bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and risk of colorectal polyps among the Korean population under 50 years
Authors: Jeong Su Jin , Lee Jinho , Kim Eunju , Hwang Jun Seong , Lee Jin , Choi Joon Hyuk , Heo Nae-Yun , Park Jongha , Park Seung Ha , Kim Tae Oh , Park Yong Eun
Published: July 2022

Colorectal cancer is a common cancer; generally, adults aged ≥ 50 years are screened using stool occult blood tests and colonoscopy. However, colorectal adenoma and cancer have been found in patients under the aged of 50, and studies on characteristics and risk factors in young patients are lacking. We evaluated the prevalence and risk factors of colorectal adenoma and cancer in young adults aged under 50 years.

We retrospectively analyzed 570 individuals aged under 50 years who underwent colonoscopy at the Haeundae Paik Hospital, Korea, from January to June 2018. Logistic regression model was used to identify the risk factors for colorectal adenoma and colorectal cancer.

The prevalence of colorectal adenoma in group of 19–29 years was 3.2% (1 of 31), 30–39 years was 13.8% (30 of 217) and in the group of 40–49 years was 21.1% (68 of 322) (P = .009). In multivariable analysis, age over 45 years (adjusted odds ratio [OR], 1.941; 95% confidence interval [CI], 1.187–3.172; P = .008) and male sex (adjusted OR, 1.711; 95% CI, 1.044–2.806; P = .033) were independent risk factors for colorectal neoplasia including cancer.

The prevalence of colorectal adenoma increases as the age increased in young adults under 50 years of age, especially after the age of 45 years, the risk of colorectal neoplasia increases; hence, early screening should be considered before the age of 50 years.
Comparison of the background echotexture between automated breast ultrasound and handheld breast ultrasound
Authors: Kim Jieun , Ko Eun Young , Han Boo-Kyung , Ko Eun Sook , Choi Ji Soo , Park Ko Woon , Kim Haejung
Published: July 2022

This study aimed to compare the background echotexture (BE) between automated breast ultrasound (ABUS) and handheld breast ultrasound (HHUS) and evaluate the correlation of BE with mammographic (MG) density and background parenchymal enhancement (BPE) on magnetic resonance imaging (MRI). A total of 212 women with newly diagnosed breast cancer who had undergone preoperative ABUS, HHUS, MG, and MRI were included. Two breast radiologists blinded to the menopausal status analyzed the BE of the contralateral breasts of the patients with breast cancer in consensus. The MG density and BPE of breast MRI on the radiologic reports were compared with the BE in the ultrasound. We used the cumulative link mixed model to compare the BE and Spearman rank correlation to evaluate the association between BE with MG density and BPE. BE was more heterogeneous in ABUS than in HHUS (P < .001) and in the premenopausal group than in the postmenopausal group (P < .001). The heterogeneity of BE in the premenopausal group was higher with ABUS than with HHUS (P = .013). BE and MG density showed a moderate correlation in the postmenopausal group, but a weak correlation in the premenopausal group. BE and BPE showed moderate correlations only in the premenopausal group. ABUS showed a more heterogeneous BE, especially in the premenopausal group. Therefore, more attention is required to interpret ABUS screening in premenopausal women.
Delayed duodenal stump fistula after laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer: A case report
Authors: Kim Yeo Jin , Kim Dae Hoon , Choi Hanlim , Ryu Dong Hee , Yun Hyo Yung
Published: July 2022

Duodenal stump fistula (DSF) is one of the most serious complications of gastrectomy. The mean time to diagnosis of DSF is approximately 9 days after operation. Our report describes an extremely rare case of delayed DSF 144 days after a laparoscopic distal gastrectomy.

A 58-year-old man with drug-induced liver cirrhosis (Child-Pugh class A) underwent laparoscopic distal gastrectomy with Billroth-II reconstruction for early gastric cancer. On postoperative day 1, he underwent reoperation because of intra-abdominal bleeding. Ongoing bleeding was observed in the stapler line of the duodenal stump and was controlled using metallic surgical clips. The patient was discharged on postoperative day 14, without complications. After 144 days following the first operation, he visited the emergency room with right flank pain and high fever. Computed tomography revealed free air and abscess near the duodenal stump site.

Emergency laparotomy, abscess unlooping, and drain insertion were performed. After surgery, bile was drained by intra-abdominal drainage, and fistulography showed a duodenal fistula.

The patient was discharged 55 days after his third surgery.

This is an extremely rare case of DSF, which may be caused by the metallic surgical clips used for hemostasis of the duodenal stump stapler line. We believe that the use of metallic surgical clips for hemostasis of the duodenal stump after Billroth-II reconstruction should be avoided.
Accelerated-strategy renal replacement therapy for critically ill patients: A systematic review and meta-analysis
Authors: Lan Shao-Huan , Lai Chih-Cheng , Chang Shen-Peng , Lu Li-Chin , Hung Shun-Hsing , Lin Wei-Ting
Published: July 2022

Background:

The aim of this study was to investigate the clinical effect and safety of accelerated-strategy initiation of renal replacement therapy (RRT) in critically ill patients.

Methods:

PubMed, Embase, OVID, EBSCO, and the Cochrane Library databases were searched for relevant articles from inception to December 30, 2020. Only RCTs that compared the clinical efficacy and safety between accelerated-strategy RRT and standard-strategy RRT among critically ill adult patients with acute kidney injury (AKI) were included. The primary outcome was 28-day mortality.

Results:

A total of 5279 patients in 12 RCTs were included in this meta-analysis. The 28-day mortality rates of patients treated with accelerated and standard RRT were 37.3% (969/2596) and 37.9% (976/2573), respectively. No significant difference was observed between the groups (OR, 0.92; 95% CI, 0.70–1.12; I
2 = 60%). The recovery rates of renal function were 54.5% and 52.5% in the accelerated- and standard-RRT groups, respectively, with no significant difference (OR, 1.03; 95% CI, 0.89–1.19; I
2 = 56%). The rate of RRT dependency was similar in the accelerated- and standard-RRT strategies (6.7% vs 5.0%; OR, 1.11; 95% CI, 0.71–1.72; I
2 = 20%). The accelerated-RRT group displayed higher risks of hypotension, catheter-related infection, and hypophosphatemia than the standard-RRT group (hypotension: OR, 1.26; 95% CI, 1.10–1.45; I
2 = 36%; catheter-related infection: OR, 1.90; 95% CI, 1.17–3.09; I
2 = 0%; hypophosphatemia: OR, 2.11; 95% CI, 1.43–3.15; I
2 = 67%).

Conclusions:

Accelerated RRT does not reduce the risk of death and does not improve the recovery of kidney function among critically ill patients with AKI. In contrast, an increased risk of adverse events was observed in patients receiving accelerated RRT. However, these findings were based on low quality of evidence. Further large-scale RCTs is warranted.
Is brace necessary after cervical surgery: A meta-analysis of randomized controlled trials
Authors: Mao Yang , Jindong Zhao , Zhaohui Fang
Published: July 2022

Background:

Currently, there are increasing surgical treatments for neck pain. However, whether to use cervical brace after operation remains poorly defined. We aim to clear the clinical efficacy of the use of cervical brace after cervical surgery.

Methods:

We searched for relevant studies in 8 electronic databases up to March 2021. The mean difference and 95% confidence intervals were used for continuous data. Cochrane Collaboration’s tool was used to assess the risk of bias. The data were collected and input into the Review Manager 5.3 software (The Cochrane Collaboration, Copenhagen, Denmark).

Results:

Four randomized controlled trials were finally included in our study. For pain, the pooled analysis showed that postoperative neck brace compared with no brace can relieve neck pain at all follow-up periods except 6 months. For neck disability index, the result showed that postoperative neck brace compared with no brace can improve neck disability index during the 3 to 12 month follow-up period. However, no significant difference was identified between 2 groups within the follow-up of 6 weeks after surgery. In addition, the result tends to get the opposite at follow-up of 24 months. For 36-Short form health survey Physical Component Summary, there was no significant difference between 2 groups in the early 3 weeks after surgery, but the results were changed after 3 weeks. For 36-short form health survey Mental Component Summary, there appears to be no significant change between 2 groups at all time intervals.

Conclusion:

Wearing a cervical brace after cervical surgery is conducive to improving symptoms after cervical surgery at different stages. However, there is no relevant evidence indicating it can improve the mental health of postoperative patients. Higher quality, large prospective randomized studies are needed to verify the current conclusions.
Our experience with 80 cases of SARS-CoV-2-Clostridioides difficile co-infection: An observational study
Authors: Birlutiu Victoria , Dobritoiu Elena Simona , Lupu Claudia Daniela , Herteliu Claudiu , Birlutiu Rares Mircea , Dragomirescu Dan , Vorovenci Andreea
Published: July 2022

Beside the changes in the gut microbiota in context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the increased use of high-risk broad-spectrum antibiotics during the actual pandemic raises concerns about a possible increase of Clostridioides difficile infections (CDIs).

We retrospectively analyzed 80 consecutive patients, with SARS-CoV-2 pneumonia and CDI.

The mean length of hospitalization was 19.63 days. The mean time of the onset of the digestive symptoms related to CDI was 5.16 days. Patients with an onset of the digestive symptoms from hospital admission have a significantly lower median length in hospital stay. The recovered patients present a statistically significant decreased median age. coronavirus disease 2019 (COVID-19) cured patients present CDI symptoms much earlier than the deceased patients, when comparing the median days before the occurrence of any digestive symptoms regarding CDI. Among the patients that prior to their hospitalization for COVID-19 were exposed to antibiotics, 54.7% presented CDI digestive symptoms during their hospitalization and 65.6% had a severe or critical COVID-19 form.

Although the incidence of CDI in the pandemic is lower compared to the period before the pandemic, the severity of cases and the death rate increased. In the actual setting clinicians need to be aware of possible CDI and SARS-CoV-2 co-infection.
Clinical presentations and prognosis of metformin-associated lactic acidosis patients in the intensive care unit: A 20-year survey
Authors: Yang Chun-Chieh , Weng Shih-Feng , Tseng Kuei-Ling , Ho Chung-Han
Published: July 2022

Metformin-associated lactic acidosis (MALA) is a rare but serious adverse event. It is associated with a high mortality rate and is diagnosed by the peak lactate level (PLL). This study examines the relationship between the clinical presentations and PLL in patients under metformin therapy admitted to the intensive care unit (ICU) to better diagnose MALA and prevent a worsening prognosis. The mortality distribution of clinical characteristics among patients with MALA was also examined.

Methods:

We retrospectively analyzed 82 adult patients with MALA admitted to the ICU over 20 years. The association between the clinical parameters and mortality post-MALA was estimated using logistic regression analysis.

Results:

Patients with MALA admitted to the ICU presented with clinical symptoms mainly associated with the head (40.24%), chest (41.46%), and abdomen (35.37%). Additionally, the PLL distribution significantly varied with age, APACHE II = Acute Physiology and Chronic Health Evaluation II (APACHE II) score, various laboratory parameters like nadir arterial bicarbonate level, multiple treatment modalities such as renal replacement therapy, and mortality. The overall mortality rate was 17.07%. After adjustment of age and gender, the significant predictors of mortality were APACHE II score, PLL, vasoactive support, ventilator support, and cardiopulmonary resuscitation.

Conclusions:

Despite MALA being a rare event, it is necessary to evaluate its clinical characteristics, especially the associated PLL and mortality. In the current study, higher levels of APACHE II score and PLL show a greater likelihood of mortality in MALA patients.
Unintentional Pediatric Lithium Exposure
Authors: Seltzer Justin A. , Friedman Nathan A. , Winkler Garret A. , Lasoff Daniel , Cantrell F. Lee
Published: July 2022

Objectives

Lithium is an uncommon pediatric exposure, and the effects of accidental or exploratory ingestions are not well characterized. This study examined the clinical effects and outcomes of unintentional lithium ingestions treated in a health care facility for patients up to 16 years old.

Methods

The database from a single-state Poison Control System was queried for all pediatric lithium exposures managed in a health care facility between January 2006 and December 2021. Inclusion criteria were 16 years or younger and acute lithium exposure treated in a health care facility. Those older than 16 years, nonoral exposures, intentional, chronic, or nonlithium exposures, and out-of-state patients were excluded.

Results

One hundred eighteen cases were included, and 619 were excluded. The median age was 2 years (range, 0.5–15 years). One hundred fifteen (97%) were 7 years or younger. Sixty-eight (57.6%) were boys. One hundred thirteen (96%) were exploratory ingestions. Lithium carbonate was the most common formulation, with a median reported dose of 525 mg (range, 100–13,500 mg). Sixty-seven (57%) had serum lithium concentrations available: 19 (28%) were detectable (>0.1 mEq/L) and 4 were supratherapeutic (>1.2 mEq/L).

One hundred (85%) patients were coded as having no effects. Four (3%) patients had coded effects—1 mild, 2 moderate, and 1 major; all were polydrug ingestions and recovered fully with basic supportive care. The loss to follow-up rate was 12%.

A small minority received treatment with intravenous fluids and/or whole bowel irrigation. Thirteen (11%) were admitted, 3 to the ICU. No morbidity or mortality was reported.

Conclusions

The majority of unintentional pediatric lithium ingestions examined were exploratory and resulted in no significant symptoms. Only a small minority had detectable serum lithium concentrations. All isolated lithium exposures were asymptomatic. Unintentional exposures appear to be benign, even with detectable lithium levels. Further study is needed to better risk stratify for home care versus health care facility evaluation.
Mechanism of the Salvia miltiorrhiza-Codonopsis pilosula drug pair in the treatment of premature ovarian failure based on network pharmacology-molecular docking
Authors: Ni Rui-Jun , Dong Li , Huang Hong-Li , Xia Yanq-Qiu
Published: July 2022

Objective:

Premature ovarian failure (POF) is a disease characterized by irregular menstruation and results in infertility which markedly affects the reproductive health of women. The Salvia miltiorrhiza-Codonopsis pilosula drug pair is effective at treating POF; however, knowledge of the mechanisms of S. miltiorrhiza-C. pilosula in the treatment of POF is lacking. Thus, we carried out network pharmacology and molecular docking to clarify the mechanisms of this drug pair.

Methods:

The core components and targets of S. miltiorrhiza-C. pilosula were obtained using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) database and UniProt database, and the disease targets related to POF were searched using different tools to obtain the overlapping target genes of S. miltiorrhiza and C. pilosula. A protein interaction network of the intersection target was constructed using STRING database, and the network of “traditional Chinese medicine-active ingredient-intersection target-disease” and “pathways-targets” was constructed using Cytoscape 3.8.0. The DAVID online tool was also used to determine the gene ontology functions and Kyoto Encyclopedia of Genes and Genomes pathways associated with the intersection target genes. Finally, the binding ability of the drug to the active components and potential targets were predicted using molecular docking.

Results:

S. miltiorrhizae-C. pilosula had 72 active components, 128 targets, 3,775 POF targets, and 106 common targets. The potential targets were mainly related to the biological processes of DNA-binding transcription factor binding, RNA polymerase II-specific DNA-binding transcription factor binding, transcription factor activity, steroid receptor activity, and hypoxia response. Further, the Kyoto Encyclopedia of Genes and Genomes enrichment pathways included PI3K-Akt signaling pathway, apoptosis, interleukin (IL)-17 signaling pathway, relaxin signaling pathway, and other biological pathways.

Conclusion(s):

S. miltiorrhiza-C. pilosula can inhibit ovarian granulosa cell apoptosis and improve ovarian hemodynamics through multiple targets and multiple pathways and help treat POF.
Role of fatty acids and calcium in male reproduction
Authors: Naz Taniya , Chakraborty Srinjoy , Saha Sudipta
Published: July 2022

Both fatty acids (FAs) and calcium ions play important roles in contraceptive cycles via several systems. Polyunsaturated FAs (PUFAs) act as precursors for prostaglandin production and can alter the expression of numerous crucial catalysts that are involved in prostaglandin and steroid digestion. Lipids are essential components of cell membranes. A diet rich in PUFAs enhances sperm motility and viability. It also improves testis development and spermatogenesis in several domesticated animal species. Increased PUFA content in spermatozoa increases plasma membrane fluidity, which is important for fertilization. However, the major drawback of high dietary PUFA intake is that it increases the levels of reactive oxygen species in the body. An increase in reactive oxygen species levels markedly affects fertility. Calcium is an important component that acts as an intra-cellular secondary messenger and plays an important role in some of the physiological processes that occur in male gametes. Some of these processes include spermatogenesis, sperm motility, capacitation, acrosome response, and fusion of gametes. These processes are associated with calcium influx through ion protein channels. Dietary fat intake is associated with increased intestinal calcium absorption. In this review, we discuss the impact of lipids, particularly PUFAs and monounsaturated FAs, and calcium ions on male reproduction, along with their effects on each other.
Effect of vitrification on clinical outcomes of cleavage-stage embryos with poor quality in human embryo cryopreservation
Authors: Liu Tao , Lian Ying , Liu Ping , Li Rong , Yan Jie , Qiao Jie
Published: July 2022

Objective:

To evaluate the effect of morphologic factors on survival rate (SR), pregnancy rate (PR), and implantation rate (IR) of human embryo vitrification following frozen embryo transfer (FET) on day 3 post-ovulation.

Methods:

Women undergoing FET (n = 921) with embryos cryopreserved by vitrification between 2012 and 2013 were enrolled in this retrospective cohort study.

Results:

Embryos with >9 blastomeres yielded the highest SR of 100%. Lower SR was observed in embryos with 5 to 6 (57.5%) and 4 blastomeres (41.4%). In terms of blastomere symmetry, the SR of embryos with equally sized blastomeres was significantly higher than that of embryos with unequally sized cells (82.5% vs. 64.6%, P < 0.05). As fragmentation increased, SR decreased from 92.1% to 20.6% (P < 0.05). Significant differences were observed among groups when analyzing PR and IR according to the 3 embryonic parameters before vitrification. Embryos with 13 to 16 blastomeres yielded the highest PR (39.5%) and IR (24.1%). The PR and IR of embryos with blastomeres of equal size were significantly higher than those with unequally sized blastomeres (36.5% vs. 21.7%, 23.7% vs. 12.4%, P < 0.05). After warming, embryos with 13 to 16 blastomeres yielded the highest PR and IR (40.9% and 24.2%, respectively). The PR and IR were observed to grow with an increase in the percentage of intact blastomeres (23.2%-38.2%, 14.2%-23.2%).

Conclusions:

These results show that vitrification methods do not effectively improve survival outcomes for embryos of poor quality and it is needed to develop a comprehensive vitrification protocol that considers all the practical aspects, including the current limitation regarding cleavage-stage embryos of poor quality.
Source of human oocytes for infertility treatment and fertility preservation
Authors: Chian Ri-Cheng
Published: July 2022

The source of human oocytes is directly associated with the success of infertility treatment and fertility preservation. The number of oocytes obtained is possibly correlated with the success rate in terms of live birth rates. However, oocyte quality must be refined such that the number of oocytes is not positively correlated with the quality of oocytes. Different ovarian stimulation protocols can be used to obtain numerous oocytes. However, oocyte quality should be considered the most important factor affecting infertility treatment and fertility preservation. Infertile women are generally willing to take health-related risks to achieve a live birth, and ovarian stimulation using high-dose hormonal treatments may be harmful for both women and infants. Therefore, successful infertility treatment and fertility preservation should be defined as the birth of a healthy baby at term without compromising the health and safety of the mother and infant. Therefore, the source of high-quality oocytes must be carefully considered prior to infertility treatment and fertility preservation.
How fertility preservation guidelines have progressed worldwide: Potential implications and inspiration
Authors: Chen Min-Xin , Zhang Ying , Cai Qing-Qing , Zhang Shuo , Xu Ran , Chen Hua , Kang Yu , Wu Yue , Chian Ri-Cheng , Xu Cong-Jian
Published: July 2022

To summarize fertility preservation (FP) guidelines and consensus provided by medical facilities worldwide. Five reference databases (PubMed/Embase, China BioMedical Literature Database, ClinicalKey, Wanfang Data, and China Knowledge Resource Integrated) and 7 guideline databases (Guideline International Network, National Collaborating Centre for Women's and Children's Health, National Guideline Clearinghouse, The National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, New Zealand Guideline Group, and Canadian Medical Association infobase) were searched. Official websites of societies were searched to find relevant guidelines and consensus, and guidelines and published systematic reviews and consensus were reviewed from inception through May 2021. A literature search was performed regarding guidance offered in professional facilities, and 304 records (including 4 in Chinese) of existing guidelines for full-text review were found. Moreover, 55 guidelines were identified after a manual search. The literature review demonstrated that FP guidance and options were unevenly distributed worldwide for women who wanted to post-pone pregnancy or had impaired fertility after gonadal toxicity. With promising cancer survival rates and diversified family decisions, more attention should be paid to the improvement and update of accessible guidelines and regulatory infrastructure to inform patients about the available options and empower them to make informed choices. Restrictions to such services can be gradually eased due to the efficacy and safety of certain FP techniques for the right candidates to initiate pregnancy conception.
Non-invasive chromosome screening for embryo preimplantation using cell-free DNA
Authors: He Fang , Yao Ya-Xin , Wang Jing , Zhao Dun-Mei , Wan An-Qi , Ren Jun , Lei Xi
Published: July 2022

Preimplantation genetic testing (PGT) is a widely adopted screening method that can be performed to identify and select embryos with normal ploidy; however, PGT relies on embryo biopsy, that is, polar body, embryo cells, or trophectoderm biopsy, to obtain embryonic DNA, increase its technical limitations. Studies have indicated that biopsy may have an influence on the quality and development of embryos, and increase the chance of abnormal epigenetic modifications. Therefore, non-invasive PGT (niPGT) detection of cell-free DNA (cfDNA) has gradually become a hot research topic in the field of assisted reproduction. Studies showed cfDNA could be detected in blastocyst fluid and spent culture medium (SCM) in vitro cultured embryos. The cfDNA collection requires less skill and makes lower risk to embryos. Some studies have been conducted to evaluate the feasibility of SCM-based niPGT approaches. When comparing the ploidy consistency of cfDNA in SCM, its consistency to the conventional PGT for aneuploidies results fluctuated widely, it is critical to recognize the factors influencing accuracy. These contradictory results may be related to factors such as the difference in SCM sampling methods and sampling time, and the definition of consistency. In this review, we aimed to comprehensively summarize how researchers use embryonic cfDNA to conduct niPGT detection. It also systematically reviews the factors affecting the accuracy of the test and its underlying issues, as well as prospective applications. We hope to provide a basis for future niPGT research and a useful reference for the standardized operation of niPGT that can be widely applied in clinical practice.
Characterization of Secondary Interventions After Fenestrated-branched Endovascular Repair of Complex Aortic Aneurysms and Its Effect on Quality of Life and Patient Survival
Authors: Tenorio Emanuel R. , Mirza Aleem K. , Lima Guilherme B.B. , Marcondes Giulianna B. , Wong Joshua , Mendes Bernardo C. , Saqib Naveed , Khan Sophia , Macedo Thanila A. , Oderich Gustavo S.
Published: July 2022

Objective:

To assess the impact of secondary intervention (SI) on health-related quality of life (HR-QOL) after fenestrated-branched endovascular aortic repair (FB-EVAR) for complex abdominal aortic aneurysms and thoracoabdominal aortic aneurysms.

Background:

The effect of SI after FB-EVAR on physical and mental HR-QOL has not been described.

Methods:

A cohort of 430 consecutive patients enrolled in a prospective, nonrandomized study to evaluate FB-EVAR (2013–2020) was assessed with 1325 short-form 36 HR-QOL questionnaires preoperatively and during follow-up visits. SIs were classified as major or minor procedures. Endpoints included patient survival, freedom from aortic-related mortality (ARM), freedom from SIs, and changes in HR-QOL physical component score (PCS) and mental component score.

Results:

There were 302 male with mean age 74±8 years treated by FB-EVAR for 133 complex abdominal aortic aneurysms and 297 thoracoabdominal aortic aneurysms. After a mean follow up of 26±20 months, 97 patients (23%) required 137 SIs. At 5 years, freedom from any SI was 64%±4%, including freedom from minor SIs of 77%±4% and major SIs of 87%±3%. There was no difference in patient survival and freedom from ARM at same interval. On adjusted analysis, minor SIs correlated with improved survival. SIs had a negative correlation with PCS (r=−0.8). There were no significant changes in mental component score with SIs. Predictors for SIs were fluoroscopy time, graft design, and aneurysm sac change.

Conclusion:

SIs were needed in nearly 1 out of 4 patients treated by FB-EVAR with no effect on patient survival or ARM. SI resulted in decline in PCS.
Right Lobe Versus Left Lobe Living Donor Liver Transplantation: A Systematic Review and Meta-analysis of Donor and Recipient Outcomes
Authors: Acuna Sergio A. , Zhang Wei , Yoon Peter D. , Ivanics Tommy , Zhu Mary P. , Claasen Marco , Zuckerman Jesse , Ghanekar Anand , Cattral Mark S. , Sapisochin Gonzalo
Published: July 2022

Background.

Living donor liver transplantation (LDLT) is an established treatment for advanced liver disease. Whether right lobe (RL) or left lobe (LL) LDLT provides the best outcomes for donors and recipients remains contentious.

Methods.

MedLine, Embase, PubMed, and Cochrane Central were searched to identify studies comparing RL- and LL-LDLT and reporting donor and/or recipient outcomes. Effect sizes were pooled using random-effect meta-analysis. Meta-regressions were used to explore heterogeneity.

Results.

Sixty-seven studies were included. RL donors were more likely to experience major complications (relative risk [RR] = 1.63; 95% confidence interval [CI] = 1.30-2.05; I
2 = 19%) than LL donors; however, no difference was observed in the risk of any biliary complication (RR = 1.41; 95% CI = 0.91-2.20; I
2 = 59%), bile leaks (RR = 1.56; 95% CI = 0.97-2.51; I
2 = 52%), biliary strictures (RR = 0.99; 95% CI = 0.43-1.88; I
2 = 27%), or postoperative death (RR = 0.51; 95% CI = 0.25-1.05; I
2 = 0%). Among recipients, the incidence of major complications (RR = 0.85; 95% CI = 0.68-1.06; I
2 = 21%), biliary complications (RR = 1.10; 95% CI = 0.91-1.33; I
2 = 8%), and vascular complications (RR = 0.79; 95% CI = 0.44-1.43; I
2 = 0%) was similar. Although the rate of small for size syndrome (RR = 0.47; 95% CI = 0.30-0.74; I
2 = 0%) and postoperative deaths (RR = 0.62; 95% CI = 0.44-0.87; I
2 = 0%) was lower among RL-LDLT recipients, no differences were observed in long-term graft (hazard ratio = 0.87; 95% CI = 0.55-1.38; I
2 = 74%) and overall survival (hazard ratio = 0.86; 95% CI = 0.60-1.22; I
2 = 44%).

Conclusions.

LL donors experience fewer complications than RL donors, and LL-LDLT recipients had similar outcomes to RL-LDLT recipients. These findings suggest that LL-LDLT offers the best outcomes for living donors and similar outcomes for recipients when measures are taken to prevent small for size syndrome.
Interprofessional Electronic Consultations for the Diagnosis and Management of Neuro-Ophthalmic Conditions
Authors: Xu Timothy T. , Kung Felix F. , Lai Kevin E. , Ko Melissa W. , Brodsky Michael C. , Bhatti M. Tariq , Chen John J.
Published: July 2022

Background:

Interprofessional electronic consultation (eConsult) is a telemedicine modality in which consulting providers review outside records and provide recommendations without in-person consultation. The purpose of this study was to describe the utilization of eConsults in the management of neuro-ophthalmic conditions.

Methods:

Retrospective cohort study of all patients who received an eConsult for a neuro-ophthalmic condition at a single quaternary referral center from 2018 to 2020. Main outcome measures included proportion of eConsults in which sufficient data were provided to the neuro-ophthalmologist to generate a definitive management decision, proportion of patients for whom an in-person neuro-ophthalmology evaluation was recommended, and the eConsult's impact on patient care.

Results:

Eighty eConsults were conducted on 78 patients during the 3-year study period. Forty-eight (60.0%) subjects were female, mean age was 54 years, and 65 (81.3%) were White. The median time from eConsult request to completion was 4 days (range: 0–34 days). The most frequent eConsult questions were vision/visual field disturbances in 28 (35.0%) cases, optic neuropathies in 22 (27.5%), and optic disc edema in 17 (21.3%). At the time of eConsult, sufficient prior information was provided in 35 (43.8%) cases for the neuro-ophthalmologist to provide a definitive management decision. In 45 (56.3%) eConsults, further diagnostic testing was recommended. In-person neuro-ophthalmology consultation was recommended in 24 (30.0%) cases. Sixty-one (76.3%) eConsults provided diagnostic and/or treatment direction, and 12 (15.0%) provided reassurance.

Conclusion:

eConsults increase access to timely neuro-ophthalmic care and provide diagnostic and treatment direction to non–neuro-ophthalmology providers when sufficient information is provided at the time of eConsult.
Ontogeny and Trophic Factor Sensitivity of Gastrointestinal Projecting Vagal Sensory Cell Types
Authors: McCoy Meaghan E. , Kamitakahara Anna K.
Published: July 2022

Vagal sensory neurons located in the nodose ganglion provide a direct line of communication from the gut to the brain. Information, such as stomach stretch or the presence of ingested nutrients in the intestine, is conveyed to the caudal medulla via specialized cell types that express unique marker genes. Here, we leverage vagal cell type marker genes identified in adult mice to determine when specialized vagal subtypes arise developmentally, as well as the factors that shape their growth and target innervation. Initial sequencing and pathway analysis comparing early postnatal to adult nodose ganglia identified an enrichment of differentially expressed genes (DEGs) related to axon growth and guidance, synaptic strengthening, and DEGs downstream of brain derived neurotrophic factor (BDNF). Subsequent experiments performed to screen for trophic factor sensitivity revealed that both BDNF and glial cell derived neurotrophic factor (GDNF) robustly stimulate neurite outgrowth from early postnatal nodose ganglion explantsin vitro. Anatomical examination of whole-body trophic factor expression in perinatal mice revealed that BDNF is expressed by neurons of the nodose ganglion itself, while GDNF is expressed by developing intestinal smooth muscle cells. Thus, BDNF may support vagal neurons as a locally derived trophic factor, while GDNF may act as a target derived trophic factor supporting the growth of vagal sensory processes at distal innervation sites in the gut. Consistent with this, expression of the GDNF receptor,Gfra1, was enriched in vagal afferent cell types that project to the gastrointestinal tract. The BDNF receptor,Ntrk2,was expressed by the majority vagal sensory neurons, irrespective of cell type. Lastly, spatial mapping of genetic markers in the nodose ganglion demonstrates that defined vagal cell types begin to emerge as early as embryonic day 13, even as sensory neurons continue to grow to reach gastrointestinal targets. Despite the early onset of expression for some cell type marker genes, expression patterns of many individual cell type markers appear largely immature in prenatal life and mature considerably by the end of the first postnatal week. Together, the data support a role for GDNF in stimulating vagal sensory growth to gastrointestinal targets and establish a prolonged perinatal timeline for vagal sensory cell type maturation.
The role of hippocampal CAMKII in resilience to trauma-related psychopathology
Authors: Hazra S. , Hazra J. D. , Amit Bar-On R. , Duan Y. , Edut S. , Cao X , Richter-Levin G
Published: July 2022

Traumatic stress exposure can form persistent trauma-related memories. However, only a minority of individuals develop post-traumatic stress disorder (PTSD) symptoms upon exposure. We employed a rat model of PTSD, which enables differentiating between exposed-affected and exposed-unaffected individuals. Two weeks after the end of exposure, animals were tested behaviorally, following an exposure to a trauma reminder, identifying them as trauma ‘affected’ or ‘unaffected’. In light of the established role of hippocampal synaptic plasticity in stress and the essential role of Ca2+/calmodulin-dependent protein kinase II (CaMKII) in hippocampal based synaptic plasticity, in two separate experiments, we pharmacologically inhibited CaMKII or knocked-down αCaMKII in the dorsal dentate gyrus of the hippocampus (dDG) following exposure to the same trauma paradigm. Both manipulations brought down the prevalence of ‘affected’ individuals in the trauma- exposed population. A day after the last behavioral test, long-term potentiation (LTP) was examined in the dDG as a measure of synaptic plasticity. Trauma exposure reduced the ability to induce LTP, whereas, contrary to expectation, αCaMKII-kd reversed this effect. Further examination revealed that reducing αCaMKII expression, enables the formation of αCaMKII-independent LTP, which may enable increased resilience in the face of a traumatic experience. The current findings further emphasize the pivotal role dDG has in stress resilience.
Binucleated cells generated by nuclear movement during neural transdifferentiation from human bone marrow-derived mesenchymal cells
Authors: Bueno Carlos , Blanquer Miguel , García-Bernal David , Martínez Salvador , Moraleda José M.
Published: July 2022

Although it has been reported that bone marrow-derived cells (BMDCs) can transdifferentiate into neural cells, the findings are considered unlikely. It has been argued that the rapid neural transdifferentiation of BMDCs reported in culture studies is actually due to cytotoxic changes induced by the media. While transplantation studies indicated that BMDCs can form new neurons, it remains unclear whether the underlying mechanism is transdifferentiation or BMDCs-derived cell fusion with the existing neuronal cells. Cell fusion has been put forward to explain the presence of gene-marked binucleated neurons after gene-marked BMDCs transplantation. In the present study, we demostrated that human BMDCs can rapidly adopt a neural-like morphology through active neurite extension and binucleated human BMDCs can form with independence of any cell fusion events. We also showed that BMDCs neural transdifferentiation involves the formation of intermediate cells which can then redifferentiate into neural-like cells, redifferentiate back to the mesenchymal fate or even repeatedly switch lineages without cell division. Furthermore, we have discovered that nuclei from intermediate cells rapidly move within the cell, adopting different morphologies and even forming binucleated cells. Therefore, our results provide a stronger basis for rejecting the idea that BMDCs neural transdifferentiation is merely an artefact.
Springing Forward and Falling Back on Health: The Effect of Daylight Saving Time on Acute Myocardial Infarction
Authors: Tanaka Shinsuke , Koizumi Hideto
Published: July 2022

We examine the effects of Daylight Saving Time (DST) on the incidence of acute myocardial infarction (AMI) over three distinct time frames: short, medium, and long run. By exploiting the unique circumstances in Indiana, our findings highlight substantial short-term costs of increased AMI admissions at the spring transition by 27.2%, which last for approximately two weeks, are not displaced by counteractive reductions during the DST period, and are incurred at each transition over the years studied without adaptation. Together, in the context of current policy debates, these findings support terminating time adjustments yet provide little evidence to support permanent DST.
A scoping review of the “at-risk” student literature in higher education
Authors: Chibaya Colin , Whata Albert , Madzima Kudakwashe , Rudolph Godfrey , Verkijika Silas , Makhoere Lucky , Mosia Moeketsi
Published: July 2022

Institutions’ inclination to fulfilling the mandate of producing quality graduates is overwhelming. Insistent petition for institutions to understand their students is about creating equitable opportunities for the diverse student bodies. However, “at-risk” students ubiquitously co-exist. This article conducted a scoping review of literature published locally and internationally that sought to understand “at-risk” students in higher education. The study examined the aims, participants, variables, data analytics tools, and the methods used when the topic on “at-risk” students is studied. Broadly, we sought the bigger picture of what matters, where, when, why, and how so. The Population, Concept, and Context (PCC) framework was considered for demarcating appropriate literature for the concept and context of “at-risk” students. The JBI protocol was chosen for selecting relevant literature published between 2010 and 2022, searched from the EBSCOhost and ScienceDirect databases. A search tool was developed using the litsearchr R package and screening proceeded guided by the PRISMA framework. Although 1961 articles were obtained after applying the search criteria, 84 articles satisfied the stipulated inclusion criteria. Although Africa is lagging, research on “at-risk” students is exponentially growing in America, Europe, and Asia. Notably, relevant articles use academic data to understand students at risk of dropping-out or failing in the first year. Often, statistical and machine learning methods were preferred. Most factors that determined whether a student is at risk of failing or dropping out were found to be highly correlated with high school knowledge. Also, being “at-risk” connoted one’s geographical context, ethnicity, gender, and academic culture. It was noted that autonomously motivated students, with good time management, succeed. Ideally, institutions need to identify areas that need intervention, including courses where special tutoring programmes are needed. Institutions should detect staff who need further training. Nonetheless, psychosocial well-being programmes should augment institutional investments to improve students’ success. Precisely, institutional environments should be stimulating, conducive, and motivating.
Chaperone-mediated Autophagy Deficiency Reprograms Cancer Metabolism Via TGFβ Signaling to drive Mesenchymal Tumor Growth
Authors: Zhou Xun , Shi Yong , Shirokova Vera , Kochetkova Elena , Becirovic Tina , Zhang Boxi , Kaminskyy Vitaliy O. , Lindskog Cecilia , Hydbring Per , Ekman Simon , Genander Maria , Norberg Erik , Vakifahmetoglu-Norberg Helin
Published: July 2022

The role of chaperone-mediated autophagy (CMA) in cancer initiation and progression is not well understood due to the lack of a loss-of-function cancer models of LAMP2A, the key regulator of this process. Here, by generating an isoform-specific knockout of LAMP2A, we show that CMA deficiency promotes proliferation and tumor growth in human cancers of mesenchymal origin. Accordingly, we observed that LAMP2A diminishes in metastatic lesions compared to matched primary human tumors from the same patients. Loss of CMA enhanced TGFβ signaling in tumors, rewired the tumor metabolome to promote anabolic pathways and mitochondrial metabolism, meeting the metabolic requirements of rapid growth. Mechanistically, we show that TGFβR2 enhances the enzymatic activity of glucose-6-phosphate dehydrogenase (G6PD), the rate-limiting enzyme of the pentose phosphate pathway (PPP), to promote the generation of nucleotides. Consequently, pharmacological inhibition of TGFβ-signaling in LAMP2A-KO cells suppresses G6PD activity, mitochondrial metabolism, and proliferation to WT levels. Conversely, pharmacological inhibition of mitochondrial metabolism suppressed LAMP2A-KO driven proliferation. Overall, our study provides a molecular mechanism on the CMA’s tumor-suppressive function by connecting two important oncogenic pathways, the TGFβ signaling and PPP metabolism, to the loss-of-function LAMP2A in mesenchymal cancer types.
Role of lone-pair electron localization in temperature-induced phase transitions in mimetite
Authors: Cametti Georgia , Nagashima Mariko , Churakov Sergey V.
Published: July 2022

The crystal structure of mimetite Pb5(AsO4)3Cl, a phosphate with apatite structure-type has been investigated in situ at 123, 173, 273, 288, 353 and 393 K. A careful inspection of the diffraction pattern and subsequent structure refinements indicated that mimetite transforms from the monoclinic to the hexagonal polymorph with increasing temperature. At 123 K, a monoclinic superstructure, mimetite-2M, with cell parameters a = 20.4487 (9),  b = 7.4362 (2), c = 20.4513 (9) Å, β = 119.953 (6)°, V = 2694.5 (2) Å3 and space group P21 was observed. From 173 to 353 K, the reflections of the supercell were evident only along one direction of the corresponding hexagonal apatite-cell and the structure transforms to the polymorph mimetite-M with space group P21/b and unit-cell parameters a = 10.2378 (3), b = 20.4573 (7), c = 7.4457 (2) Å, β = 120.039 (5)°, V = 1349.96 (9) Å3. Only at higher temperature, i.e. 393 K, does mimetite adopt the hexagonal space group P63/m characteristic of apatite structure-types. The role of the electron lone pairs of Pb atoms in the phase transition was investigated through the analysis of the electron localization function (ELF) calculated based on the DFT-geometry optimized structures of the three polymorphs. The changes in spatial distribution of the 6s
2 electron density during the phase transitions were explored by means of the Wannier Function Centres (WFCs) derived from ab initio molecular dynamics trajectories. In the high-temperature hexagonal structure the 6s
2 electrons are spherically symmetric relative to the position of Pb atoms. At low temperature the maximum of 6s
2 electron density is displaced relative to the position of Pb atom contributing to the polar interaction in the monoclinic polymorphs.
Macroeconomic and institutional conditions: the drivers behind divestment of FDI in Sub-Saharan Africa
Authors: Edo Samson , Nnadozie Obianuju
Published: July 2022

Purpose

The purpose of this paper is to determine how macroeconomic performance work with institutional quality influences divestment of foreign direct investment (FDI) in Sub-Saharan Africa, in the short and long run.

Design/methodology/approach

This paper investigates divestment of FDI in Sub-Saharan Africa, within the period 1980–2020. The investigation is undertaken by first comparing the trend with what is obtained in other economic regions of the world. The factors behind the divestment are subsequently investigated, using the vector error-correction model.

Findings

In the comparative analysis, Sub-Saharan Africa and other regions are observed to have witnessed sustained divestment in recent years. The estimation results of the model reveal that macroeconomic performance and institutional quality are the predominant drivers behind the divestment.

Research limitations/implications

The findings, however, do not conform to the neoclassical theory that lays emphasis on investment return as the fundamental factor influencing investment. Long-run structural stability is also established; hence, the results may be considered suitable for predicting future divestment in the region.

Practical implications

In view of the empirical findings, macroeconomic performance and institutional quality need to be improved to ameliorate FDI divestment in Sub-Saharan Africa.

Originality/value

There is paucity of research works on divestment of FDI in Sub-Saharan Africa. Again, there is paucity of works on how macroeconomic and institutional conditions work together to influence divestment. This study provides some evidence to bridge the perceived gaps.