bluuebunny/crossref_metadata_2025 huggingface dataset:
Top and bottom longevity of nations: a retrospective analysis of the age-at-death distribution across 18 OECD countries
Authors: Verguet Stéphane , Niwa Miyu , Bolongaita Sarah
Published: October 2022

Background

Similar to the study of the distribution of income within countries, population-level health disparities can be examined by analyzing the distribution of age at death.

Methods

We sourced period-specific death counts for 18 OECD countries over 1900–2020 from the Human Mortality Database. We studied the evolution of country-year-specific distributions of age at death, with an examination of the lower and upper tails of these distributions. For each country-year, we extracted the 1st, 5th, 10th, 90th, 95th and 99th percentiles of the age-at-death distribution. We then computed the corresponding shares of longevity—the sum of the ages weighted by the age-at-death distribution as a fraction of the sum of the ages weighted by the distribution—for each percentile. For example, for the 10th percentile, this would correspond to how much longevity accrues to the bottom 10% of the age-at-death distribution in a given country-year.

Results

We expose a characterization of the age-at-death distribution across populations with a focus on the lower and upper tails of the distribution. Our metrics, specifically the gap measures in age and share across the 10th and 90th percentiles of the distribution, enable a systematic comparison of national performances, which yields information supplementary to the cross-country differences commonly pointed by traditional indicators of life expectancy and coefficient of variation.

Conclusions

Examining the tails of age-at-death distributions can help characterize the comparative situations of the better- and worse-off individuals across nations, similarly to depictions of income distributions in economics.
Investigation of the pharmacokinetic properties of synthetic heparan sulfate oligosaccharides
Authors: Arnold Katelyn , Wang Zhangjie , Lucas Andrew , Zamboni William , Xu Yongmei , Liu Jian
Published: October 2022

Heparan sulfate (HS) is a sulfated polysaccharide with a wide range of biological activities. There is an increasing interest in the development of structurally homogeneous HS oligosaccharides as therapeutics. However, the factors influencing the pharmacokinetic properties of HS-based therapeutics remain unknown. Here, we report the pharmacokinetic properties of a panel of dodecasaccharides (12-mers) with varying sulfation patterns in healthy mice and uncover the pharmacokinetic properties of an octadecasaccharide (18-mer) in acutely injured mice. In the 12-mer panel, 1 12-mer, known as dekaparin, is anticoagulant, and 3 12-mers are nonanticoagulant. The concentrations of 12-mers in plasma and urine were determined by the disaccharide analysis using liquid chromatography coupled with tandem mass spectrometry. We observed a striking difference between anticoagulant and nonanticoagulant oligosaccharides in the 12-mer panel, showing that anticoagulant dekaparin had a 4.6-fold to 8.6-fold slower clearance and 4.4-fold to 8-fold higher plasma exposure compared to nonanticoagulant 12-mers. We also observed that the clearance of HS oligosaccharides is impacted by disease. Using an antiinflammatory 18-mer, we discovered that the clearance of 18-mer is reduced 2.8-fold in a liver failure mouse model compared to healthy mice. Our results suggest that oligosaccharides are rapidly cleared renally if they have low interaction with circulating proteins. We observed that the clearance rate of oligosaccharides is inversely associated with the degree of binding to target proteins, which can vary in response to pathophysiological conditions. Our findings uncover a contributing factor for the plasma and renal clearance of oligosaccharides which will aid the development of HS-based therapeutics.
Elucidation of the O-antigen structure of Escherichia coli O93 and characterization of its biosynthetic genes
Authors: Furevi Axel , Ståhle Jonas , Muheim Claudio , Gkotzis Spyridon , Daley Daniel O , Udekwu Klas I , Widmalm Göran
Published: October 2022

The structure of the O-antigen from the international reference strain Escherichia coli O93:−:H16 has been determined. A nonrandom modal chain-length distribution was observed for the lipopolysaccharide, a pattern which is typical when long O-specific polysaccharides are expressed. By a combination of (i) bioinformatics information on the gene cluster related to O-antigen synthesis including putative function on glycosyl transferases, (ii) the magnitude of NMR coupling constants of anomeric protons, and (iii) unassigned 2D 1H, 13C-HSQC, and 1H,1H-TOCSY NMR spectra it was possible to efficiently elucidate the structure of the carbohydrate polymer in an automated fashion using the computer program CASPER. The polysaccharide also carries O-acetyl groups and their locations were determined by 2D NMR experiments showing that ~½ of the population was 2,6-di-O-acetylated, ~¼ was 2-O-acetylated, whereas ~¼ did not carry O-acetyl group(s) in the 3-O-substituted mannosyl residue of the repeating unit. The structure of the tetrasaccharide repeating unit of the O-antigen is given by: →2)-β-d-Manp-(1→3)-β-d-Manp2Ac6Ac-(1→4)-β-d-GlcpA-(1→3)-α-d-GlcpNAc-(1→, which should also be the biological repeating unit and it shares structural elements with capsular polysaccharides from E. coli K84 and K50. The structure of the acidic O-specific polysaccharide from Cellulophaga baltica strain NN015840T differs to that of the O-antigen from E. coli O93 by lacking the O-acetyl group at O6 of the O-acetylated mannosyl residue.
Effects of Taurine in Mice and Zebrafish Behavioral Assays With Translational Relevance to Schizophrenia
Authors: Giongo Franciele Kich , Gallas-Lopes Matheus , Benvenutti Radharani , Sachett Adrieli , Bastos Leonardo Marensi , Rosa Adriane Ribeiro , Herrmann Ana Paula
Published: October 2022

Background

Altered redox state and developmental abnormalities in glutamatergic and GABAergic transmission during development are linked to the behavioral changes associated with schizophrenia. As an amino acid that exerts antioxidant and inhibitory actions in the brain, taurine is a potential candidate to modulate biological targets relevant to this disorder. Here, we investigated in mice and zebrafish assays whether taurine prevents the behavioral changes induced by acute administration of MK-801 (dizocilpine), a glutamate N-methyl-D-aspartate (NMDA) receptor antagonist.

Methods

C57BL/6 mice were i.p. administered with saline or taurine (50, 100, and 200 mg/kg) followed by MK-801 (0.15 mg/kg). Locomotor activity, social interaction, and prepulse inhibition of the acoustic startle reflex were then assessed in different sets of animals. Zebrafish were exposed to tank water or taurine (42, 150, and 400 mg/L) followed by MK-801 (5 µM); social preference and locomotor activity were evaluated in the same test.

Results

MK-801 induced hyperlocomotion and disrupted sensorimotor gating in mice; in zebrafish, it reduced sociability and increased locomotion. Taurine was mostly devoid of effects and did not counteract NMDA antagonism in mice or zebrafish.

Discussion

Contradicting previous clinical and preclinical data, taurine did not show antipsychotic-like effects in the present study. However, it still warrants consideration as a preventive intervention in animal models relevant to the prodromal phase of schizophrenia; further studies are thus necessary to evaluate whether and how taurine might benefit patients.
HIV RNA Screening Reduces Integrase Strand Transfer Inhibitor Resistance Risk in Persons Receiving Long-Acting Cabotegravir for HIV Prevention
Authors: Eshleman Susan H , Fogel Jessica M , Halvas Elias K , Piwowar-Manning Estelle , Marzinke Mark A , Kofron Ryan , Wang Zhe , Mellors John , McCauley Marybeth , Rinehart Alex R , St Clair Marty , Adeyeye Adeola , Hinojosa Juan C , Cabello Robinson , Middelkoop Keren , Hanscom Brett , Cohen Myron S , Grinsztejn Beatriz , Landovitz Raphael J ,   HPTN 083 Study Team, Seisa Michael , Lie Yolanda , Meyer William , Marrazzo Jeanne , Peel Sheila , Wallis Carole , Asmelash Aida , Daar Eric , Rooney James , Clark Richard
Published: October 2022

Background

The HPTN 083 trial demonstrated that long-acting cabotegravir (CAB-LA) was superior to tenofovir-disoproxil fumarate/emtricitabine for human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP). Integrase strand transfer inhibitor (INSTI) resistance-associated mutations (RAMs) were detected in some participants with HIV infection. We used a low viral load INSTI genotyping assay to evaluate the timing of emergence of INSTI RAMs and assessed whether HIV screening with a sensitive RNA assay would have detected HIV infection before INSTI resistance emerged.

Methods

Single-genome sequencing to detect INSTI RAMs was performed for samples with viral loads <500 copies/mL from 5 participants with previously identified INSTI RAMs and 2 with no prior genotyping results.

Results

Major INSTI RAMs were detected in all 7 cases. HIV RNA testing identified infection before major INSTI RAMs emerged in 4 cases and before additional major INSTI RAMs accumulated in 1 case. Most INSTI RAMs were detected early when the viral load was low and CAB concentration was high.

Conclusions

When using CAB-LA PrEP, earlier detection of HIV infection with a sensitive RNA assay may allow for earlier treatment initiation with the potential to reduce INSTI resistance risk. Further studies are needed to evaluate the value and feasibility of HIV RNA testing with CAB-LA PrEP.
Behavior and welfare impacts of water provision via misting in commercial Pekin ducks
Authors: Campbell Dana L M , Belson Sue , Erasmus Marisa A , Lea Jim M
Published: October 2022

Ducks will access water to maintain feather condition and exhibit natural water-related behaviors such as wet preening. Providing water to ducks commercially is challenging as it may reduce litter and air quality leading to higher duck mortality or illness. This research aimed to measure the behavioral and welfare impacts of water provision via a misting system for commercial Pekin grower ducks in Victoria, Australia. Seven grower flocks were observed (four misted and three nonmisted in open-sided sheds) during May and November 2021. From 26 until 33 d of age, treatment ducks were provided 1 h of misting with shed curtains closed in both treatment and control sheds. At the start and end of the misting application period, external health and welfare measures were taken directly on the ducks via transect walks throughout each shed and catch-and-inspect observations on a sample of 150 ducks from each shed. Video recordings were also made of the misted and nonmisted ducks for 3 h representing time periods prior to, during, and after the 1-h misting across all sheds for all 8 d of the treatment period. Observations were made of all behavior that ducks exhibited at 10-min scan sample intervals across four cameras per shed, totaling 4,198 scans across the seven sheds. General linear mixed models showed the misting application predominantly had impacts on the patterns of behavioral change across the treatment time periods between the misted and nonmisted ducks rather than increasing or decreasing the overall expression of specific behaviors (interaction terms all P ≤ 0.003). The misted ducks increased drinking, tail wagging, and walking, and reduced preening, rooting litter, sitting, and stretching during misting relative to what they showed prior. The nonmisted ducks showed less sitting and more panting during misting relative to prior. Pearson’s Chi-square tests showed some differences between the treatment groups in feather cleanliness on the back and wings (both P < 0.0001), likely resulting from pre-existing differences between sheds in blood from pin feathers. Most welfare indicators showed no positive or negative effect of the misting treatment. These results indicate overhead misting does affect duck behavior to some degree without compromising their welfare, but further research with larger water droplet sizes resulting in greater accumulation of surface water or extended durations of misting may lead to greater effects.
Valuing digital possessions: the role of affordances
Authors: Denegri-Knott Janice , Jenkins Rebecca , Lindley Siân
Published: October 2022

In this article, we introduce an affordance-orientated approach for the study of digital possessions. We identify affordances as a source of value for digital possessions and argue that dominant meaning-orientated approaches do not enable us to fully appreciate these sources of value. Our work recognizes that value is released and experienced in “the doing”—people must do things with digital objects to locate and obtain value in and from them. We distinguish three levels of affordance for digital possessions—low, mid, and high—and introduce the concept of digital incorporation to explain how the three levels of affordances come together, with the individual’s own intentionality to enable the achievement of goals. We draw from postphenomenological interviews with 47 individuals in the UK to provide a possession-based and lived experience approach to affordances that sheds new light on their vital role in everyday life and goals.
The rediscovered Islamic manuscripts of the Cospi Museum in the University Library of Bologna
Authors: Gigante Federica
Published: October 2022

This article reconstructs, by means of unpublished and newly discovered archival sources, the path of the Islamic manuscripts of the Cospi Museum from their entry into the collection of Ferdinando Cospi up to the present day, and identifies them, for the first time, in a group of manuscripts currently held in the University Library of Bologna. Although Islamic manuscripts had made their way to Italy since medieval times and numerous examples may be found in Italian libraries today, very few represent the collection of a single individual and, among these, fewer still have survived as a coherent group. The rediscovered collection of Islamic manuscripts of the Cospi Museum therefore represents a rare survival which provides new insights into early modern collecting practices in Italy, as well as new material through which to explore the history of the interaction between the Islamic world and Italy in the early modern period.
The combination of volumetric arc radiation therapy and boost high-dose rate interstitial brachytherapy for T3N2c tongue cancer: a technical report
Authors: Murakami Naoya , Sakuramachi Madoka , Kashihara Tairo , Chiba Takahito , Nakamura Satoshi , Ono Keisuke , Ueno Takao , Yoshimoto Seiichi , Yoshida Ken , Masui Koji , Akiyama Hironori , Igaki Hiroshi
Published: October 2022

Currently, tongue cancers are primarily managed by surgery, and interstitial brachytherapy is only recommended for a selected group of early state T1-2N0 patients who refuse surgery or are medically inoperable. In this report, a case with T3N2cM0 tongue cancer who has been effectively treated by the combination of concurrent chemoradiotherapy involving volumetric arc therapy and boost high-dose rate interstitial brachytherapy is presented. Of course, surgery remains the main treatment strategy for tongue cancer patients; however, the authors believe that if volumetric arc therapy is carefully planned to reduce the mandible dose as much as possible and high-dose rate interstitial brachytherapy with a mouthpiece that protects the mandible is combined, it is possible to treat T3N2 disease, and this can be considered for patients who want to preserve organ function.
Clinicopathological Features and Outcomes Comparing Patients With Invasive Ductal and Lobular Breast Cancer
Authors: Oesterreich Steffi , Nasrazadani Azadeh , Zou Jian , Carleton Neil , Onger Tiffany , Wright Matthew D , Li Yujia , Demanelis Kathryn , Ramaswamy Bhuvaneswari , Tseng George , Lee Adrian V , Williams Nicole , Kruse Megan
Published: October 2022

Background

There is increasing interest in better understanding the biology and clinical presentation of invasive lobular cancer (ILC), which is the most common special histological subtype of breast cancer. Limited large contemporary data sets are available allowing comparison of clinicopathologic features between ILC and invasive ductal cancer (IDC).

Methods

The Great Lakes Breast Cancer Consortium was formed to compare clinical behavior of ILC (n = 3617) and IDC (n = 30 045) from 33 662 patients treated between 1990 and 2017 at 3 large clinical centers. We used Kaplan-Meier analysis, Cox proportional hazards modeling, and propensity score matching to evaluate treatment differences and outcomes. All statistical testing used 2-sided P values.

Results

Compared with IDC, patients with ILC were more frequently diagnosed at later stages and with more lymph node involvement (corrected P < .001). Estrogen receptor–positive ILCs were of lower grade (grade 1 and 2: 90% in ILC vs 72% in IDC) but larger in size (T3 and 4: 14.3% in ILC vs 3.4% in IDC) (corrected P < .001), and since 1990, the mean ILC size detected at diagnosis increased yearly. Patients with estrogen receptor (ER)–positive ILC underwent statistically significantly more mastectomies compared with ER-positive IDC (57% vs 46%). Using Kaplan-Meier analysis, patients with ER-positive ILC had statistically significantly worse disease-free survival and overall survival than ER-positive IDC although 6 times more IDCs were classified as high risk by OncotypeDx Breast Recurrence Score assay.

Conclusions

This large, retrospective, collaborative analysis with 3 clinical centers identified meaningful differences in clinicopathological features between ILC and IDC, providing further evidence that these are 2 different entities requiring different clinical management.
Online Intervention for Caregivers of Children with Early Traumatic Brain Injury: Pilot Trial
Authors: Maggard Brianna L , Gies Lisa M , Sidol Craig A , Moscato Emily L , Schmidt Matthew , Landry Susan H , Makoroff Kathi L , Rhine Tara D , Wade Shari L
Published: October 2022

Objective

To assess the feasibility and acceptability of an online parenting-skills program for caregivers of young children with traumatic brain injury (TBI). Positive parenting contributes to recovery following early TBI and social and emotional development in typically developing children. Yet, few interventions have been designed to support psychosocial recovery and subsequent development after early TBI.

Methods

This study protocol was registered with clinicaltrials.gov (NCT05160194). We utilized an academic hospital’s Trauma Registry to recruit caregivers of children, ages 0–4 years, previously hospitalized for TBI. The GROW intervention integrated six online learning modules with videoconference meetings with a coach to review and practice skills while receiving in vivo coaching and feedback. Interactive modules addressed strategies for responsive parenting, stimulating cognition, and managing parenting stress. Enrollment and retention rates served as feasibility metrics and satisfaction surveys assessed acceptability.

Results

18 of 72 families contacted (25%) consented, and 11 of 18 (61%) completed the intervention and follow-up assessments. All participants rated the intervention as helpful and indicated that they would recommend the intervention to others. All endorsed a better understanding of brain injury and how to optimize their child’s recovery and development. Both coaches rated intervention delivery as comparable to traditional face-to-face treatment.

Conclusions

Low levels of uptake and initial engagement underscore the challenges of intervening with caregivers following early TBI, which likely were exacerbated due to the COVID-19 pandemic. High levels of acceptability and perceived benefit support the potential utility of GROW while highlighting the need to improve accessibility and early engagement.
A nationwide evaluation of bevacizumab-based treatments in pediatric low-grade glioma in the UK: Safety, efficacy, visual morbidity, and outcomes
Authors: Green Katherine , Panagopoulou Paraskevi , D’Arco Felice , O’Hare Patricia , Bowman Richard , Walters Bronwen , Dahl Christine , Jorgensen Mette , Patel Pritesh , Slater Olga , Ahmed Rehana , Bailey Simon , Carceller Fernando , Collins Rhiannon , Corley Elizabeth , English Martin , Howells Lisa , Kamal Ahmed , Kilday John-Paul (JP) , Lowis Stephen , Lumb Blanche , Pace Erika , Picton Susan , Pizer Barry , Shafiq Ayad , Uzunova Lena , Wayman Harriet , Wilson Shaun , Hargrave Darren , Opocher Enrico
Published: October 2022

Background

Bevacizumab is increasingly used in children with pediatric low-grade glioma (PLGG) despite limited evidence. A nationwide UK service evaluation was conducted to provide larger cohort “real life” safety and efficacy data including functional visual outcomes.

Methods

Children receiving bevacizumab-based treatments (BBT) for PLGG (2009–2020) from 11 centers were included. Standardized neuro-radiological (RANO-LGG) and visual (logMAR visual acuity) criteria were used to assess clinical–radiological correlation, survival outcomes and multivariate prognostic analysis.

Results

Eighty-eight children with PLGG received BBT either as 3rd line with irinotecan (85%) or alongside 1st/2nd line chemotherapies (15%). Toxicity was limited and minimal. Partial response (PR, 40%), stable disease (SD, 49%), and progressive disease (PD, 11%) were seen during BBT. However, 65% progressed at 8 months (median) from BBT cessation, leading to a radiology-based 3 yr-progression-free survival (PFS) of 29%. Diencephalic syndrome (P = .03) was associated with adverse PFS. Pre-existing visual morbidity included unilateral (25%) or bilateral (11%) blindness. Improvement (29%) or stabilization (49%) of visual acuity was achieved, more often in patients’ best eyes. Vision deteriorated during BBT in 14 (22%), with 3-year visual-PFS of 53%; more often in patients’ worst eyes. A superior visual outcome (P = .023) was seen in neurofibromatosis type 1-associated optic pathway glioma (OPG). Concordance between visual and radiological responses was 36%; optimized to 48% using only best eye responses.

Conclusions

BBTs provide effective short-term PLGG control and delay further progression, with a better sustained visual (best > worst eye) than radiological response. Further research could optimize the role of BBT toward a potentially sight-saving strategy in OPG.
Angiotensin receptor blockade is associated with increased risk of giant cell arteritis
Authors: Zhao Sizheng Steven , Lyu Houchen , Zeng Chao , Lei Guanghua , Wei Jie , Mackie Sarah L
Published: October 2022

Objectives

Angiotensin II is implicated in GCA pathology. We examined whether the use of angiotensin receptor blockers (ARBs) is associated with GCA risk compared with angiotensin-converting enzyme inhibitors (ACEis) or other antihypertensives.

Methods

We performed a matched cohort study including adults who were initiators of antihypertensives in UK primary care data between 1995 and 2019. Treatment-naïve individuals without prior GCA or PMR were categorized into three groups—ARB initiators, ACEi initiators, or other antihypertensive initiators (beta-blockers, calcium channel blockers, diuretics or alpha-adrenoceptor blockers)—and followed for up to 5 years. Incident GCA was defined using validated Read codes, with age of onset ≥50 years and two or more glucocorticoid prescriptions. Inverse probability–weighted Cox models were used to model outcome risk, adjusting for lifestyle parameters, comorbidities and comedications.

Results

Among >1 million new starters of antihypertensives (81 780 ARBs, 422 940 ACEis and 873 066 other antihypertensives), the incidence rate of GCA per 10 000 patient-years was 2.73 (95% CI 2.12, 3.50) in the ARB group, 1.76 (95% CI 1.25, 2.39) in the ACEi group and 1.90 (95% CI 1.37, 2.56) in the other antihypertensives group. The hazard of GCA was higher in ARB initiators [hazard ratio (HR) 1.55; 95% CI 1.16, 2.06] than initiators of ACEis, but similar between initiators of other antihypertensives and ACEis (HR 1.08; 95% CI 0.87, 1.35).

Conclusions

Initiation of ARBs is associated with a higher risk of GCA compared with ACEis or other antihypertensives. Mechanistic studies of angiotensin receptor biology will provide further clarity for our findings.
New treatment strategies for human epidermal growth factor receptor 2-positive breast cancer in 2023
Authors: Banys-Paluchowski Maggie , Krawczyk Natalia , Stickeler Elmar , Müller Volkmar , Fehm Tanja
Published: October 2022

Purpose of review

Taxanes in combination with trastuzumab and pertuzumab are the established first-line standard in the treatment of human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer. In the last years, several new HER2-targeted therapies, including antibody–drug conjugates (ADCs) and tyrosine kinase inhibitors, have been approved for therapy after trastuzumab or dual blockade. In this review, the current treatment algorithms are discussed, including these new treatment options.

Recent findings

The ADC T-DM1 was the established second-line standard based on the results of the EMILIA trial. Recently, the DESTINY-Breast03 trial compared T-DM1 with the new ADC trastuzumab deruxtecan (T-DXd) in patients with disease progression after treatment with taxanes and trastuzumab. T-DXd was associated with an improved progression-free survival and a trend toward improved overall survival, establishing T-DXd as a new second-line standard. The HER2CLIMB trial demonstrated a significant progression-free survival and overall survival benefit for the tyrosine kinase inhibitor tucatinib in combination with trastuzumab and capecitabine after T-DM1 and trastuzumab/pertuzumab. This benefit was also observed in patients with active brain metastases defining this combination as the preferred second or third-line option in these patients.

New treatment strategies in HER2-positive metastatic breast cancer have substantially improved the clinical outcome of these patients, including those with active brain metastases.
Chronic Strongyloidiasis in the Primary Care Setting
Authors: Sy Hendrik , Zalcgendler Sara , Edelman Deborah
Published: October 2022

Strongyloides stercoralis can persist for decades in the human host through autoinfection. It can lead to hyperinfection syndrome, which has a high mortality rate and is associated with corticosteroid use. Twelve patients presented to our primary care clinic in New York with eosinophilia and were found to have chronic strongyloidiasis. The patients' characteristics are summarized and the current literature on screening of strongyloidiasis is reviewed. We aim to increase awareness for this condition among primary care providers that care for immigrant populations, especially with widespread use of corticosteroids for the treatment of coronavirus disease 2019.
A Murine Model of Veno-Arterial Extracorporeal Membrane Oxygenation
Authors: Kharnaf Mousa , Hogue Spencer , Wilkes Zachariah , Reagor James A. , Leino Daniel G. , Gourley Benjamin , Rosenfeldt Leah , Ma Qing , Devarajan Prasad , Palumbo Joseph S. , Tweddell James S. , Zafar Farhan
Published: October 2022

The mechanisms driving the pathologic state created by extracorporeal membrane oxygenation (ECMO) remain poorly defined. We developed the first complete blood-primed murine model of veno-arterial ECMO capable of maintaining oxygenation and perfusion, allowing molecular studies that are unavailable in larger animal models. Fifteen C57BL/6 mice underwent ECMO by cannulating the left common carotid artery and the right external jugular vein. The mean arterial pressure was measured through cannulation of the femoral artery. The blood-primed circuit functioned well. Hemodynamic parameters remained stable and blood gas analyses showed adequate oxygenation of the animals during ECMO over a 1-hour timeframe. A significant increase in plasma-free hemoglobin was observed following ECMO, likely secondary to hemolysis within the miniaturized circuit components. Paralleling clinical data, ECMO resulted in a significant increase in plasma levels of multiple proinflammatory cytokines as well as evidence of early signs of kidney and liver dysfunction. These results demonstrate that this novel, miniature blood-primed ECMO circuit represents a functional murine model of ECMO that will provide unique opportunities for further studies to expand our knowledge of ECMO-related pathologies using the wealth of available genetic, pharmacological, and biochemical murine reagents not available for other species.
Disseminated intravascular coagulation in a cohort of adult acute leukemia patients: a single center experience
Authors: Alnuaimy Sarah L. , Shamoon Rawand P.
Published: October 2022

Objectives

We aimed to detect the incidence of disseminated intravascular coagulation (DIC) in patients with acute leukemia (AL) and find out its association with types of AL and patients’ clinical and pathological parameters.

Methods

In this prospective study, 59 newly diagnosed adults with AL were clinically examined and screened for DIC presentation time. Coagulation tests, including prothrombin time, activated partial thromboplastin time, fibrinogen level, D-dimer, antithrombin, and protein C and protein S levels were all assessed. The International Society for Thrombosis and Hemostasis scoring system was adopted to diagnose overt DIC.

Results

The age of the studied patients ranged from 15 to 81 years with a median of 41 years; male to female ratio was 1.1:1. acute myeloid leukemia (AML) constituted 64.4% of the total cases (38 patients). DIC was detected in 28 patients (47.5%); its incidence was higher in AML than in acute lymphoblastic leukemia (ALL) (52.6% vs. 38.1%). Overt DIC was significantly associated with bleeding manifestations, duration of symptoms, and leukocytosis (P-values = 0.050, 0.044, and 0.003, respectively). Bleeding events were encountered in 50.8% of patients (25 AML and 5 ALL patients). Bleeding was associated significantly with leukocytosis, thrombocytopenia, and low fibrinogen level. Thrombosis was found in two patients (3.4%) at presentation.

Conclusions

Overt DIC was common in patients with AL at presentation, mostly in AML. Routine testing for coagulopathy in newly diagnosed AL patients will possibly aid in improving the overall patients’ survival.
Vascular healing responses to paclitaxel coated balloons or everolimus eluting stents for the treatment of in-stent restenosis. Insights from optical coherence tomography
Authors: McInerney Angela , Salazar Carlos , Pérez-Vizcayno María José , Jimenez-Quevedo Pilar , Jiménez-Valero Santiago , Brugaletta Salvatore , Romaguera Rafael , Nombela-Franco Luis , Travieso-Gonzalez Alejandro , Jerónimo-Baza Adrián , Tirado-Conte Gabriela , Fernández-Ortiz Antonio , Escaned Javier , Alfonso Fernando , Macaya Carlos , Gonzalo Nieves
Published: October 2022

Background

Treatment of in-stent restenosis (ISR) remains a significant challenge. Current options include repeat stenting or drug-coated balloons. However, there is a paucity of data regarding vascular healing after these strategies. We, aimed to compare optical coherence tomography (OCT)-based vessel healing after treatment with paclitaxel-coated balloons (PCB) or everolimus-eluting stents (EES).

Methods

An OCT substudy (baseline and 6–9 months) of patients from RIBS IV and RIBS V, two prospective multicenter, randomized controlled clinical trials comparing PCB vs. EES in patients with ISR was performed.

Results

Sixty-four patients were included (30 PCB and 34 EES). There were no differences in the baseline or angiographic characteristics between groups. Both groups had the same proportion of drug-eluting and bare-metal stent (BMS) ISR. Baseline OCT analysis did not show differences in the qualitative characteristics of the ISR nor the restenotic tissue burden. Follow-up OCT showed a larger mean lumen area in the EES group (6.03 ± 1.5 vs. 5.24 ± 1.3 mm2; P = 0.043) but no difference in angiographic restenosis (P = 0.66). Percentage tissue coverage was higher with PCB vs. EES (26 ± 13 vs. 19 ± 11%; P = 0.031). EES-treated ISR more frequently had uncovered struts at follow-up [21 (72%) vs. 12 (44%); P = 0.034]. Tissue covering struts more frequently had a high backscatter structure after PCB [21 (78%) vs. 16 (55%); P = 0.07].

Conclusions

Compared with EES, ISR treated with PCB demonstrated more strut coverage with mainly high backscattering tissue. Larger OCT-defined neointimal proliferation in PCB-treated ISR did not translate into higher angiographic restenosis rates.
Effectiveness and safety of acupuncture and moxibustion for chronic prostatitis: A protocol for an overview of systematic reviews and meta-analysis
Authors: Zhou Xingchen , Lv Zhizhen , Hong Shuangwei , Hu Huijie , Tian Yu , Wu Shuang , Wang Kaizheng , Wei Zicheng , Lv Lijiang
Published: October 2022

Background:

Chronic prostatitis (CP) refers to a disease characterized by local pain and discomfort, urination discomfort, and quality of life. Acupuncture (ACU) and moxibustion are widely used in the treatment of CP, and the curative effect is satisfactory. Several systematic reviews (SRs) and meta-analyzes have reported the effectiveness of ACU and moxibustion in treating patients with CP. However, the evidence is not systematically integrated. This overview aims to integrate and evaluate the reliability of these SRs and the evidence generated from the ACU and moxibustion for CP meta-analysis.

Methods:

We will make a comprehensive retrieval in seven databases as following: Embase, Cochrane Library, Pubmed, Chinese databases SinoMed (previously called the Chinese Biomedical Database), Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wanfang Data (WF). The time is limited from the construction of the library to May 2021. We will use the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool to evaluate methodological quality. Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P) will be used in the report checklist to assess the quality of reports in the study. The GRADE will be used to evaluate the included SRs and meta-analysis. Our reviewers will conduct SRs, qualification evaluation, data extraction, methodological quality and evidence quality screening in pairs. The outcomes of interest include: NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), effective rate, other CP symptom scales, EPS-WBC, and adverse events. Evidence will be combined based on patient subgroups and results where appropriate.

Results:

The results will be published in a peer-reviewed journal.

Trial registration number:

INPLASY202150018.

Conclusion:

This overview will provide comprehensive evidence of ACU and moxibustion for patients with CP.
Comparison of regional cerebral oxygen saturation during one-lung ventilation under desflurane or propofol anesthesia: A randomized trial
Authors: Hayashi Keishu , Yamada Yuko , Ishihara Takuma , Tanabe Kumiko , Iida Hiroki
Published: October 2022

Background:

During one-lung ventilation (OLV), deterioration of pulmonary oxygenation reduces arterial oxygen saturation and cerebral oxygen saturation (rSO2). However, oxidative stress during OLV causes lung injury, so the fraction of inspiratory oxygen (FiO2) should be kept as low as possible. We investigated the changes in rSO2 under propofol or desflurane anesthesia while percutaneous oxygen saturation (SpO2) was kept as low as possible during OLV.

Methods:

Thirty-six patients scheduled for thoracic surgery under OLV in the lateral decubitus position were randomly assigned to propofol (n = 19) or desflurane (n = 17) anesthesia. FiO2 was set to 0.4 at the start of surgery under two-lung ventilation (measurement point: T3) and then adjusted to maintain an SpO2 of 92% to 94% after the initiation of OLV. The primary outcome was the difference in the absolute value of the decrease in rSO2 from T3 to 30 minutes after the initiation of OLV (T5), which was analyzed by an analysis of covariance adjusted for the rSO2 value at T3.

Results:

The mean rSO2 values were 61.5% ± 5.1% at T3 and 57.1% ± 5.3% at T5 in the propofol group and 62.2% ± 6.0% at T3 and 58.6% ± 5.3% at T5 in the desflurane group. The difference in the absolute value of decrease between groups (propofol group − desflurane group) was 0.95 (95% confidence interval, [−0.32, 2.2]; P = .152).

Conclusions:

Both propofol and desflurane anesthesia maintain comparable cerebral oxygenation and can be used safely, even when the SpO2 is kept as low as possible during OLV.
Systematic review and meta-analysis of acupuncture in the treatment of cognitive impairment after stroke
Authors: Wang Zhen-Zhi , Sun Zhen , Zhang Mei-Ling , Xiong Kang , Zhou Feng
Published: October 2022

Background:

We aim to make a systematic evaluation of the clinical efficacy of acupuncture in the treatment of cognitive impairment after stroke, to provide evidence-based medical evidence for clinical practice.

Methods:

We searched all the randomized controlled trials of China National Knowledge Infrastructure, Wan fang data knowledge service platform, VIP Chinese periodical service platform full-text Journal Database, Chinese Biomedical Literature Database, Cochrane Library Database, and PubMed Database about acupuncture treatment of post-stroke cognitive impairment (PSCI). Two researchers independently screened the literature and extracted the data according to the inclusion and exclusion criteria. The bias risk assessment manual of Cochrane collaboration Network was used to evaluate the bias risk, and all data were analyzed by Stata16.0.

Results:

Fourteen articles were included, with a total of 2402 patients. Meta-analysis showed that acupuncture combined with routine therapy could significantly reduce the score of cognitive impairment symptoms compared with the control group. The mini-mental state examination scale (MMSE) score (weighted mean difference [WMD] = 3.23, 95% confidence interval [CI]: 1.89–4.56, P < .01), Montreal cognitive assessment scale (MoCA) score (WMD = 3.41, 95% CI: 0.93–5.89, P < .01), Barthel index of activities of daily living (MBI) score (WMD = 4.59, 95% CI: 1.43–7.75, P < .01), and Lowenstein assessment scale (LOTCA) score (WMD = 8.60, 95% CI: 6.32–10.89, P = .00) were significantly improved in the patients receiving group acupuncture combined with routine therapy.

Conclusion:

Acupuncture combined with routine therapy seems to be more effective than conventional therapy alone in the treatment of PSCI. However, the differences between different acupuncture types need to be clarified in more high-quality randomized controlled trials.
The safety of esophageal cancer surgery during COVID-19
Authors: Wang Qiuxiang , Yao Chengjiao , Li Yilin , Luo Lihong , Xie Fengjiao , Xiong Qin , Wu Ruike , Wang Juan , Feng Peimin
Published: October 2022

Background:

The ongoing coronavirus disease 2019 (COVID-19) pandemic has drastically challenged the safety of on esophageal cancer (EC) surgery during COVID-19. The study aimed to evaluate the safety of EC surgery during the COVID-19 pandemic.

Methods:

This systematic review was performed in accordance with the PRISMA-P 2015 guidelines and registered in PROSPERO (registration number: CRD42022335164). A systematic search of PubMed, Embase, Cochrane Library, Web of Science, Medline, Chinese National Knowledge Infrastructure database, Chinese Scientific Journal database, and Wan Fang database was conducted to identify potentially relevant publications from January 2020 to May 2022. All data were independently extracted by two researchers. We will apply a fixed-effect model or random effect model basis on the heterogeneity test and employ with RevMan 5.4.1 software for data synthesis. The dichotomous surgical outcomes used risk ratios or risk differences, and for continuous surgical outcomes, mean differences (MD) or standardized MD, both with 95% confidence intervals were used. The primary outcomes were postoperative complications, anastomotic leaks, and mortality. The secondary outcomes were total hospital stay, postoperative stay, preoperative waiting, operation time, blood loss, transfusion, postoperative intensive care unit (ICU) stay, number of patients needing ICU stay, and 30-day readmission.

Results:

This study will comprehensively summarize the high-quality trials to determine the safety of EC surgery during COVID-19.

Conclusion:

Our systematic review and meta-analysis will present evidence for the safety of EC surgery during COVID-19.
The clinical efficacy of Shenmai injection in the prophylaxis and treatment of intradialytic hypotension: A protocol for systematic review and meta-analysis
Authors: Xiang Zhen , Lin Xin , Wang Jun , Yu Guodan
Published: October 2022

Background:

Intradialytic hypotension (IDH) is a common complication in hemodialysis. IDH can induce vomiting, chest tightness and syncope, and hemodialysis shall be discontinued in patients with severe IDH. As is revealed in related studies, Shenmai injection (SMI) can be used in the prophylaxis and treatment of IDH. However, there is still a lack of consensus about the efficacy among reported studies, which cannot provide compelling evidence. Therefore, a meta-analysis was conducted in this study to further investigate the efficacy and safety of SMI in the prophylaxis and treatment of IDH.

Methods:

PubMed, Web of Science, Scopus, Cochrane Library, Embase, China Scientific Journal Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and Wanfang Data were systematically retrieved from their establishment to June 2022. Subsequently, literature screening, data extraction, quality evaluation and cross-checking of results were performed according to the Cochrane Handbook. Besides, a meta-analysis was performed with the assistance of Revman 5.3 software.

Results:

This study will evaluate whether SMI is effective in the prophylaxis and treatment of IDH.

Conclusions:

The latest evidence for the efficacy and safety of SMI in the prevention and treatment of IDH can be provided through this study.
Expression of miR-92a is associated with the prognosis in non-small cell lung cancer: An observation study
Authors: Huang Yu-Fang , Liu Ming-Wei , Xia Han-Biao , He Rong
Published: October 2022

With the development of molecular biology technology, the discovery of microRNAs (miRNAs) has provided new ideas for the diagnosis, treatment, and prognosis of lung cancer and laid a foundation for the study of this malignancy. To assess the potential prognostic value of miR-92a as a new biomarker in non-small cell lung cancer (NSCLC) via clinical evaluation, a total of 100 patients with NSCLC admitted to the Respiratory and Intensive Care Department of Suining Central Hospital in Sichuan Province between August 2007 and April 2020 were retrospectively analyzed. The correlation between miR-92a expression and prognosis of patients with NSCLC was also evaluated in the present study. The expression level of miR-92a was measured by PT-PCR and in situ hybridization. Chi-square test was adopted to explore the relationship of miR-92a expression and clinical features. Kaplan–Meier survival curves were plotted to delineate the overall survival rate of patients with NSCLC. Cox regression analysis was performed to evaluate the prognostic significance of miR-92a expression in NSCLC. The miR-92a expression in NSCLC tissue samples was significantly higher than that in normal lung tissues (P < .001) and significantly correlated with the Eastern Cooperative Oncology Group score, histological type, and distant metastasis (P < .05). Survival curve revealed that patients with NSCLC and high miR-92a expression had relatively higher mortality than those with low PAK4 expression (P = .001). Cox regression analysis explained that miR-92a expression was associated with the prognosis of patients with NSCLC (HR = 1.8, 95% CI: 1.0–3.2, P = .036). In summary, miR-92a was highly expressed in NSCLC tissues and could act as a prognostic factor for patients with NSCLC. These results illustrate that miR-92a expression plays an important role in the invasion and metastasis of NSCLC, and miR-92a can be used as a new biomarker to determine the prognosis of this cancer.
Development of a 4-miRNA prognostic signature for endometrial cancer
Authors: Huang Jiazhen , Du Furong , Wang Ning
Published: October 2022

To develop an effective uterine corpus endometrial carcinoma (UCEC) risk assessment tool to monitor treatment outcomes. Limma package was used to analyze differentially expressed microRNAs (miRNAs) between UCEC tissues and normal tissues in the TCGA database. According to univariate Cox risk regression, least absolute shrinkage, and selection operator (LASSO) Cox analysis were performed to screen prognostic miRNAs and construct a risk scoring model. The prognostic performance of signature was evaluated by Kaplan–Meier and receiver operating characteristic. Multivariate Cox regression analysis was used to determine the independent prognostic factors of UCEC. Nomogram was constructed according to age, clinical stage, and risk score. A 4-miRNA signature based on miR-31-5p, miR-34a-5p, miR-26a-1-3p and miR-4772-3p was established. Risk scores of each patient were calculated by the 4-miRNA signature. After z-score, the patients were divided into high- and low-risk groups. The overall survival of high-risk patients was significantly shorter than that of low-risk patients, pointing to the high performance and independence of the 4-miRNA signature in predicting UCEC prognosis. The nomogram showed a high accuracy in predicting overall survival of UCEC patients. We developed a 4-miRNA signature that could effectively predict the prognosis of UCEC.