality risk associated with vascular disease after amputation (hazard ratio = 22.07) was 11 times greater than risk associated with amputation-specific complications from impaired mobility (hazard ratio = 1.90; P < 0.01). Having diabetes was associated with lower mortality at 30 days, 90 days, and 1 year (P < 0.01) but not at 5 years (P = 0.22).

Conclusions:

This study suggests that people may be living longer after their major LEA than was previously thought. This study suggests that patients’ PAD may play a bigger role in contributing to their mortality than complications from loss of mobility postamputation. Although having diabetes was associated with lower postamputation mortality, the difference was no longer significant by 5 years.
Diabetes and cirrhosis: Current concepts on diagnosis and management
Authors: Castera Laurent , Cusi Kenneth
Published: January 2023

Type 2 diabetes mellitus is often associated with cirrhosis as comorbidities, acute illness, medications, and other conditions profoundly alter glucose metabolism. Both conditions are closely related in NAFLD, the leading cause of chronic liver disease, and given its rising burden worldwide, management of type 2 diabetes mellitus in cirrhosis will be an increasingly common dilemma. Having diabetes increases cirrhosis-related complications, including HCC as well as overall mortality. In the absence of effective treatments for cirrhosis, patients with type 2 diabetes mellitus should be systematically screened as early as possible for NAFLD-related fibrosis/cirrhosis using noninvasive tools, starting with a FIB-4 index followed by transient elastography, if available. In people with cirrhosis, an early diagnosis of diabetes is critical for an optimal management strategy (ie, nutritional goals, and glycemic targets). Diagnosis of diabetes may be missed if based on A1C in patients with cirrhosis and impaired liver function (Child-Pugh B–C) as anemia may turn the test unreliable. Clinicians must also become aware of their high risk of hypoglycemia, especially in decompensated cirrhosis where insulin is the only therapy. Care should be within multidisciplinary teams (nutritionists, obesity management teams, endocrinologists, hepatologists, and others) and take advantage of novel glucose-monitoring devices. Clinicians should become familiar with the safety and efficacy of diabetes medications for patients with advanced fibrosis and compensated cirrhosis. Management is conditioned by whether the patient has either compensated or decompensated cirrhosis. This review gives an update on the complex relationship between cirrhosis and type 2 diabetes mellitus, with a focus on its diagnosis and treatment, and highlights knowledge gaps and future directions.
Telehealth interventions in patients with chronic liver diseases: A systematic review
Authors: Muftah Abdullah A. , Banala Chaitra , Raasikh Taaj , Jamali Taher , Bustamante Gabriel , Cholankeril George , Kanwal Fasiha , Flores Avegail , Hernaez Ruben
Published: January 2023

Background and Aim:

Telehealth interventions may improve access to care, disease-specific, and quality outcomes in chronic liver diseases (CLDs). We aimed to systematically evaluate outcomes of telehealth interventions in CLDs.

Materials and Methods:

We used key terms and searched PubMed/EMBASE from inception to January 10, 2022. Two authors independently screened abstracts. Disagreements were resolved by a third reviewer. We included any type of CLD, including posttransplant patients, and extracted outcomes as defined by authors for each etiology of CLD (sustained virological response in HCV or weight loss in NAFLD). Meta-analysis was not performed because of the heterogeneity of data. Quality assessment was performed using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk of Bias tool for clinical trials.

Results:

Of 4250 studies screened, 43 met the inclusion criteria. Of these, 28 reported HCV treatment outcomes. All studies showed no statistically significant differences between sustained virological response rates in TH groups compared with control groups or historic cohorts. Eight studies evaluating liver transplant-related processes and outcomes demonstrated improved rates of transplant evaluation and referrals and decreased short-term readmission rates. Three randomized controlled trials and 1 observational study on NAFLD showed improved weight loss outcomes. One retrospective study showed reduced mortality risk in CLD patients with at least 1 TH encounter.

Conclusions:

TH interventions in patients with CLDs consistently show equivalent or improved clinical outcomes compared with traditional encounters. TH in CLDs can bridge the gap in access while maintaining the quality of care for underserved populations.
SERPINA12 promotes the tumorigenic capacity of HCC stem cells through hyperactivation of AKT/β-catenin signaling
Authors: Yu Huajian , Zhou Lei , Loong Jane H.C. , Lam Ka-Hei , Wong Tin-Lok , Ng Kai-Yu , Tong Man , Ma Victor W.S. , Wang Yanyan , Zhang Xiang , Lee Terence K. , Yun Jing-Ping , Yu Jun , Ma Stephanie
Published: January 2023

Background and Aims:

HCC is an aggressive disease with poor clinical outcome. Understanding the mechanisms that drive cancer stemness, which we now know is the root cause of therapy failure and tumor recurrence, is fundamental for designing improved therapeutic strategies. This study aims to identify molecular players specific to CD133+ HCC to better design drugs that can precisely interfere with cancer stem cells but not normal stem cell function.

Approach and Results:

Transcriptome profiling comparison of epithelial-specific “normal” CD133+ cells isolated from fetal and regenerating liver against “HCC” CD133+ cells isolated from proto-oncogene-driven and inflammation-associated HCC revealed preferential overexpression of SERPINA12 in HCC but not fetal and regenerating liver CD133+ cells. SERPINA12 upregulation in HCC is tightly associated with aggressive clinical and stemness features, including survival, tumor stage, cirrhosis, and stemness signatures. Enrichment of SERPINA12 in HCC is mediated by promoter binding of the well-recognized β-catenin effector TCF7L2 to drive SERPINA12 transcriptional activity. Functional characterization identified a unique and novel role of endogenous SERPINA12 in promoting self-renewal, therapy resistance, and metastatic abilities. Mechanistically, SERPINA12 functioned through binding to GRP78, resulting in a hyperactivated AKT/GSK3β/β-catenin signaling cascade, forming a positive feed-forward loop. Intravenous administration of rAAV8-shSERPINA12 sensitized HCC cells to sorafenib and impeded the cancer stem cell subset in an immunocompetent HCC mouse model.

Conclusions:

Collectively, our findings revealed that SERPINA12 is preferentially overexpressed in epithelial HCC CD133+ cells and is a key contributor to HCC initiation and progression by driving an AKT/β-catenin feed-forward loop.
Menstrual Status and Pregnancy in Former Elite Long-Distance Runners With Menstrual Disorders
Authors: Fujita Yuki , Sasaki Eiji , Yoneda Katsuro , Kinugasa Shoko , Oishi Maika , Tsuda Eiichi , Ishibashi Yasuyuki , Umeda Takashi
Published: January 2023

Objective:

To estimate the ratio of menstrual abnormalities, infertility, and other problems related to pregnancy and childbirth in former long-distance runners. We hypothesized that the female athlete triad during an athletic career affects future fertility and childbearing in former athletes.

Design:

Cross-sectional study.

Setting:

Participants of the All Japan University Women's Ekiden.

Participants:

Female former athletes who competed at national level were asked to complete the questionnaire; 137 valid responses were obtained.

Independent Variables:

Age at menarche and at the onset of pregnancy, history of amenorrhea and gynecological disorders, and lowest body mass index (BMI) during their athletic career.

Main Outcome Measures:

Menstrual status, history of pregnancy and childbirth, any related infertility treatment and problems, and history of stress fractures.

Results:

The mean age at menarche was 13.3 ± 2.2 (range, 10-25) years. Five athletes (3.6%) had primary amenorrhea. Eleven of the 137 participants (8.0%) required treatment for infertility. Sixty participants had 121 pregnancies, of which 5 were yet to deliver during the survey. Fifteen of 116 pregnancies (12.9%) ended in miscarriage, induced abortion, or stillbirth. Logistic regression analysis showed that the factors related to “infertility treatment” were age at the onset of pregnancy (P = 0.047) and higher BMI during their athletic career (P = 0.032; odds ratio, 2.19).

Conclusions:

The main factor influencing infertility was an older age at the time of pregnancy, similar to that observed in the general population. Amenorrhea or being underweight during their athletic career was not associated with problems related to conception and childbirth.
The use of the time-to-event index (Tevent) to compare the negative impact of COVID-19 on public health among continents/regions in 2020 and 2021: An observational study
Authors: Chuang Hua-Ying , Wu Hing-Man , Chien Tsair-Wei , Chou Willy , Chen Szu-Hau
Published: January 2023

Background:

During the COVID-19 pandemic, how to measure the negative impact caused by COVID-19 on public health (ImpactCOV) is an important issue. However, few studies have applied the bibliometric index, taking both infected days (quantity) and impact (damage) into account for evaluating ImpactCOV thus far. This study aims to verify the proposed the time-to-event index (Tevent) that is viable and applicable in comparison with 11 other indicators, apply the Tevent to compare the ImpactCOVs among groups in continents/countries in 2020 and 2021, and develop an online algorithm to compute the Tevent-index and draw the survival analysis.

Methods:

We downloaded COVID-19 outbreak data of daily confirmed cases (DCCs) for all countries/regions. The Tevent-index was computed for each country and region. The impactCOVs among continents/countries were compared using the Tevemt indices for groups in 2020 and 2021. Three visualizations (i.e., choropleth maps, forest plot, and time-to-event, a.k.a. survival analysis) were performed. Online algorithms of Tevent as a composite score to denote the ImpactCOV and comparisons of Tevents for groups on Google Maps were programmed.

Results:

We observed that the top 3 countries affected by COVID-19 in 2020 and 2021 were (India, Brazil, Russia) and (Brazil, India, and the UK), respectively; statistically significant differences in ImpactCOV were found among continents; and an online time-event analysis showed Hubei Province (China) with a Tevent of 100.88 and 6.93, respectively, in 2020 and 2021.

Conclusion:

The Tevent-index is viable and applicable to evaluate ImpactCOV. The time-to-event analysis as a branch of statistics for analyzing the expected duration of time until 1 event occurs is recommended to compare the difference in Tevent between groups in future research, not merely limited to ImpactCOV.
Modelling factors associated with therapeutic inertia in hypertensive patients: Analysis using repeated data from a hospital registry in West Africa
Authors: Barro Mahamadou , Yaméogo Aristide Relwendé , Mba Robert Darlin , Kaboré Rémi , Mandi Germain , Dahourou Désiré Lucien , Zabsonré Patrice , Méda Nicolas , Goungounga Juste
Published: January 2023

The proportion of poorly controlled hypertensives still remains high in the general African population. This is largely due to therapeutic inertia (TI), defined as the failure to intensify or modify treatment in a patient with poorly controlled blood pressure (BP). The objective of this study was to identify the determinants of TI. We conducted a retrospective cohort study from March 2012 to February 2014 of hypertensive patients followed during 4 medical visits. The TI score was the number of visits with TI divided by the number of visits where a therapeutic change was indicated. A random-effects logistic model was used to identify the determinants of TI. A total of 200 subjects were included, with a mean age of 57.98 years and 67% men. The TI score was measured at 85.57% (confidence interval [CI] 95% = [82.41–88.92]). Measured individual heterogeneity was significantly significant (0.78). Three factors were associated with treatment inertia, namely the number of antihypertensive drugs (odd ratios [OR] = 1.27; CI = [1.02–1.58]), the time between consultations (OR = 0.94; CI = [0.91–0.97]), and treatment noncompliance (OR = 15.18; CI = [3.13–73.70]). The random-effects model performed better in predicting high-risk patients with TI than the classical logistic model (P value < .001). Our study showed a high TI score in patients followed in cardiology in Burkina Faso. Reduction of the TI score through targeted interventions is necessary to better control hypertension in our cohort patients.
Efficacy and toxicity of three concurrent chemoradiotherapy regimens in treating nasopharyngeal carcinoma: Comparison among cisplatin, nedaplatin, and lobaplatin
Authors: Liang Xuexia , Liu Qiaodan , Yao Wei , Yang Shuai
Published: January 2023

Few studies directly compare efficacy and toxicity among lobaplatin, nedaplatin and cisplatin concurrently with intensity-modulated radiotherapy (IMRT) in nasopharyngeal carcinoma (NPC). Totally 141 treatment-naïve NPC without distant metastasis receiving IMRT concurrent with cisplatin or nedaplatin or lobaplatin were retrospectively enrolled. Their response rate, toxicity and long-term survival were compared. Complete response (CR) rates of concurrent lobaplatin (CR-nasopharynx [CR-nx], 82.7%; CR-cervical lymph node [CR-nd], 94.2%) were lower than those of cisplatin (CR-nx, 89.3%; CR-nd, 98.2%) and nedaplatin (CR-nx, 93.9%; CR-nd, 97.0%), but statistical significance wasn’t detected. Estimated five-year overall survival (OS), local relapse-free survival (LRFS), distant metastasis-free survival (DMFS) and progression-free survival (PFS) weren’t statistically significant between three groups. Multivariable analysis by COX proportional hazards model showed concurrent chemotherapy regimen wasn’t an independent prognostic factor. Gastrointestinal toxicity was prevalent in platinum-based concurrent chemotherapy; cisplatin group suffered heavier (≥grade 2) than other two groups. More nephrotoxicity happened in cisplatin group (17.9%) than nedaplatin (9.1%) and lobaplatin (2.0%) groups. Incidence of dermatitis of ≥grade 2 was higher in cisplatin group (60.7%) than nedaplatin (27.3%) and lobaplatin (9.6%) groups. More patients in lobaplatin and nedaplatin groups suffered from any grade thrombocytopenia (P < .001), but incidence of severe thrombocytopenia (≥grade 3) was similar. Economic cost was significant less in lobaplatin group. Cisplatin, nedaplatin and lobaplatin are equally effective when used concurrently with IMRT in NPC. Lobaplatin and nedaplatin have potential to be alternatives to cisplatin in terms of less severe acute side-effects and economic cost.
Detection value of FOXO1 gene methylation, blood glucose and lipids in patients with type 2 diabetic kidney disease
Authors: Li Xiaofeng , Liao Jing , Guo Zhongqiu
Published: January 2023

Forkhead transcription factor O1 (FOXO1) methylation is associated with inflammation. Diabetic kidney disease (DKD) is characterized with increased inflammatory markers such as uric acid, hemogram indices, C-reactive protein derived markers, omentin and neuregulin. This study aimed to investigate the effect of DNA methylation in FOXO1 gene promoter, blood glucose and lipids in the process of type 2 DKD. Bisulfite genomic sequencing was used to monitor DNA methylation in the promoter region (+1021, +1193) of FOXO1 gene. The detections were taken in glycosylated hemoglobin A1c, fasting plasma glucose and blood lipid. 81 participants were divided into the control group, the preliminary diabetes mellitus group, the pure diabetes mellitus group, and the DKD group. The other groups displayed higher fasting plasma glucose than the control group (all P value < .05). The fasting plasma glucose level was higher in the pure diabetes mellitus group than the preliminary diabetes mellitus group (P = .004). The levels of HbA1c were higher in other groups than control group and preliminary diabetes mellitus groups (all P values < .01). The high-density lipoprotein level was lower in the DKD group (P = .021, P = .022) than control and pure diabetes mellitus group. The levels of low-density lipoprotein were statistically lower in preliminary diabetes mellitus and DKD groups than control group (all P value < .02). Along with the progress of DKD, a down trend was observed in the total methylation rate of FOXO1 gene (P = .025), which contains 5 CpG sites (1021, +1193) in the promoter. Hypomethylation in the promoter of FOXO1 gene, hyperglycemia and low level of serum lipid might be associated with the pathogenesis of type 2 DKD.
Single leg drop jump performance identifies functional deficit in collegiate athletes who have returned to sports after ACL reconstruction: A case–control study
Authors: Lem Han Wei , Cheng Shih-Chung , Chang Hsiao-Yun , Hung Min-Hao , Yeh Wen-Ling
Published: January 2023

Despite its apparent functional importance, there is a general lack of data in explosive strength in individuals recovering from an anterior cruciate ligament reconstruction (ACLR). Hence, we wonder if single leg drop jump (SLDJ) can be an effective testing since drop jump is a commonly used testing which rely on adequate development of explosive strength and stretch shortening cycle function. The purpose of this study was to determine if SLDJ test can identify functional deficit in collegiate athletes who have returned to sports (RTS) after ACLR when comparing it with the common return to sport testing. Nine collegiate athletes who had undergone a unilateral ACLR and returned to their primary sport with at least 10 months post-surgery were recruited and assigned into the injured group and compared with 9 matched non-injured athletes as the control group. Both groups underwent an identical battery testing in 1 session with the sequence of first modified star excursion balance test (SEBT), second single hop and bound test, third SLDJ and lastly 1 repetition maximum (1RM) single leg press. A 2-way mixed model analysis of variance showed that there is no significant interaction effect on common RTS testing which include modified SEBT, single hop and bound tests, and 1RM single leg press, but significant interaction effect on SLDJ jump height (P = .03), reactive strength index (P = .03) and mean propulsion force (P = .03). For the injured group, ACLR leg jump height (10.35 ± 2.71 cm) was significantly lower than non-ACLR leg (12.86 ± 3.51 cm) with a mean difference of 2.51 (95% confidence interval [CI]: 0.55‐4.47). ACLR leg reactive strength index (0.29 ± 0.10 m/s) was significantly < non-ACLR leg (0.39 ± 0.16 m/s) with a mean difference of 0.1 (95% CI: 0.03‐0.17) and ACLR leg mean propulsion force (1087.49 ± 287.26 N) was significantly < non-ACLR leg (1157.40 ± 299.80 N) with a mean difference of 69.91 (95% CI: 16.04 to 123.78). SLDJ was able to identify jump height, reactive strength and propulsion force deficit in the involved limb of collegiate athletes who have returned to sports after ACLR.
The hypodermic syringe performance based on the ISO 7886-1:2017: A narrative review
Authors: Krisdiyanto  , Bin Raja Ghazilla Raja Ariffin , Azuddin M. , Bin Ahmad Hairuddin Muhammad Khairi Faiz , Muflikhun Muhammad Akhsin , Risdiana Nurvita , Afifuddin Eki
Published: January 2023

A syringe is used to inject fluid or medicine into the patient’s soft tissue. The main components of the syringe were the needle, barrel, and plunger. The use of syringes in the medical world is relatively high, and especially since the COVID-19 pandemic, the use of hypodermic syringes increased sharply due to vaccination. The syringe used must be effective and of good quality, so the International Organization for Standardization (ISO) has published test procedures and minimum specifications for hypodermic syringes. The performance of the syringe can be observed from the dead space, force piston operation, water and air leakage, and fitting position of the plunger in the barrel. This review shows that most researchers use the weighing method to measure the dead space, although some use other methods. The researchers found that most of the products met the minimum specifications of the ISO, and that the dimensions and shape of the syringe affected the dead space. Researchers have not examined other performance measures recommended by the ISO. Researchers have focused more on force injection than force piston operation, leakage after injection or back spray than air and water leakage, and reduction the friction of the plunger without considering the fitting position of the plunger in the barrel.
Traditional Chinese exercise for non-valvular atrial fibrillation: A protocol for systematic review and meta-analysis
Authors: Wang Te , Jin Hongguang , Wang Yiqiang , Liu Meixi , Liu Huan , Zhu Xing , Guo Wenping , Fan Chunhui , Huang Yongsheng , Jiang Lihong
Published: January 2023

Introduction:

Traditional Chinese exercises have become an important part of cardiac rehabilitation. It can coordinate the essence, qi, and spirit of the human body, and has the functions of promoting joints, stretching muscles and bones, ventilating and blood circulation, so as to achieve the balance between hardness and softness, and between yin and yang. We hope that the research results based on systematic review and meta-analysis will provide a theoretical basis for the treatment of atrial fibrillation (AF) with traditional Chinese exercise.

Methods:

The systematic review will be performed according to the Cochrane Handbook for Systematic Reviews of Interventions. The protocol is being reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols Statement. An literature search strategy will be developed and adapted for 9 databases. Searches will be run from the database inception until the date of the search implementation and be updated before the review is completed. Meta analysis will be performed using Review Manager 5.3 and R packages.

Conclusion:

This protocol introduces a systematic review and meta-analysis of traditional Chinese exercises in the treatment of nonvalvular AF and will clarify the efficacy and safety of traditional Chinese exercises in the treatment of AF. This will further provide theoretical support for clinical treatment of AF.
Efficacy of recombinant human bone morphogenetic protein-2 for bone regeneration in alveolar defects: A protocol for systematic review and meta-analysis
Authors: Ma Xudong , Ju Xueqi , Shen Juehui , Zheng Lala
Published: January 2023

Background:

There is still a lack of credible evidence in the literature regarding the effectiveness of recombinant human bone morphogenetic protein 2 (rhBMP-2) in bone regeneration of alveolar bone defects. Therefore, the purpose of this study is to evaluate the efficacy and safety of rhBMP-2 in autogenous bone graft in bone regeneration of alveolar bone defects and to provide basis for clinical practice.

Methods:

As of March 2023, two independent investigators will identify target literature by searching seven major databases (EMBASE, Google Scholar, PubMed, Cochrane Library, Wan Fang, CNKI, and Web of Science). All clinical cohort studies evaluating the efficacy of rhBMP-2 will be included. The outcomes of the study include changes in the depth of the dental pocket at the involved site, increased clinical attachment levels, patient satisfaction, and adverse events. The Cochrane risk of bias tool will be independently used to evaluate the risk of bias of included randomized cohort studies by two reviewers. A modified version of the Downs and Black tool is adopted to evaluate the quality of nonrandomized cohort studies.

Results:

We hypothesized that rhBMP-2 plays an active role in bone regeneration in alveolar bone defects.

Conclusions:

It is worthy to critically review the evidence of the assessment of rhBMP-2 to inform clinical practice.
Crosstalk between YY1 and lncRNAs in cancer: A review
Authors: Wang Xiao-li , Li Jing , Cao Yan-hua
Published: January 2023

Transcription factor YY1 is an important regulator of many pathways in tumor cell growth, prognosis, epithelial-mesenchymal transition, invasion, and resistance to chemotherapy. These effects lead to upregulation of YY1 associated with poor outcomes in many tumors. Growing research evidence suggests that long non-coding RNAs (lncRNAs) play important roles in the regulatory network of YY1. YY1 can regulate lncRNA, and serve as the regulatory molecule of YY1, and lncRNA and YY1 even form a feedback loop. In this review, we summarize the relevant mechanisms of the interaction between YY1 and noncoding RNAs during tumor progression, which will provide a possible theoretical basis for the clinical treatment of tumors.
Acute hemicranial pain accompanied with a pearl and string type dissection of intracranial vertebral artery: Consideration for the time when to finish the medical observation
Authors: Jeon Yoo Sung , Cho Joon , Park Jeong-Jin , Roh Hong Gee , Chun Young Il
Published: January 2023

The International Classification of Headache Disorder (ICHD) clearly guides the suspicion of intracranial vertebral artery dissection (ICVAD) in headache patients, but guidelines on how observational or imaging studies should be performed to detect dangerous progression early are unclear. Fifty-six cases with pearl and string type intracranial vertebral artery dissection were divided into 3 groups: 39 in the headache group, 6 in the infarction group, and 11 in the hemorrhagic group. Clinical and angiographic data were analyzed and compared. Most headaches resolved within 2 weeks and did not exceed 8 weeks. Of the 33 patients (84.6%) who underwent continuous follow-up imaging, 18 (54.5%) returned to normal, but 3 (9%) had deteriorated. All the patients survived without subsequent bleeding or infarction. Image changes started before 3rd month and ended after 6 to 7 months. In acute ICVADs, image changes occur at the same time as the headache resolves and continue for several months after the headache has subsided. Since the dissection is likely to worsen even after the headache disappears, the image changes continue over several months, and prediction of rupture of unruptured ICVAD is unpredictable, it is desirable to conduct continuous imaging studies regularly after the initiation of dissection until stabilization is confirmed.