bluuebunny/crossref_metadata_2025 huggingface dataset:
Management of a complex transjugular intrahepatic portosystemic shunt dysfunction with endotipsitis through rotational thrombectomy
Authors: Vizzutti Francesco , Casamassima Emanuele , Falcone Gianmarco , Gabbani Giacomo , Rosi Martina , Adotti Valentina , Marra Fabio , Fanelli Fabrizio
Published: February 2024

Transjugular intrahepatic portosystemic shunting (TIPS) is an established strategy for the management of complications of portal hypertension. Endoprosthetic infection (“endotipsitis”) is a rare but serious and difficult-to-treat complication of TIPS placement. Here we report the occurrence of an infected thrombus complicating TIPS placement in a patient with extra-hepatic portal vein obstruction, recurrent variceal bleeding and portal biliopathy accompanied by recurrent cholangitis. Infected thrombotic material within TIPS could be removed only by employing rotational thrombectomy. This procedure revealed the presence of a biliary fistula which carried pathogens in the systemic circulation. The multiple episodes of sepsis did no longer recur following exclusion of the biliary fistula. This case highlights the possibility to use rotational thrombectomy for the management of complex cases of TIPS dysfunction.
4. ULTRASOUND STUDY OF TROCAR HERNIA IN POST-OPERATED PATIENTS OF BARIATRIC SURGERY: MEDIUM AND LONG-TERM FOLLOW-UP
Authors: López-Negrete Cueto E , Rodicio Miravalles J L , Suárez Sánchez A , Amoza Pais S , Moreno Gijón M , Noriega Menéndez P , Montes García A , Sanz Álvarez L
Published: February 2024

Introduction

Patients undergoing bariatric surgery have comorbidities and risk factors that increase the likelihood of incisional hernias. Bladeless trocars are safe and not very harmful, so we opted not to close them due to the difficulty they present in these patients.

Methods

Observational, descriptive, longitudinal, and retrospective study in patients who underwent bariatric surgery by laparoscopy with 12mm trocars without a blade or fascial closure between January 2015 and July 2016. Data on risk factors, pain scale, and ultrasound of ports by an expert radiologist in 2018 and 2022.

Results

A total of 45 patients, with a mean age of 49.9 years and an initial BMI of 45.5 kg/m², were included in the study. The majority (88.9%) underwent gastric bypass, while the rest underwent vertical gastrectomy. In 2018, 45 abdominal wall ultrasounds were conducted, revealing 7 trocar hernias out of 225 explored ports (3.1%). All hernias were located in the epigastric port and were asymptomatic. In 2022, 32 ultrasound scans were performed with findings of 7 hernias (4.4%), 3 new and 4 known, with 2 symptomatic patients at the site of the hernia with mild symptoms not consulted.

Conclusion

The incidence of trocar hernia in the medium and long term following bariatric surgery with 12mm ports, without blade or fascial closure, is notably low, with all cases located in the midline (p<0.00001). These findings lead us to question the necessity of closing transmuscular accesses and assess the closure or lateralization of the midline trocar.
9. OPEN ABDOMEN: ANALYSIS OF RESULTS AFTER 7 YEARS SINCE ITS PROTOCOLIZATION IN A THIRD-LEVEL HOSPITAL
Authors: García Alonso L , Rodicio Miravalles J L , López-Negrete Cueto E , Íbero Casadiego P , Del Val Ruiz P , Amoza Pais S , Moreno Gijón M , Sanz Álvarez L
Published: February 2024

Introduction

The open abdomen (OA) procedure is a useful resource in critical situations. Its use has increased significantly since the development of negative pressure therapy (NPT) and the implementation of specific protocols.

Methods

Retrospective descriptive study in a third level hospital between January 2015 and December 2022. All patients who required OA were included.

Results

92 patients (68 men, 24 women) underwent surgery, with a mean age of 65 years, 65.3% were ASA 3-4. Although there were multiple indications for open abdomen, more than 50% were due to intestinal ischemia or damage control surgery.

45 patients were closed without need of replacement, while in the remaining cases, the first replacement was conducted within 48-72 hours, requiring a mean of 3.5 changes. 14 patients died before the definitive closure.

Of the 78 patients who were closed, 24 patients died before discharge, there were 54 survivors.

The median follow-up time was 22 months. Among the 30 patients with primary fascial closure, 5 developed incisional hernias. In contrast, among the 43 patients treated with prophylactic mesh, there were no instances of eventrations, although one case of chronic rejection and one of enterocutaneous fistula were reported. 9 patients died during follow-up.

Conclusion

Although OA is a useful resource, it must not be forgotten that it is used in complex patients with high morbidity and mortality in the short and long term. These patients have multiple risk factors for the development of incisional hernias, justifying the use of prophylactic mesh.
18. RISK FACTORS FOR EVISCERATION IN PATIENTS UNDERGOING MIDLINE LAPAROTOMY AT A TERTIARY HOSPITAL
Authors: Nieto Martos M R , Bajawi Carretero M , Andrade Yagual A A , Oto González D , Fernández Cebrián J M
Published: February 2024

Introduction

Evisceration is a frequent complication in patients undergoing median laparotomy that results in a significant increase in morbidity and mortality, hospital stay and healthcare expenditure. Numerous risk factors associated with the appearance of this complication have been described without being able to determine the individual influence of each one of them. Our aim is to describe the most frequent risk factors in our sample.

Methods

We retrospectively collected all eviscerations registered in our center between January 1, 2010 and December 31, 2020 in patients undergoing median laparotomy. Seventy-five cases were recruited. Seventy-five controls undergoing median laparotomy in the same time period were collected and associated risk factors were analyzed.

Results

The risk factors that were statistically significant were male sex (protective factor with OR 6.4 CI95% 3.4-7.6), COPD (OR 5.6 CI95% 1.69-19.9), surgical wound infection (OR 3.49 CI95% 1.86-14.1), ileus (OR 14.7 CI95% 1.66-131.40) and anastomotic dehiscence (OR 7.58 CI95% 1.76-32.50). No statistically significant differences were found between the different types of sutures used for abdominal wall closure. 92% of the cases underwent surgical repair, 8% were managed conservatively. Postoperative mortality was 16%.

Conclusion

The occurrence of evisceration appears to be related to risk factors associated with the patients' pre-existing comorbidities and postoperative complications.
27. OBJECTIVE ANALYSIS OF ERGONOMICS IN ROBOTIC MICROSURGERY
Authors: Kappel M , Sánchez Margallo J A , Pérez Salazar M J , González Nuño F M , Pires Louça L C , Sánchez Margallo F M
Published: February 2024

Introduction

This study compares the surgeon's ergonomics during the performance of microsurgical procedures using a robotic platform and conventional techniques. The study evaluates the differences in the surgeons' muscle activity.

Methods

Four surgeons with expertise in microsurgery participated in this study. They performed various microsurgical and supermicrosurgical procedures, including vascular and lymphatic-venous anastomoses. The procedures were performed by both robotic and conventional techniques. Muscle activity of five muscle groups was recorded bilaterally using a wireless electromyography system. For analysis, derivation of the evolution of mean frequencies and amplitudes was calculated to quantify muscle fatigue.

Results

Less muscle activity was observed with the use of the robot for the upper trapezius. In contrast, the brachioradialis shows higher muscle activity in robotic surgery. The erector spinae, medial trapezius and abductor did not show significant differences in terms of median but in terms of distribution. As for muscle fatigue, it is less dispersed among subjects in robotic surgery and tends to be less accentuated than with the conventional surgical technique.

Conclusion

According to muscle activity indicators, ergonomics differs in conventional and robotic surgery depending on the muscle group. However, preliminary results show less muscle fatigue in robotic surgery.
Incident Proteinuria by HIV Serostatus Among Men With Pre­–Diabetes Mellitus: The Multicenter AIDS Cohort Study
Authors: Slama Laurence , Barrett Benjamin W , Abraham Alison G , Palella Frank J , Magnani Jared W , Viard Jean Paul , Lake Jordan E , Brown Todd T
Published: February 2024

Background

Pre–diabetes mellitus (DM) is associated with proteinuria, a risk factor for chronic kidney disease. While people with human immunodeficiency virus (HIV; PWH) have a higher risk of proteinuria than people without HIV (PWOH), it is unknown whether incident proteinuria differs by HIV serostatus among prediabetic persons.

Methods

The urine protein-to-creatinine ratio was measured at semiannual visits among men in the Multicenter AIDS Cohort Study since April 2006. Men with pre-DM on or after April 2006 and no prevalent proteinuria or use of antidiabetic medications were included. Pre-DM was defined as a fasting glucose level of 100–125 mg/dL confirmed within a year by a repeated fasting glucose or hemoglobin A1c measurement of 5.7%–6.4%. Incident proteinuria was defined as a urine protein-to-creatinine ratio (UPCR) >200 mg/g, confirmed within a year. We used Poisson regression models to determine whether incident proteinuria in participants with pre-DM differed by HIV serostatus and, among PWH, whether HIV-specific factors were related to incident proteinuria.

Results

Between 2006 and 2019, among 1276 men with pre-DM, proteinuria developed in 128 of 613 PWH (21%) and 50 of 663 PWOH (8%) over a median 10-year follow-up. After multivariable adjustment, the incidence of proteinuria in PWH with pre-DM was 3.3 times (95% confidence interval, 2.3–4.8 times) greater than in PWOH (P < .01). Among PWH, current CD4 cell count <50/µL (P < .01) and current use of protease inhibitors (P = .03) were associated with incident proteinuria, while lamivudine and integrase inhibitor use were associated with a lower risk.

Conclusions

Among men with pre-DM, the risk of incident proteinuria was 3 times higher in PWH. Strategies to preserve renal function are needed in this population.
Exposure to air pollution is associated with DNA methylation changes in sperm
Authors: Schrott Rose , Feinberg Jason I , Newschaffer Craig J , Hertz-Picciotto Irva , Croen Lisa A , Fallin M Daniele , Volk Heather E , Ladd-Acosta Christine , Feinberg Andrew P
Published: February 2024

Exposure to air pollutants has been associated with adverse health outcomes in adults and children who were prenatally exposed. In addition to reducing exposure to air pollutants, it is important to identify their biologic targets in order to mitigate the health consequences of exposure. One molecular change associated with prenatal exposure to air pollutants is DNA methylation (DNAm), which has been associated with changes in placenta and cord blood tissues at birth. However, little is known about how air pollution exposure impacts the sperm epigenome, which could provide important insights into the mechanism of transmission to offspring. In the present study, we explored whether exposure to particulate matter less than 2.5 microns in diameter, particulate matter less than 10 microns in diameter, nitrogen dioxide (NO2), or ozone (O3) was associated with DNAm in sperm contributed by participants in the Early Autism Risk Longitudinal Investigation prospective pregnancy cohort. Air pollution exposure measurements were calculated as the average exposure for each pollutant measured within 4 weeks prior to the date of sample collection. Using array-based genome-scale methylation analyses, we identified 80, 96, 35, and 67 differentially methylated regions (DMRs) significantly associated with particulate matter less than 2.5 microns in diameter, particulate matter less than 10 microns in diameter, NO2, and O3, respectively. While no DMRs were associated with exposure to all four pollutants, we found that genes overlapping exposure-related DMRs had a shared enrichment for gene ontology biological processes related to neurodevelopment. Together, these data provide compelling support for the hypothesis that paternal exposure to air pollution impacts DNAm in sperm, particularly in regions implicated in neurodevelopment.
Successful ablation of Purkinje ectopy–triggered ventricular fibrillation storm in a patient with orthotopic heart transplantation and severe SARS-CoV-2 pneumonia: a case report
Authors: Khalaph Moneeb , Costard-Jäckle Angelika , Braun Martin , El Hamriti Mustapha
Published: February 2024

Background

Catheter ablation is one of the most effective treatment options for patients with drug-refractory, scar-related monomorphic ventricular tachycardia (VT). In selected cases, catheter ablation also plays an important role in treatment of polymorphic VT (PMVT) and/or ventricular fibrillation (VF). Rarely, premature ventricular contractions (PVCs) originating from the Purkinje network can induce PMVT/VF. Ablation and elimination of these PVCs can prevent VF recurrences.

Case summary

A 41-year-old patient with a history of orthotopic heart transplantation (HTX) 8 years before admission and newly diagnosed SARS-CoV-2 pneumonia was referred to our centre after experiencing several episodes of drug-refractory VF. An electrophysiological study showed ectopy-triggered VF originating from the anterior and posterior fascicles of the left bundle branch (LBB). Ablation of these PVCs from the LBB led to complete elimination of VF. A subcutaneous implantable cardioverter defibrillator was implanted as secondary prophylaxis. During the observation period of 6 months, no VF recurrence was observed.

Conclusion

Identifying and eliminating the trigger (PVCs) can be life-saving and prevent VF in the specific cohort of HTX patients. High-density mapping using multipolar catheters with microelectrodes contributes significantly to our understanding of tachycardia mechanisms.
Tricuspid valve agenesis: a case report of a rare cause of tricuspid regurgitation in an adult
Authors: Raicea Victor C , Mirea Oana , Berceanu Mihaela C , Raicea Andrei D
Published: February 2024

Background

Tricuspid valve agenesis is an exceptionally rare congenital cardiac disease characterized by the incomplete formation or complete absence of one or more tricuspid leaflets. It is commonly diagnosed during childhood due to the development of heart failure symptoms.

Case summary

We report the case of a 62-year-old woman admitted for a worsening of heart failure symptoms (New York Heart Association functional Class IV at admission). A standard transthoracic echocardiogram was performed, which showed severe right heart dilatation and severe tricuspid regurgitation. A three-dimensional echocardiogram revealed the absence of the posterior tricuspid leaflet. The patient underwent an uncomplicated surgical bioprosthetic valve replacement with a favourable outcome and partial recovery of right ventricular function. In our patient, valve repair was not favoured due to the additional mild hypoplasia of the anterior leaflet. The 3-month post-operative evolution of the patient was favourable, with significant symptom relief.

Discussion

The diagnosis of tricuspid agenesis during adulthood is uniquely uncommon. A three-dimensional echocardiography can provide accurate pre-procedural insight into the valve anatomy, allowing surgeons to plan for either valve repair when the anatomy is suitable or valve replacement.
Cardiovascular magnetic resonance imaging-derived intraventricular pressure gradients in ST-segment elevation myocardial infarction: a long-term follow-up study
Authors: Konijnenberg Lara S F , Beijnink Casper W H , van Lieshout Maarten , Vos Jacqueline L , Rodwell Laura , Bodi Vicente , Ortiz-Pérez José T , van Royen Niels , Rodriguez Palomares José , Nijveldt Robin
Published: February 2024

Aims

Recently, novel post-processing tools have become available that measure intraventricular pressure gradients (IVPGs) on routinely obtained long-axis cine cardiac magnetic resonance (CMR) images. IVPGs provide a comprehensive overview of both systolic and diastolic left ventricular (LV) functions. Whether IVPGs are associated with clinical outcome after ST-elevation myocardial infarction (STEMI) is currently unknown. Here, we investigated the association between CMR-derived LV-IVPGs and major adverse cardiovascular events (MACE) in a large reperfused STEMI cohort with long-term outcome.

Methods and results

In this prospectively enrolled multi-centre cohort study, 307 patients underwent CMR within 14 days after the first STEMI. LV-IVPGs (from apex-to-base) were estimated on the long-axis cine images. During a median follow-up of 9.7 (5.9–12.5) years, MACE (i.e. composite of cardiovascular death and de novo heart failure hospitalisation) occurred in 49 patients (16.0%). These patients had larger infarcts, more often microvascular injury, and impaired LV-IVPGs. In univariable Cox regression, overall LV-IVPG was significantly associated with MACE and remained significantly associated after adjustment for common clinical risk factors (hazard ratio (HR) 0.873, 95% confidence interval (CI) 0.794–0.961, P = 0.005) and myocardial injury parameters (HR 0.906, 95% CI 0.825–0.995, P = 0.038). However, adjusted for LV ejection fraction and LV global longitudinal strain (GLS), overall LV-IVPG does not provide additional prognostic information (HR 0.959, 95% CI 0.866–1.063, P = 0.426).

Conclusion

Early after STEMI, CMR-derived LV-IVPGs are univariably associated with MACE and this association remains significant after adjustment for common clinical risk factors and measures of infarct severity. However, LV-IVPGs do not add prognostic value to LV ejection fraction and LV GLS.
Training simulator efficacy in developing thoracic and general surgical skills in a residency programme: a pilot study
Authors: Grossi Sarah , Cattoni Maria , Filipponi Luca , Marzorati Alessandro , Rotolo Nicola , Carcano Giulio , Imperatori Andrea
Published: February 2024

OBJECTIVES

Virtual training simulators have been introduced in several surgical disciplines to improve residents’ abilities. Through the use of the LapSim® virtual training simulator (Surgical Science, Göteborg, Sweden), this study aims to plan an effective learning path in minimally invasive thoracic and general surgery.

METHODS

All thoracic and general surgery trainees in their 1st and 2nd year of residency at the University of Insubria were enrolled and randomized into 2 groups: residents undergoing an intensive twice-a-week virtual training programme (group A: n = 8) and those undergoing a once-weekly non-intensive virtual training programme (group B: n = 9). The virtual training programme was divided into 4 modules, each of 12 weeks. In the 1st module, trainees repeated grasping, cutting, clip application, lifting and grasping, and fine dissection exercises during each training session. Seal-and-cut exercise was performed as the initial and final test. Data on surgical manoeuvres (time and on mistakes) were collected; intra- and inter-group comparisons were planned.

RESULTS

No significant differences were observed between groups A and B at the 1st session, confirming that the 2 groups had similar skills at the beginning. After 12 weeks, both groups showed improvements, but comparing data between initial and final test, only Group A registered a significant reduction in total time (P-value = 0.0015), left (P-value = 0.0017) and right (P-value = 0.0186) instrument path lengths, and in left (P-value = 0.0010) and right (P-value = 0.0073) instrument angular path lengths, demonstrating that group A acquired greater precision in surgical manoeuvres.

CONCLUSIONS

Virtual simulator training programme performed at least twice a week was effective for implementing basic surgical skills required for the trainee’s professional growth. Additional virtual training modules focused on more complex exercises are planned to confirm these preliminary results.
Impact of bacterial and fungal inoculants on the resident rhizosphere microbiome and the volatilome of tomato plants under leaf herbivory stress
Authors: Lee Díaz Ana Shein , Minchev Zhivko , Raaijmakers Jos M , Pozo María José , Garbeva Paolina
Published: February 2024

Various studies have addressed the impact of microbial inoculants on the composition of the resident microbiome. How microbial inoculants impact plant metabolism and interact with the resident rhizobiota under herbivory stress remains elusive. Here, we investigated the impact of two bacterial and two fungal inoculants, inoculated as single species and as a synthetic community, on the rhizosphere microbiome and volatilome of tomato plants (Solanum lycopersicum) comparing nonstress conditions to exposed to leaf herbivory by Spodoptera exigua. Based on amplicon sequencing analysis, rhizobacterial community composition was significantly affected by all four inoculants and the magnitude of this effect was dependent on herbivory stress. Fungal community composition was altered by the microbial inoculants but independent of herbivory stress. The rhizosphere volatilome was impacted by the microbial inoculation and differences between treatments were evened under herbivory stress. Each microbial inoculant caused unique changes in the volatilome of stressed plants but also shared similar responses, in particular the enhanced production of dimethyl disulfide and benzothiazole. In conclusion, the introduction of microbial inoculants in the tomato rhizosphere caused unique as well as common changes in the rhizosphere microbiome and volatilome, but these changes were minor compared to the microbiome changes induced by herbivory stress.
Novel techniques for in situ estimation of shear-wave velocity and damping ratio through MASW testing part II: a Monte Carlo algorithm for the joint inversion of phase velocity and phase attenuation
Authors: Aimar Mauro , Foti Sebastiano , Cox Brady R
Published: February 2024

This paper deals with in situ characterization of the small-strain shear-wave velocity VS and damping ratio DS from an advanced interpretation of Multi-channel Analysis of Surface Waves (MASW) surveys. A new approach based on extracting Rayleigh wave data using the CFDBFa method has been discussed in the companion paper. This paper focuses on mapping the experimental Rayleigh wave phase velocity and attenuation into profiles of VS and DS versus depth, which is achieved through a joint inversion procedure. The joint inversion of phase velocity and attenuation data utilizes a newly developed Monte Carlo global search algorithm, which implements a smart sampling procedure. This scheme exploits the scaling properties of the solution of the Rayleigh eigenvalue problem to modify the trial earth models and improve the matching with the experimental data. Thus, a reliable result can be achieved with a limited number of trial ground models. The proposed algorithm is applied to the inversion of synthetic data and of experimental data collected at the Garner Valley Downhole Array site, as described in the companion paper. In general, inverted soil models exhibit well-defined VS profiles, whereas DS profiles are affected by larger uncertainties. Greater uncertainty in the inverted DS profiles is a direct result of higher variability in the experimental attenuation data, the limited wavelength range at which reliable values of attenuation parameters can be retrieved, and the sensitivity of attenuation data to both DS and VS. Nonetheless, the resulting inverted earth models agree well with alternative in situ estimates and geological data. The results stress the feasibility of retrieving both stiffness and attenuation parameters from active-source MASW testing and the effectiveness of extracting in situ damping ratio estimates from surface wave data.
Novel techniques for in situ estimation of shear-wave velocity and damping ratio through MASW testing – I: a beamforming procedure for extracting Rayleigh-wave phase velocity and phase attenuation
Authors: Aimar Mauro , Foti Sebastiano , Cox Brady R
Published: February 2024

A robust, in situ estimate of shear-wave velocity VS and the small-strain damping ratio DS (or equivalently, the quality factor QS) is crucial for the design of buildings and geotechnical systems subjected to vibrations or earthquake ground shaking. A promising technique for simultaneously obtaining both VS and DS relies on the Multichannel Analysis of Surface Waves (MASW) method. MASW can be used to extract the Rayleigh wave phase velocity and phase attenuation data from active-source seismic traces recorded along linear arrays. Then, these data can be inverted to obtain VS and DS profiles. This paper introduces two novel methodologies for extracting the phase velocity and attenuation data. These new approaches are based on an extension of the beamforming technique which can be combined with a modal filter to isolate different Rayleigh propagation modes. Thus, the techniques return reliable phase velocity and attenuation estimates even in the presence of a multimode wavefield, which is typical of complex stratigraphic conditions. The reliability and effectiveness of the proposed approaches are assessed on a suite of synthetic wavefields and on experimental data collected at the Garner Valley Downhole Array and Mirandola sites. The results reveal that, under proper modelling of wavefield conditions, accurate estimates of Rayleigh wave phase velocity and attenuation can be extracted from active-source MASW wavefields over a broad frequency range. Eventually, the estimation of soil mechanical parameters also requires a robust inversion procedure to map the experimental Rayleigh wave parameters into soil models describing VS and DS with depth. The simultaneous inversion of phase velocity and attenuation data is discussed in detail in the companion paper.
TCRosetta: An Integrated Analysis and Annotation Platform for T-cell Receptor Sequences
Authors: Yue Tao , Chen Si-Yi , Shen Wen-Kang , Zhang Zhan-Ye , Cheng Liming , Guo An-Yuan
Published: February 2024

T cells and T-cell receptors (TCRs) are essential components of the adaptive immune system. Characterization of the TCR repertoire offers a promising and highly informative source for understanding the functions of T cells in the immune response and immunotherapy. Although TCR repertoire studies have attracted much attention, there are few online servers available for TCR repertoire analysis, especially for TCR sequence annotation or advanced analyses. Therefore, we developed TCRosetta, a comprehensive online server that integrates analytical methods for TCR repertoire analysis and visualization. TCRosetta combines general feature analysis, large-scale sequence clustering, network construction, peptide–TCR binding prediction, generation probability calculation, and k-mer motif analysis for TCR sequences, making TCR data analysis as simple as possible. The TCRosetta server accepts multiple input data formats and can analyze ∼ 20,000 TCR sequences in less than 3 min. TCRosetta is the most comprehensive web server available for TCR repertoire analysis and is freely available at https://guolab.wchscu.cn/TCRosetta/.
The effect of gradually lifting the two-child policy on demographic changes in China
Authors: Lin Yidie , Zhang Baiyang , Hu Meijing , Yao Qiang , Jiang Min , Zhu Cairong
Published: February 2024

Low-fertility rate has been a common problem in many industrialized countries. To reverse the declining trend of new births, Chinese government gradually lifted its restrictions on the number of births per family, allowing for a household to have no more than two children. Little is known about the additional births or population increase contributed by the gradual relaxation of birth restrictions. To fill this gap, this quasi-experimental design study including data from 124 regions used the synthetic control method and controlled interrupted time series analysis to evaluate the differences in birth rates and rates of natural population increase between China and its synthetic control following implementation of the two-child policy from 2011 to 2020. A total of 123 regions were included in the control pool. Data collected during 1990–2010 were used to identify the synthetic China for each study outcome. The mean rate differences of birth rates and rates of natural increase between China and synthetic China after two-child policy implementation were 1.16 per 1000 population and 1.02 per 1000, respectively. These rate differences were distinguished from variation due to chance (one-sided pseudo-P-values: P for birth rates = 0.047, P for rates of natural increase = 0.020). However, there were statistically significant annual reductions in the pre–post trend of birth rates and rates of natural increase compared with those of controls of <0.340 per 1000 population per year [P = 0.007, 95% CI = (−0.584, −0.096)] and <0.274 per 1000 per year [P = 0.028, 95% CI = (−0.518, −0.031)]. The results suggested that lifting birth restrictions had a short-term effect on the increase in birth rates and rates of natural population increase. However, birth policy with lifting birth restrictions alone may not have sustained impact on population growth in the long run.
Plant-LncPipe: a computational pipeline providing significant improvement in plant lncRNA identification
Authors: Tian Xue-Chan , Chen Zhao-Yang , Nie Shuai , Shi Tian-Le , Yan Xue-Mei , Bao Yu-Tao , Li Zhi-Chao , Ma Hai-Yao , Jia Kai-Hua , Zhao Wei , Mao Jian-Feng
Published: February 2024

Long non-coding RNAs (lncRNAs) play essential roles in various biological processes, such as chromatin remodeling, post-transcriptional regulation, and epigenetic modifications. Despite their critical functions in regulating plant growth, root development, and seed dormancy, the identification of plant lncRNAs remains a challenge due to the scarcity of specific and extensively tested identification methods. Most mainstream machine learning-based methods used for plant lncRNA identification were initially developed using human or other animal datasets, and their accuracy and effectiveness in predicting plant lncRNAs have not been fully evaluated or exploited. To overcome this limitation, we retrained several models, including CPAT, PLEK, and LncFinder, using plant datasets and compared their performance with mainstream lncRNA prediction tools such as CPC2, CNCI, RNAplonc, and LncADeep. Retraining these models significantly improved their performance, and two of the retrained models, LncFinder-plant and CPAT-plant, alongside their ensemble, emerged as the most suitable tools for plant lncRNA identification. This underscores the importance of model retraining in tackling the challenges associated with plant lncRNA identification. Finally, we developed a pipeline (Plant-LncPipe) that incorporates an ensemble of the two best-performing models and covers the entire data analysis process, including reads mapping, transcript assembly, lncRNA identification, classification, and origin, for the efficient identification of lncRNAs in plants. The pipeline, Plant-LncPipe, is available at: https://github.com/xuechantian/Plant-LncRNA-pipline.
Impact of cryoablation on operative outcomes in thoracotomy patients
Authors: Pourak Kian , Kubiak Rachel , Arivoli Kumaran , Lagisetty Kiran , Lynch William , Lin Jules , Chang Andrew , Reddy Rishindra M
Published: February 2024

OBJECTIVES

Cryoablation is increasingly being utilized as an alternative to epidurals for patients undergoing thoracotomies. Current evidence suggests cryoablation may decrease postoperative analgesia utilization, but could increase operative times. We hypothesized that the adoption of intraoperative cryoablation to manage post-thoracotomy pain would result in reduced length of stay and reduced perioperative analgesia compared to routine epidural use.

METHODS

A retrospective analysis was performed from a single, quaternary referral centre, prospective database on patients receiving thoracotomies between January 2020 and March 2022. Patients undergoing transthoracic hiatal hernia repair, lung resection or double-lung transplant were divided between epidural and cryoablation cohorts. Primary outcomes were length of stay, intraoperative procedure time, crossover pain management and oral narcotic usage the day before discharge.

RESULTS

During the study period, 186 patients underwent a transthoracic hiatal hernia repair, lung resection or double-lung transplant with 94 receiving a preoperative epidural and 92 undergoing cryoablation. Subgroup analysis demonstrated no significant differences in demographics, operative length, length of stay or perioperative narcotic use. Notably, over a third of patients in each cryoablation subgroup received a postoperative epidural (45.5% transthoracic hiatal hernia repair, 38.5% lung resection and 45.0% double-lung transplant) for further pain management during their admission.

CONCLUSIONS

Cryoablation use was not associated with an increase in procedure time, a decrease in narcotic use or length of stay. Surprisingly, many cryoablation patients received epidurals in the postoperative period for further pain control. Additional analysis is needed to fully understand the benefits and costs of epidural versus cryoablation strategies.
Effects of sequential vs single pneumococcal vaccination on cardiovascular diseases among older adults: a population-based cohort study
Authors: Tong Xinning , Gao Le , Wong Ian C K , Chan Vivien K Y , Wong Angel Y S , Mak Judith C W , Yuen Jacqueline K Y , Jit Mark , Hung Ivan F N , Yiu Kai Hang , Li Xue
Published: February 2024

Background

Recommendations around the use of 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13) seldom focus on potential benefits of vaccine on comorbidities. We aimed to investigate whether sequential vaccination with PCV13 and PPSV23 among older adults would provide protection against cardiovascular diseases (CVD) compared with using a single pneumococcal vaccine.

Methods

We conducted a Hong Kong-wide retrospective cohort study between 2012 and 2020. Adults aged ≥65 years were identified as receiving either a single or sequential dual vaccination and followed up until the earliest CVD occurrence, death or study end. To minimize confounding, we matched each person receiving a single vaccination to a person receiving sequential vaccination according to their propensity scores. We estimated the hazard ratio (HR) of CVD risk using Cox regression and applied structural equation modelling to test whether the effect of sequential dual vaccination on CVD was mediated via the reduction in pneumonia.

Results

After matching, 69 390 people remained in each group and the median (interquartile range) follow-up time was 1.89 (1.55) years. Compared with those receiving a single vaccine, those receiving sequential dual vaccination had a lower risk of CVD [HR (95% CI): 0.75 (0.71, 0.80), P < 0.001]. Post-hoc mediation analysis showed strong evidence that the decreased CVD risk was mediated by the reduction in all-cause pneumonia.

Conclusions

Sequential dual pneumococcal vaccination was associated with lower risk of CVD compared with single-dose PCV13 or PPSV23 in older adults. Such additional CVD benefits should be considered when making decisions about pneumococcal vaccination.
New Window Into Hepatitis B in Africa: Liver Sampling Combined With Single-Cell Omics Enables Deep and Longitudinal Assessment of Intrahepatic Immunity in Zambia
Authors: Musonda Taonga , Wallace Michael S , Patel Hailey , Martin Owen P , Oetheimer Christopher , Mwakamui Simutanyi , Sinkala Edford , Nsokolo Bright , Kanunga Annie , Lauer Georg , Chung Raymond T , Wandeler Gilles , Bhattacharya Debika , Kelly Paul , Alatrakchi Nadia , Vinikoor Michael J
Published: February 2024

In Lusaka, Zambia, we introduced liver fine-needle aspiration biopsy (FNAB) into a research cohort of adults with treatment-naive chronic hepatitis B virus (HBV) infection, with and without human immunodeficiency virus (HIV) coinfection, as well as with acute HBV infection. From 117 enrollment and 47 longitudinal FNABs (at 1-year follow-up), we established participant acceptability and safety. We also demonstrated the quality of the material through single-cell RNA sequencing of selected enrollment FNAs, which revealed a range of immune cells. This approach can drive new insights into HBV immunology, informing cure strategies, and can improve our understanding of HBV natural history in Africa.
Effect of different strategies for excluding duplicate cultures on the correlation between hospital resistance rates and antibiotic consumption
Authors: Reyes Barros Tomás , Gutiérrez Torres Waldo , García Cañete Patricia , Cerda Lorca Jaime
Published: February 2024

Introduction

Studies may underestimate the impact of antibiotics on bacterial resistance when correlating hospital antibiotic use with resistance rates (RRs) that exclude duplicate cultures as duplicates usually include more resistant isolates. Comparing correlations between antibiotic consumption and RRs resulting from different strategies for excluding duplicates could help explore how their exclusion affects such correlations.

Methods

We obtained antibiotics consumption and Pseudomonas aeruginosa susceptibility data from 2017 to 2021 for seven antibiotics and for carbapenems as a group in a university hospital. We calculated RRs using seven different time criteria for excluding duplicates. We assessed the correlations of antibiotic consumption to the same-year and next-year RR rates for the three most distinct rates.

Results

Duplicate cultures represented 53.45% of total cultures. RRs were higher when duplicates were included. We compared RRs resulting from excluding all duplicates, excluding duplicates monthly or admitting one culture per day. All antibiotics except meropenem showed a correlation with same-year RRs, either positive or negative, whereas all antibiotics showed a positive correlation with next-year RRs. For same-year and next-year correlations, the criteria with fewer duplicates (and therefore fewer resistant strains) found more correlations. However, the inclusion of duplicates taken at least 1 month apart found the most correlations. Admitting one culture per day found the fewest correlations.

Conclusions

Excluding duplicates from RRs affects the correlation of antibiotics consumption with RRs in P. aeruginosa. Including at least some duplicate cultures in correlation analyses, such as those taken 1 month apart, should be considered.
Carriage of methicillin-resistant Staphylococcus aureus in children <6 years old: a retrospective follow-up study of the natural course and effectiveness of decolonization treatment
Authors: Helbo Thomas , Boel Jonas Bredtoft , Bartels Mette Damkjær , Ahlström Magnus Glindvad , Holzknecht Barbara Juliane , Eriksen Helle Brander
Published: February 2024

Background

Decolonization treatment of MRSA carriers is recommended in Denmark, except in households with MRSA-positive children <2 years old (wait-and-see approach).

Objectives

To investigate a wait-and-see approach in children 2–5 years old, and the effect of decolonization treatment of MRSA carriage in all children <6 years old.

Patients and methods

In this retrospective follow-up study, we included MRSA carriers <6 years old in the Capital Region of Denmark from 2007 to 2021. Data were collected from laboratory information systems and electronic patient records. We divided children into age groups of <2 years or 2–5 years and decolonization treatment versus no treatment. Treatment was chlorhexidine body washes and nasal mupirocin, sometimes supplemented with systemic antibiotics. Children were followed until becoming MRSA free, or censoring. The probability of becoming MRSA free was investigated with Cox regression (higher HRs indicate faster decolonization).

Results

Of 348 included children, 226 were <2 years old [56/226 (25%) received treatment] and 122 were 2–5 years old [90/122 (74%) received treatment]. Multivariable analyses did not show a larger effect of decolonization treatment versus no treatment in <2-year-olds (HR 0.92, 95% CI 0.52–1.65) or 2–5-year-olds (HR 0.54, 95% CI 0.26–1.12). Without treatment, 2–5-year-olds tended to clear MRSA faster than <2-year-olds (HR 1.81, 95% CI 0.98–3.37).

Conclusions

We did not find a larger effect of decolonization treatment versus no treatment in children <6 years old, and 2–5-year-olds tended to become MRSA free faster than <2-year-olds. These results support a wait-and-see approach for all children <6 years old, but further studies are needed.
Improving phage therapy by evasion of phage resistance mechanisms
Authors: Bleriot Inés , Pacios Olga , Blasco Lucia , Fernández-García Laura , López María , Ortiz-Cartagena Concha , Barrio-Pujante Antonio , García-Contreras Rodolfo , Pirnay Jean-Paul , Wood Thomas K , Tomás María
Published: February 2024

Antibiotic failure is one of the most worrisome threats to global health. Among the new therapeutic efforts that are being explored, the use of bacteriophages (viruses that kill bacteria), also known as ‘phages’, is being extensively studied as a strategy to target bacterial pathogens. However, one of the main drawbacks of phage therapy is the plethora of defence mechanisms that bacteria use to defend themselves against phages. This review aims to summarize the therapeutic approaches that are being evaluated to overcome the bacterial defence systems, including the most innovative therapeutic approaches applied: circumvention of phage receptor mutations; modification of prophages; targeting of CRISPR-Cas systems and the biofilm matrix; engineering of safer and more efficacious phages; and inhibition of the anti-persister strategies used by bacteria.
Neutrality, non-belligerency, and permanent neutrality according to recent practice and doctrinal views
Authors: Ronzitti Natalino
Published: February 2024

The conflict between the Russian Federation and Ukraine has again raised the problem of neutrality in the light of the massive shipment by Western States of military assets to Ukraine and the restrictive measures (sanctions) against the Russian Federation. The resolutions by the UN General Assembly and the qualification of the Russian Federation as an aggressor have induced to consider the relationship between neutrality and the UN Charter. This article examines the problem of neutrality according to recent practice and argues that neutrality is still alive, notwithstanding its transformation from its origin. The notion of non-belligerency is also in conformity with international law. Neutrality is no longer an institution of jus in bello but belongs to jus ad bellum and the principle of equality of belligerents should not be applied, except for those rules that have purely humanitarian nature. Permanent neutrality is still a valid institution as the practice shows. Lastly, this article deals with neutrality and non-international conflicts, concluding that the recognition of belligerency, that is the mechanism allowing the application of neutrality to this category of conflict, is almost obsolete.
A comprehensively prognostic and immunological analysis of PARP11 in pan-cancer
Authors: Wang Shengli , Zhang Mingyue , Li Tao , Chen Xinru , Wu Qinhan , Tian Dan , Granot Zvi , Xu Hongbiao , Hao Jianlei , Zhang Hongru
Published: February 2024

Poly (ADP-ribose) polymerase family member 11 (PARP11) has important immune regulatory functions in viral infection and tumor immune response. Particularly, PARP11 showed protumor activities in multiple preclinical murine models. However, no systematic pan-cancer analysis has been conducted to explore PARP11 function. In this study, we used multiple databases to assess PARP11 expression, which is associated with clinical outcomes, immune checkpoint factors, prognostic significance, genomic characteristics, and immunological aspects. The analysis revealed varying expression levels of PARP11 across different cancer types and a significant correlation between its expression and immune cell infiltration. Insights from the CellMiner database suggest a strong link between PARP11 expression and sensitivity to anticancer drugs, highlighting its potential as a therapeutic target. Moreover, PARP11 expression correlates with patient survival during anti-PD1 and anti-CTLA4 treatments, suggesting that PARP11 would be a predictor of immune checkpoint inhibitor treatment. In summary, PARP11 would be a potential immunoregulatory target and a diagnosis and prognosis marker for certain types of cancers. The detailed mechanisms of PARP11 in tumor immune responses need to be further investigated.
Geriatric assessment and quality of life for 2 years in older patients with head and neck cancer
Authors: Lafont Charlotte , Paillaud Elena , Bertolus Chloe , Baron Melany , Caillet Philippe , Bouvard Eric , Laurent Marie , Salvan Didier , Chaumette Laurence , de Decker Laure , Piot Benoit , Barry Beatrix , Raynaud-Simon Agathe , Sauvaget Elisabeth , Minard Aurélien , Anota Amélie , Panjo Henri , Brugel Lydia , Canouï-Poitrine Florence
Published: February 2024

Due to the location and toxicity of treatments, head and neck cancer (HNC) has a major impact on quality of life (QoL). Objective: to assess the effects of geriatric-assessment (GA)-driven interventions on QoL over 2 years in older adults with HNC.

EGeSOR was a randomized study of HNC patients aged ≥65, receiving a pretreatment GA, a geriatric intervention and follow-up (intervention) or standard of care (control). The primary endpoint was QoL score using the European Organisation for Research and Treatment of Cancer’s (EORTC QLQ-C30) and HNC (QLQ-HN35) QoL questionnaires over 24 months.

In total, 475 patients were included (median age: 75.3; women: 31%; oral cancer: 44%). QoL scores improved over 24 months with various trajectories, without significant differences between the groups. A total of 74% of patients (interventional group) did not receive the complete intervention. Cancer characteristics, functional status, and risk of frailty were associated with change in the Global Health Status QoL score.

There is a need to develop an alternative model of implementation such as patient-centered health-care pathways.

Trial registration

NCT02025062.
Better to Trust in the Lord? Religious Salience, Regime Religiosity, and Interstate Dispute Resolution
Authors: Zellman Ariel , Justwan Florian , Fox Jonathan
Published: February 2024

How do religiously salient issues influence the peaceful resolution of interstate territorial disputes? Conflict scholars tend to represent “religious” disputes as uniquely resistant to compromise owing to their supposed symbolic indivisibility and the ideological inflexibility of the actors who pursue them. Rather, we argue that religious regimes’ preferred forums to advance peaceful resolution depend upon interactions between the breadth of a dispute’s religious salience and a claimant regime’s domestic religious legitimacy. Secular regimes lack both religious legitimacy and political motivation to engage. Thus, their dispute resolution forum preferences are unrelated to religious salience. Highly religious regimes command significant religious legitimacy and are therefore empowered to directly negotiate over broadly salient religious issues. Yet their political dependence upon religious constituencies causes them to strictly avoid legally binding conflict management over narrowly salient religious issues. By contrast, moderately religious regimes lack sufficient religious legitimacy to directly negotiate over both broadly and narrowly salient issues, rendering them particularly dispute-resolution avoidant. We test and generally confirm these propositions, utilizing new data measuring the religious salience of interstate territorial disputes in the post-Cold War era.