bluuebunny/crossref_metadata_2025 huggingface dataset:
P722 Compositional differences of gut microbiome using taxonomic profiling in patients with ulcerative colitis after treatment with vedolizumab
Authors: Yoon A , Kim K , Oh K , Kim E S , Kim E H , Kim S , Jeong J Y , Kweon M N , Hwang S W , Park S H , Myung S J , Yang S K , Ye B D
Published: January 2022

Background

Gut microbial dysbiosis has been suggested to contribute to pathogenesis of inflammatory bowel disease (IBD). Vedolizumab (VDZ), an α4β7 integrin blocker, has been used as an effective agent for patients with IBD. However, effect of VDZ on gut microbiome and its relationship with efficacy outcomes are still unclear. We investigated gut microbial change in patients with ulcerative colitis (UC) during VDZ treatment.

Methods

Patients with UC were prospectively enrolled and were given a 300 mg infusion of VDZ at weeks 0, 2, and 6 as an induction therapy and then every 8 weeks as a maintenance therapy. In cases of insufficient response, the interval of maintenance therapy was shortened to every 4 week infusion. Faecal samples were collected at weeks 0, 14, and 54 and 16S rRNA gene microbiome profiling analysis was performed. Clinical remission (CREM), clinical response (CRES), endoscopic mucosal healing (MH) and biochemical response (BioRES) were evaluated. Compositional differences in microbiome were analysed according to CREM, CRES, MH, and BioRES at weeks 0, 14, and 54.

Results

Faecal samples were collected from 27 patients and patients were classified according to their outcomes (Table 1). In the analyses regarding species richness (ACE, Chao1, Jackknife, The number of OTUs) and diversity indices (NPShannon, Shannon, Simpson, Phylogenetic Diversity), no significant difference was observed among groups at weeks 0, 14, and 54. There were no significant changes in microbial composition at week 14 and 54, respectively compared to basal level. However, compared to baseline, relative abundance of genus Prevotella showed significant differences between groups which achieved normalsation of C-reactive protein or not (p=0.0394) (Figure 1). In the linear discriminant analysis effect size (LEfSe) analysis, the genus Actinomyces and the species Actinomyces odontolyticus group increased in patients who had no response at efficacy outcomes (achievement of clinical remission, achievement of clinical response, achievement of endoscopic mucosal healing, normalisation of C-reactive protein, and normalisation of faecal calprotectin) at week 14, compared to week 0 (Fig 2A). The genus Clostridium_g24, the species Paraprevotella_uc and PAC001224_s were also significantly increased in the same patient group at week 54 (Fig 2B).

Conclusion

In UC patients treated with VDZ, microbial composition showed differences depending on the achievement of efficacy outcomes. Further studies regarding the causal relationship between microbial composition and outcomes are warranted with a larger number of patients.
N04 A systematic review of the impact of Inflammatory Bowel Disease (IBD) on family members
Authors: Thapwong P , Norton C , Rowland E , Farah N , Czuber- Dochan W
Published: January 2022

Background and Aims

Inflammatory Bowel Disease (IBD) impacts the individuals’ quality of life and affects all family members considerably. Previous reviews have focused on the impact of IBD on the patient, with limited exploration of the impact of IBD on family members. Therefore, this review aims to synthesise existing knowledge on the impact of IBD on family members, their coping strategies, the support needed, and interventions for family members to prevent and alleviate the burden of IBD.

Methods

A systematic review using the mixed-method systematic review approach suggested by Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews (PRISMA) was undertaken. A systematic search of six bibliographic databases: MEDLINE, EMBASE, PsycINFO, CINAHL, British Nursing Index, and Web of Science, was performed in February 2021. The search focused on the impact of IBD on family members and coping strategies and interventions for this population. A narrative synthesis was conducted.

Results

In total, 3,258 records were identified, from which 33 relevant papers (2,748 participants) were included in the review, with case-control, cross-sectional, and qualitative designs. Synthesis of these papers found three themes: the impact of IBD on family members; the coping strategies for family members to overcome the negative impact of IBD; and the support needed. The IBD affects the family members in term of emotional well-being, fear and concern, relationship and social life, work and financial impacts, and leisure time and travelling. The coping strategy theme shows that family members use adaptive coping patterns such as acceptance, resilience, and emotional support from others. Maladaptive coping patterns such as denial following the initial relief of diagnosis, self-distraction, and self-blame were also used. In the theme ‘support needed’, family members reported the need for improved information about IBD, social support groups, self-help groups, educational meetings, and providing easy access to a counsellor or psychologist to support family members. There have been no studies assessing outcomes of interventions to relieve family members’ burden in the IBD population.

Conclusion

Our findings suggest that policymakers in healthcare services should emphasise the multidisciplinary professional care model such as a family therapist, IBD nurse, and psychologist. Researchers could incorporate a bio-psycho-social approach into their work on IBD to improve quality of life of both patients and their family members.
N09 Disease knowledge and quality of life perception in Inflammatory Bowel Disease: a randomised controlled trial
Authors: Martinato M , Comoretto R I , Monaco E , Ocagli H , Gregori D
Published: January 2022

Background

Inflammatory bowel diseases (IBD) negatively impact daily activities and perceived quality of life (QoL); good information of IBD patients on disease, diagnostics, and treatments may change this perception, even if the evidence on this topic is lacking; moreover, too much information overwhelms the patient, which inhibits both understanding and recall. No studies are available on the impact produced by different techniques or amounts of information provided. This study aimed at assessing the impact of essential, patient-centred information on the level of knowledge and on the QoL in IBD patients.

Methods

Patients with a recent diagnosis of IBD in follow-up at a third-level referral centre were randomly assigned to two different interventions, the “standard of care” information package or the experimental one. The latter is a synthetic, standardised, and structured informative intervention developed with a “less is more” approach in collaboration with local IBD patients’ associations. The knowledge level was measured with the Crohn’s and Colitis Knowledge score – CCKNOW – (Eaden, Abrams, and Mayberry, 1999), while the perception of QoL with the Short Inflammatory Bowel Disease Quality of life - S-IBDQ – (Irvine, Zhou, and Thompson, 1996). Disease activity was assessed with the Modified Trulove and Witt Severity Index - MTWSI - (Lichtiger et al., 1994) in ulcerative colitis and the Harvey Bradshaw Index – HBI – (Harvey and Bradshaw, 1980) in Crohn’s disease.CCKNOW, S-IBDQ and MTWSI or HBI were administered at baseline and two months after the intervention.

Results

68 patients were assessed for study participation and 49 were enrolled. At baseline, the patients’ level of knowledge was very low, with correct answers ranging from 2 to 50% in different domains, positively correlated with the patient’s instruction level (ρ = 0.40; p<0.01) and negatively with age (ρ = -0.30; p<0.05). QoL, disease activity, gender, disease duration, type of IBD, number of outpatient visits, and hospital admissions were not related to the level of knowledge. Two months after the administration of the educational intervention, patients in the experimental group showed a higher level of knowledge than the control group (p<0.01) and better perception of QoL (p<0.01), while disease activity remained stable in both groups.

Conclusion

Increasing patients’ knowledge improves QoL and an educational intervention with less information performed shortly after diagnosis significantly improves the patient’s knowledge and QoL, regardless of disease activity.
What Happens on the Back Table? Viability and Osteogenic Potential of Reamed Autogenous Bone Graft as a Function of Time and Temperature—A Pilot Study
Authors: Kantor Adam H. , Uffmann William , Marchand Lucas S. , Haller Justin M. , Higgins Thomas F. , Rothberg David L.
Published: January 2022

Objectives:

To provide guidelines for reamed autogenous bone graft (R-ABG) in nonunion surgery to best manage modifiable intraoperative factors, like storage temperature and time, for optimal graft viability. Our hypothesis was that R-ABG graft will show decreased cell viability as a function of increased time and storage temperature.

Methods:

R-ABG samples were obtained using an RIA system from 10 patients undergoing harvest for the treatment of a nonunion. A 10 cm3 sample of cancellous bone graft was divided into 10 samples. A control sample was processed immediately and analyzed using fluorescence activated cell sorting to determine its cell viability. The remaining samples were stored at 0, 15, and 37°C and processed similarly after 60 and 120 minutes. A paired t test was used to compare the mean change in percent viability.

Results:

The mean percent cell viability for the experimental conditions was not significantly different from the initial percent cell viability (P ≥ 0.08). There were no significant differences in the change in mean percentage of viable cells (P ≥ 0.07). After 60 and 120 minutes of storage, there were no significant differences in mean cell viability based on storage temperature (P ≥ 0.53 and P ≥ 0.68, respectively). A power analysis estimated that a sample size of 52 patients would be needed to detect a difference.

Conclusions:

The results of our pilot study indicate that storage conditions may have less effect on cell viability than previously hypothesized. Further research with more patients is needed to confirm these preliminary results.

Level of Evidence:

Level II.
Treg/Th17 Ratio Regulation May Play an Important Role in Epigallocatechin-3-Gallate–Mediated Attenuation of Increased Afterload-Induced Cardiac Hypertrophy
Authors: Luo Min , Mou Qiuhong , Liu Lingjuan , Tian Jie , Liu Lifei
Published: January 2022

The aim of this study was to investigate whether Treg/Th17 ratio regulation plays an important role in epigallocatechin-3-gallate (EGCG) in attenuating increased afterload-induced cardiac hypertrophy. Three-month-old male C57BL/6 mice were divided into sham + vehicle, abdominal aortic constriction (AAC) + vehicle, and AAC + EGCG groups. Intraperitoneal EGCG (50 mg/kg/d) administration was conducted. Cardiac structure and function were examined by ultrasonography. Pathology was examined by hematoxylin and eosin staining, wheat germ agglutinin staining, and Masson's trichome staining. T-lymphocyte subtypes were analyzed using immunofluorescence and flow cytometry assays. Ultrasonography showed that the ventricular wall in the AAC + vehicle group was thicker than that in the sham + vehicle group (P < 0.05). Hematoxylin and eosin staining revealed cardiomyocyte hypertrophy accompanied by a small amount of inflammatory cell infiltration in the AAC + vehicle group. The results of wheat germ agglutinin staining demonstrated the presence of hypertrophic cardiomyocytes in the AAC + vehicle group (P < 0.01). Masson's trichome staining showed cardiac fibrosis in the AAC + vehicle group, and the immunofluorescence assay revealed infiltration of CD4+ cells in both AAC + vehicle and AAC + EGCG groups. Splenic flow cytometry showed a significant increase in the proportion of Treg cells in the AAC + EGCG group (P < 0.05). The proportion of Th17 cells in the AAC + vehicle group was significantly higher than that in the sham + vehicle group (P < 0.05). In conclusion, changes in the Treg/Th17 ratio are associated with the occurrence of myocardial hypertrophy caused by increased afterload. Moreover, regulation of the Treg/Th17 ratio by EGCG may play an important role in the attenuation of myocardial hypertrophy.
Impact of Laparoscopic Sleeve Gastrectomy on Cardiovascular Pharmacotherapy in Left Ventricular Assist Device Patients
Authors: Al-Ani Mohammad A. , Murray Melissa R. , Taha Mohamad Badie , Meece Lauren , Elsayed Abdelrahman H. , Jeng Eric I. , Arnaoutakis George J. , Wu Yu , Friedman Jeffrey E. , Vilaro Juan R. , Parker Alex M. , Aranda Juan M. , Ahmed Mustafa M.
Published: January 2022

Left ventricular assist device (LVAD) implantation is increasingly utilized in patients with advanced heart failure and morbid obesity. Laparoscopic sleeve gastrectomy (LSG) can facilitate weight loss in this population and can ultimately change the pharmacokinetics of heart failure therapeutics. In this study, we aimed to explore the changes in cardiovascular pharmacotherapy post LSG intervention. We conducted a retrospective observational cohort study of morbidly obese LVAD patients between 2013 and 2019 at the University of Florida with available pharmacotherapeutic data at 1 and 6 months. Thirteen post-LSG patients and 13 control subjects were included in the final analysis. In the post-LSG group, the mean body mass index decreased significantly (44 ± 5 vs. 34 ± 4.9, P < 0.001), and 7 patients were successfully bridged to cardiac transplantation. Only 3 patients required adjustment of their LVAD speed. Mean return to flow decreased by 8 mm Hg, despite a 45% reduction in the mean number of vasodilators per patient (1.2 vs. 0.7, P = 0.03). Mean weekly warfarin dose decreased by 35% after 6 months (32.9 ± 20.9 vs. 50.7 ± 26.6, P = 0.01). The use of diuretics, vasodilators, and beta-blockers was significantly reduced by 50%, 45%, and 35%, respectively. None of these changes were observed in the control group at 6-month follow-up post LVAD. In this single-center experience, weight loss post LSG is associated with decreased vasodilator, diuretic, and anticoagulant medication requirements in LVAD patients.
Management of a Highly Vascular Low-grade Myofibroblastic Sarcoma of the Mandible
Authors: Emanuelli Elisa , O’Connor Michaela , Garg Ravi K.
Published: January 2022

An 11-year-old male patient presented with a large, highly vascular, destructive mandibular mass. An intraoral biopsy showed pleomorphic spindle cells arranged in intersecting fascicles, with scattered atypia. A diagnosis of low-grade myofibroblastic sarcoma was made. The lesion was treated with preoperative arterial embolization followed by surgical resection and reconstruction with a fibular osteomyocutaneous free flap. To our knowledge, no reports of highly vascular mandibular low-grade myofibroblastic sarcoma are available in the literature.
Demonstrating Excellence in Plastic Surgery Residency
Authors: Hackenberger Paige N. , Janis Jeffrey E.
Published: January 2022

Background:

Residents can achieve distinction by discerning which areas of achievement are worth additional focus at each stage in training. Our survey examines the perspectives of faculty members affiliated with Accreditation Council for Graduation Medical Education–accredited plastic surgery residency programs regarding qualities indicative of resident excellence.

Methods:

A survey including Likert scales and rank-ordering was distributed to plastic surgery program directors and faculty with the intent to assess perspectives regarding resident excellence at each stage of training. Responses were analyzed using marginal homogeneity tests and summary tables.

Results:

In total, 90 respondents completed the survey. An estimated 94.5% believe it is possible for residents to achieve excellence at any stage of clinical training, and 87.7% report their definition of excellence differs by training level. Top three metrics indicative of resident excellence for interns and junior residents were preparation for operative cases, bedside manner, and personality. For seniors: preparation for operative cases, leadership capability, and bedside manner. For chief residents: preparation for operative cases, leadership capability, and technical operative expertise.

Conclusions:

A resident who displays excellence inspires mentorship, which can propel future career success. Faculty agree excellence can be achieved by residents of any stage, although the qualities that define this evolve by training year. Preparation for operative cases is considered a critical component of resident performance at all levels. Bedside manner and personality are ways intern and junior level residents excel, whereas leadership ability and technical expertise in the operating room become significant in senior and chief trainees.
Increased Health Risk in Office Workers in the COVID-19 Era
Authors: Suka Machi , Shimazaki Takashi , Yamauchi Takashi , Yanagisawa Hiroyuki
Published: January 2022

Objective:

To examine whether the incidence of health problems increases during the COVID-19 pandemic.

Methods:

Using the health examination data (April 2018–March 2021) of Japanese workers aged 15 to 64 years, the 1-year incidence of five health problems (overweight, hypertension, hypercholesterolemia, hyperglycemia, and liver damage) and four unhealthy habits (snacking, heavy drinking, physical inactivity, and sleep deprivation) were compared before and during the COVID-19 pandemic.

Results:

The 1-year incidence of overweight, hypertension, hyperglycemia, and liver damage increased by 15% to 65% during the COVID-19 pandemic. Increased weight gain, related to decrease physical activity during the COVID-19 pandemic, was significantly associated with increased incidence of health problems.

Conclusions:

The COVID-19 pandemic have deteriorated workers’ health even without the COVID-19 infection. Lifestyle interventions should be promptly started particularly targeting workers with gained weight to avoid more serious consequences.
Impact of Cochlear Implantation on Canal and Otolith Function
Authors: Kwok Belinda Y. C. , Rosengren Sally M. , Kong Jonathan H. K. , Birman Catherine S. , Hoskisson Emma , Young Allison S. , Argaet Emma C. , Fratturo Luke , Rivas Cheryl , Greenberg Simon L. , Saxby Alex J. , Welgampola Miriam S.
Published: January 2022

Objective:

To quantify the impact of cochlear implantation (CI) on all five vestibular end-organs and on subjective ratings of post-CI dizziness.

Methods:

Seventy-two patients undergoing unilateral CI were recruited for the study. All participants completed pre- and post-CI three-dimensional video head-impulse tests (3D vHITs) to assess semicircular-canal (SC) function, air- and bone-conducted (AC and BC) cervical and ocular vestibular-evoked myogenic potentials (cVEMPs and oVEMPs) to assess otolith-function and the dizziness handicap inventory (DHI) to measure self-perceived disability.

Results:

Nineteen percent of patients reported new or worsened dizziness postsurgery. Post-CI abnormalities (new lesions and significant deteriorations) were seen in the AC cVEMP (48%), AC oVEMP (34%), BC cVEMP (10%), and BC oVEMP (7%); and lateral (L) (17%), posterior (P) (10%), and anterior (A) (13%) SC vHITs. CI surgery was more likely to affect the AC cVEMP compared with the other tests (χ2 test, p < 0.05). Fifty percent of patients reported no dizziness pre- and postsurgery. In the implanted ear, normal pre-CI vHIT gain was preserved in lateral semicircular canal (LSC) (69%), anterior semicircular canal (ASC) (74%), and posterior semicircular canal (PSC) (67%), and normal reflex amplitudes were found in AC cVEMP (25%), AC oVEMP (20%), BC cVEMP (59%), and BC oVEMP (74%). Statistically significant decreases were observed in LSC vHIT gain, AC cVEMP amplitude, and AC oVEMP amplitude postsurgery (p < 0.05). There was a significant moderate positive correlation between change in DHI scores and the summed vestibular deficit postsurgery (r
(51) = 0.38, p < 0.05).

Conclusion:

CI can impact tests that assess all five vestibular end-organs and subjective ratings of dizziness. These results support pre and post-surgical vestibular testing and assist preoperative counseling and candidate selection.
A rare case report of obstructive jaundice caused by mucus-producing cholangiocarcinoma
Authors: Duan Botao , Zhao Xuekai , Fan Songsong , Zhou Lei , Zhang Xingyuan
Published: January 2022

Rationale:

Cholangiocarcinoma is a common cause of obstructive jaundice but is mainly associated with solid mass and not semisolid secretion. In this report, the patient was admitted to the hospital with obstructive jaundice; however, no solid mass was found to lead to jaundice.

Patient concerns:

The patient developed symptoms of obstructive jaundice for 10 days, including fatigue and yellow skin staining.

Diagnoses:

Postoperative pathological examination of the bile duct wall revealed cholangioadenocarcinoma, and the jelly like contents were inflammatory secretions.

Interventions:

The patient underwent laparotomy and was diagnosed with obstructive jaundice. An exploratory laparotomy revealed that the content in the biliary duct tree was a jelly like inflammatory secretion.

Outcomes:

Follow-up data revealed that the levels of total bilirubin and aminotransferase were normal, and a computed tomography scan showed no tumor mass.

Lessons:

There are very few reports about obstructive jaundice caused by inflammatory secretion that almost filled up the biliary tree. Internal drainage of the cholestatic bile can be achieved through endoscopic retrograde cholangiopancreatograpy, or external drainage can be achieved through percutaneous transhepatic biliary drainage, which can relieve the symptoms of biliary obstruction and improve the patient's quality of life.
Evaluating the impact of personalized rehabilitation nursing intervention on postoperative recovery of respiratory function among thoracic surgery intensive care unit patients
Authors: Li Chun-Yan , Liang Wen , He Yan-Qin , Han Qun
Published: January 2022

Background:

Exercise tolerance and lung function can be improved by pulmonary rehabilitation. As a result, it may lower thoracic surgery intensive care unit (ICU) patients’ postoperative problems and death. Enhanced recovery after surgery has advanced significantly in the perioperative care of thoracic surgery ICU patients in recent years, and it now plays an essential role in improving ICU patients’ postoperative prognosis. Appropriate tailored rehabilitation nursing intervention is required to promote the postoperative recovery of respiratory function in thoracic surgery ICU patients. This study aims to look at the influence of tailored rehabilitation nurse intervention on postoperative respiratory function recovery in thoracic surgery ICU patients.

Methods:

To find relevant papers, a comprehensive search of electronic databases will be conducted, including three English databases (PubMed, EMBASE, and the Cochrane Library) and two Chinese databases (Chinese National Knowledge Infrastructure and WanFang). Only research that has been published in either English or Chinese will be considered. The retrieval period will run from November 2021 to November 2021. We will look at randomized controlled trials (RCTs) studies that looked at the effect of a customized rehabilitation nursing intervention on the recovery of respiratory function in thoracic surgery ICU patients after surgery. Two writers will review the literature, retrieve study data, and assess the included studies’ quality. Any disagreements will be settled via consensus. RevMan 5.3 will be used to do the meta-analysis.

Results:

This research will offer high-quality data on the influence of customized rehabilitation nurse intervention on postoperative respiratory function recovery in thoracic surgery ICU patients.

Conclusion:

This study will look at whether a targeted rehabilitation nurse intervention might help thoracic surgery ICU patients recover their respiratory function more quickly after surgery.

Ethics and dissemination:

There will be no need for ethical approval.

Registration number:

December 12, 2021.osf.io/9rdu2/ (https://osf.io/9rdu2/).
Metabolomic biomarkers for hepatocellular carcinoma
Authors: Feng Ningning , Yu Fatao , Yu Feng , Feng Yuling , Zhu Xiaolin , Xie Zhihui , Zhai Yi
Published: January 2022

Background:

Hepatocellular carcinoma (HCC) is a highly malignant cancer which lack of effective diagnosis and prognosis biomarkers, therefore surging studies focused on the metabolite candidates for HCC. The current study was designed to systematically review the metabolic studies for HCC, summarize the current available evidence and provide implication for further studies within this area. By systematically screening Pubmed and Embase, and eligibility assessment, we eventually included 55 pieces of studies. After summarized their characteristics, we reviewed them by 3 parts, regarding to the different biofluid they carried out the experiments. By collecting the candidates from all the included studies, we carried out pathway enrichment to see the representative of the reported candidates, as expected the pathway consistent with the current knowledge of HCC. Next, we conduct quality assessment on the included studies. Only 36% of the current evidence grouped as high quality, indicating the quality of metabolic studies needs further improvement.
Job stress and satisfaction in southwest Chinese hospitals
Authors: Li Yuan , Chu Lan , Zha Zongyi
Published: January 2022

This paper discusses the job characteristics, satisfaction, and stress levels experienced by clinical neurologists in Guizhou Province, China.

A questionnaire survey was conducted associated with the 2021 Annual Meeting of Neurology in Guizhou province. After obtaining ethical approval to conduct the study, the target group was asked to complete an anonymous online survey that included sociodemographic data, followed by questions related to job stress and satisfaction as well as future aspirations.

Four hundred sixty people participated in the study, including 179 (38.9%) men and 281 (61.1%) women. About 407 (88.5%) felt stress in their job. Three hundred and seventeen (68.9%) experienced depression, 307 (66.7%) experienced anxiety, and 273 (59.3%) had some degree of sleep disturbance. Three hundred fifty-three (76.7%) were disappointed with their wages, 239 (52.0%) were bored with their jobs, and 353 (76.7%) considered their jobs to be somewhat dangerous. Interestingly, 250 (54.3%) would consider becoming doctors again, but 354 (77.0%) preferred their child not to become doctors. While 338 (73.5%) said they were proud to be a neurologist, only 123 (26.7%) indicated they were optimistic concerning doctor-patient relationships.

Neurologists have significant emotional factors associated with their careers, which are more likely to lead to job burnout and decreased job satisfaction. Attention should be paid to these stresses to improve the retention and job satisfaction of neurologists.
The impact of operating room noise levels on stress and work efficiency of the operating room team
Authors: Peng Li , Chen Jia , Jiang Hong
Published: January 2022

Background:

There is no high-quality meta-analysis in the literature to determine the noise level in the operating room. Therefore, the aim of this study is to systematically review the available evidence in the literature to elucidate the impact of operating room noise levels on stress and work efficiency of the operating room team.

Methods:

Two individual researchers will conduct the platform searches on the PubMed, Cochrane Library, and Embase databases from inception to June 1, 2022. The cohort studies assessing the impact of operating room noise levels on stress and work efficiency of the operating room team will be included. The outcomes include total workload level, stress scores, anxiety scores, operation time. We will collect data according to the guidelines in the Cochrane Handbook for Systematic Reviews of Interventions. The Meta analysis will be performed using Review Manager version 5.3 provided by the Cochrane Collaboration. Risk bias analysis of the studies will be performed independently by two reviewers using the Cochrane Risk of Bias Assessment Tool.

Results:

The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.

Registration number:

10.17605/OSF.IO/7N8RY.
A high density of PD-L1-expressing immune cells is significantly correlated with favorable disease free survival in nonmetastatic colorectal cancer
Authors: Kuo Ya-Ting , Liao Chun-Kai , Chen Tse-ching , Lai Chen-Chou , Chiang Sum-Fu , Chiang Jy-Ming
Published: January 2022

The impact of immune cells (ICs) expressing various markers remains poorly understood in nonmetastatic colorectal cancer patients who have undergone colectomy. Here, we aimed to clarify the correlation between IC density and clinical parameters and survival.

Programmed death protein-1 (PD-1), programmed cell death protein ligand-1 (PD-L1), clusters of differentiation (CD)-3, CD-8, and CD45RO immunostaining was performed for 421 patients using tissue microarray and automatic counting. Tumor stroma area immune density was assessed in comparison to clinical histological factors and surgical outcomes.

High-density CD-8 expression was significantly associated with current smoking habits or a smoking history (P = .006). High-density of PD-1 expression was correlated with Lynch syndrome patients (P < .001) and with patients who did not consume alcohol (P = .034). A significant decrease in CR45RO expression density was associated with aging (P = .002 and r = –0.014), and high-density CD-3, CD-8, and PD-1 expression was significantly associated with right colon tumor location (P < .001). High CD-3 and PD-L1 expression was significantly associated with early tumor T-staging (P = .018 and P = .002). High-density PD-1 expression was significantly correlated with mucinous type adenocarcinoma (P = .027) and poor differentiation (P < .001). For treatment outcomes, multivariate analysis confirmed that patients exhibiting high-density PD-L1 expression possessed significantly longer disease free survival (adjusted hazard ratio: 0.752, 95% confidence interval [CI]: 0.61–0.92, P = .006) and overall survival (adjusted hazard ratio: 0.872, 95% CI: 0.75–1.91, P = .064)

Significantly varied density in IC subsets was related to distinct demographic or clinic-histological factors. The presence of high-density PD-L1-expressing ICs is an independent favorable prognostic factor for disease free survival and overall survival among stage I to III colorectal cancer patients.
The relationship between NLR/PLR/LMR levels and survival prognosis in patients with non-small cell lung carcinoma treated with immune checkpoint inhibitors
Authors: Liu Na , Mao Jinmei , Tao Peizhi , Chi Hao , Jia Wenhui , Dong Chunling
Published: January 2022

Background:

The relationship between neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR) and the dire prognosis of non-small cell lung carcinoma patients who received immune checkpoint inhibitors (ICIs) are not known yet.

Methods:

We screened the articles that meet the criteria from the database. The relationship between NLR/PLR/LMR levels and the survival and prognosis of non-small cell lung cancer patients treated with ICIs was analyzed. Summarize hazard ratio (HR) with 95% confidence interval (CI) to study progression-free survival (PFS) and overall survival (OS).

Results:

Thirty-four studies involving 3124 patients were enrolled in the final analysis. In short, high pre-treatment NLR was related to poor OS (HR = 2.13, 95% CI:1.74–2.61, P < .001, I2 = 83.3%, P < .001) and PFS (HR = 1.77, 95% CI:1.44–2.17, P < .001, I2 = 79.5%, P < .001). Simultaneously, high pre-treatment PLR was related to poor OS (HR = 1.49, 95% CI:1.17–1.91, P < .001, I2 = 57.6%, P = .003) and PFS (HR = 1.62, 95% CI:1.38–1.89, P < .001, I2 = 47.1%, P = .036). In all subgroup analysis, most subgroups showed that low LMR was related to poor OS (HR = 0.45, 95% CI: 0.34–0.59, P < .001) and PFS (HR = 0.60, 95% CI: 0.47–0.77, P < 0.001, I2 = 0.0%, P < .001).

Conclusion:

High pre-treatment NLR and pre-treatment PLR in non-small cell lung carcinoma patients treated with ICIs are associated with low survival rates. Low pre-treatment and post-treatment LMR are also related to unsatisfactory survival outcomes. However, the significance of post-treatment NLR and post-treatment PLR deserve further prospective research to prove.
Clinical impact of pulmonary hypertension on the outcomes of acute myocardial infarction patients with or without chronic obstructive pulmonary disease
Authors: Oh Seok , Kim Ju Han , Cho Kyung Hoon , Kim Min Chul , Sim Doo Sun , Hong Young Joon , Ahn Youngkeun , Jeong Myung Ho
Published: January 2022

Acute myocardial infarction (AMI) and chronic obstructive pulmonary disease (COPD) are leading global causes of morbidity and mortality. In patients with both of these conditions, the presence of pulmonary hypertension (PH) can further worsen their prognosis. We examined the outcomes of AMI patients with COPD (AMI+COPD) and without COPD (AMI−COPD), depending on the presence or absence of PH.

A total of 318 AMI patients with COPD (AMI+COPD cohort) (n = 109) or without COPD (AMI-COPD cohort) (n = 209) were included in this study and were subdivided into 2 groups according to right ventricular systolic pressure (RVSP) level (PH group [RVSP ≥35 mm Hg] and no PH group [RVSP <35 mm Hg]).

We investigated characteristics and clinical outcomes in both the AMI-COPD and AMI+COPD cohorts. When investigating in-hospital clinical outcomes, the PH group had a higher proportion of new-onset heart failure (HF) in both cohorts. In the AMI+COPD cohort, however, the PH group had a higher incidence of cardiogenic shock than the no PH group, which was consistent with the result of the post-inverse probability of treatment weighting (IPTW) analysis. When investigating 1-year clinical outcomes, the PH group had higher incidences of a major adverse cardiac event and all-cause mortality in both cohorts. This finding was mainly driven by cardiac death in the AMI-COPD cohort, whereas it was mainly driven by non-cardiac death in the AMI+COPD cohort. After IPTW adjustment, these differences were statistically attenuated such that all variables were similar between both groups.

PH may be associated with the development of new-onset HF (in all patients) and cardiogenic shock (in the AMI+COPD cohort). In addition, PH may be also associated with all-cause mortality, although it was statistically attenuated after IPTW adjustment.
Differences in peripheral immune system gene expression in frontotemporal degeneration
Authors: Sawyer Russell P. , Hill Emily J. , Yokoyama Jennifer , Medvedovic Mario , Ren Yan , Zhang Xiang , Choubey Divaker , Shatz Rhonna S. , Miller Bruce , Woo Daniel
Published: January 2022

The peripheral immune system has a key pathophysiologic role in Frontotemporal degeneration (FTD). We sought a comprehensive transcriptome-wide evaluation of gene expression alterations unique to the peripheral immune system in FTD compared to healthy controls and amyotrophic lateral sclerosis.Nineteen subjects with FTD with 19 matched healthy controls and 9 subjects with amyotrophic lateral sclerosis underwent isolation of peripheral blood mononuclear cells (PBMCs) which then underwent bulk ribonucleic acid sequencing.

There was increased expression in genes associated with CD19+ B-cells, CD4+ T-cells, and CD8+ T-cells in FTD participants compared to healthy controls. In contrast, there was decreased expression in CD33+ myeloid cells, CD14+ monocytes, BDCA4+ dendritic cells, and CD56+ natural killer cells in FTD and healthy controls. Additionally, there was decreased expression is seen in associated with 2 molecular processes: autophagy with phagosomes and lysosomes, and protein processing/export. Significantly downregulated in PBMCs of FTD subjects were genes involved in antigen processing and presentation as well as lysosomal lumen formation compared to healthy control PBMCs.

Our findings that the immune signature based on gene expression in PBMCs of FTD participants favors adaptive immune cells compared to innate immune cells. And decreased expression in genes associated with phagosomes and lysosomes in PBMCs of FTD participants compared to healthy controls.
Endovascular treatment of traumatic oronasal hemorrhage complicated with progressive acute epidural hemorrhage
Authors: Ye Zhinan , Jin Hanghuang , Chen Yuan , Ji Hailong , Xu Hao , Jin Yong
Published: January 2022

Rationale

Massive oronasal hemorrhage can induce shock and is life-threatening, and early endovascular treatment is the standard of care. Few studies have reported the use of endovascular treatment for acute epidural hemorrhage (AEDH). However, endovascular treatment of oronasal hemorrhage complicated by AEDH has not yet been demonstrated. Many patients with a low to moderate volume of oronasal hemorrhage complicated by AEDH choose conservative treatment but eventually undergo craniotomy due to increased intracranial hemorrhage.

Patient concerns

A 32-year-old man presented to our hospital with traumatic oronasal hemorrhage complicated by AEDH after being hit by a blunt object.

Diagnosis

Computerized tomography suggested progressive AEDH and multiple basilar skull fractures. Emergency cerebral angiography showed rupture of the right middle meningeal artery and a branch of the left maxillary artery causing AEDH and oronasal hemorrhage.

Interventions

The patient underwent interventional embolization to treat the ruptured intracranial vessels.

Outcomes

After 23 days, cranial computerized tomography showed remarkable absorption of the right frontal epidural hematoma, with the patient having a Glasgow Coma Scale score of 15.

Lessons

This case provides a valuable treatment for patients with AEDH complicated with oronasal hemorrhage, early interventional embolization may be an effective treatment strategy to prevent further complications and ensure a good patient outcome.
Identification of a novel heterozygous TSC2 splicing variant in a patient with Tuberous sclerosis complex
Authors: Liu Linli , Yu Chunshui , Yan Gaowu
Published: January 2022

Rationale:

Tuberous sclerosis complex (TSC) is an autosomal dominant genetic disorder characterized by facial angiofibromas, epilepsy, intellectual disability, and the development of hamartomas in several organs, including the heart, kidneys, brain, and lungs. Mutations in either TSC1 or TSC2 result in dysregulated mTOR activation, leading to the occurrence of TSC.

Patient concerns:

A 44-year-old man was hospitalized for acute lumbago and hematuria.

Diagnosis:

The patient presented with facial angiofibromas, epilepsy, fibrous plaques, periungual fibroma, renal angiomyolipomas (AML), pulmonary lymphangioleiomyomatosis (LAM), liver hamartomas, and osteosclerosis. A diagnosis of TSC was made based on clinical manifestations.

Interventions:

Next-generation sequencing (NGS) was performed to screen for potential variants, which were verified using Sanger sequencing. The final variant was analyzed using a minigene assay.

Outcomes:

A potentially pathogenic novel TSC2 variant (NM_000548.4, c.336_336 + 15delGGTAAGGCCCAGGGCG) was identified using NGS and confirmed using Sanger sequencing. The in vitro minigene assay showed that the variant c.336_336 + 15delGGTAAGGCCCAGGGCG caused erroneous integration of a 74 bp sequence into intron 4. This novel variant was not found in his unaffected parents or 100 unrelated healthy controls.

Lessons:

We identified a novel heterozygous TSC2 variant, c.336_336 + 15delGGTAAGGCCCAGGGCG, in a patient with classical TSC and demonstrated that this variant leads to aberrant splicing using a minigene assay. Our results extend the understanding of the mutational spectrum of TSC2.
Relationship Between Carotid Artery Angle and Plaque Morphology in Acute Cerebral Infarction Patients
Authors: Wang Jing , Wang Lin , Shen Yuan , Gong Xiping , Ju Yi
Published: January 2022

Background:

High-resolution magnetic resonance imaging (HRMRI) can be used to clearly distinguish the luminal structure of the carotid artery (CA); measure the lumen, vessel wall, and total blood vessel area; and accurately describe the morphologic features of plaques.

Methods:

This study used HRMRI to investigate the relationship between geometric features and volume and composition of carotid atherosclerotic plaques. Patients (n=81) who had experienced acute cerebral infarction (CI) within 7±3 days before admission to the Neurology Department of Beijing Tiantan Hospital between November 2011 and June 2012 were enrolled in the study. CA HRMRI was performed to analyze the geometry and morphology of plaques in 160 blood vessels.

Results:

The median left and right internal carotid artery angles (ICAAs) were 32.79 and 31.00 degrees, respectively. Aside from the nonplanar external CA angle, plaque volume and angles did not differ significantly between the left and right sides. Age (B=3.77; P=0.03) and nonplanar ICAA (B=4.70; P=0.01) were predictors of left but not right carotid plaque volume. ICAA and bifurcation angle did not predict plaque volume.

Conclusions:

In this study, CA morphology in acute stroke patients is not associated with plaque volume or composition, but age and nonplanar ICAA can predict left carotid plaque volume.
Sphingomonas arenae sp. nov., isolated from desert soil
Authors: Dong Lei , Li Shuai , Lian Wen-Hui , Wei Qi-Chuang , Mohamad Osama Abdalla Abdelshafy , Hozzein Wael N. , Ahmed Iftikhar , Li Wen-Jun
Published: January 2022

Two bacterial strains, designated as SYSU D00720T and SYSU D00722, were isolated from a desert sandy soil sample collected from Gurbantunggut Desert in Xinjiang, north-west China. Cells were Gram-stain-negative, aerobic, non-motile, rod-shaped, oxidase-positive and catalase-negative. Colonies were circular, opaque, convex, smooth, orange on Reasoner’s 2A (R2A) agar. The isolates were found to grow at 4–45 °C (optimum, 28–30 °C), at pH 6.0–7.0 (optimum, 7.0) and with 0–1.5 % (w/v) NaCl (optimum, 0%). Growth was observed on R2A agar, Luria–Bertani agar and nutrient agar, but not on trypticase soy agar. The polar lipids consisted of diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylcholine, sphingoglycolipid, two unidentified aminolipids, one unidentified glycolipid, one unidentified aminoglycolipid, one unidentified aminophospholipid, one unidentified phospholipid and two unidentified lipids. The main fatty acids (>10%) were C17 : 1
 ω6c, summed feature 8 (C18 : 1
 ω7c and/or C18 : 1
 ω6c) and C16 : 0. The major respiratory quinone was ubiquinone-10 and the major polyamine was sym-homospermidine. The genomic DNA G+C content was 66.0 mol%. Strains SYSU D00720T and SYSU D00722 were nearly identical with a 16S rRNA gene sequence similarity of 99.6 %, and 100.0 % average nucleotide identity (ANI), average amino acid identity (AAI) and digital DNA–DNA hybridization (dDDH) values. Phylogenetic analyses clearly demonstrated that these two strains belonged to the same species of the genus

Sphingomonas

, and had highest sequence similarity to

Sphingomonas lutea

KCTC 23642T (97.3 %). The ANI, AAI and dDDH values of strains SYSU D00720T and SYSU D00722 to

S. lutea

KCTC 23642T were both 73.2, 69.9 and 19.2 %, respectively. Based on phylogenetic, phenotypic and chemotaxonomic distinctiveness, strains SYSU D00720T and SYSU D00722 represent a novel species of the genus

Sphingomonas

, for which the name Sphingomonas arenae sp. nov. is proposed. The type strain is SYSU D00720T (=MCCC 1K05154T=NBRC 115061T).
miR-505 inhibits replication of Borna disease virus 1 via inhibition of HMGB1-mediated autophagy
Authors: Guo Yujie , Xu Xiaoyan , Tang Tian , Sun Lin , Zhang Xiong , Shen Xia , Li Dan , Wang Lixin , Zhao Libo , Xie Peng
Published: January 2022

Borna disease virus 1 (BoDV-1) is a highly neurotropic RNA virus which was recently demonstrated to cause deadly human encephalitis. Viruses can modulate microRNA expression, in turn modulating cellular immune responses and regulating viral replication. A previous study indicated that BoDV-1 infection down-regulated the expression of miR-505 in rats. However, the underlying mechanism of miR-505 during BoDV-1 infection remains unknown. In this study, we found that miR-505 can inhibit autophagy activation by down-regulating the expression of its target gene HMGB1, and ultimately inhibit the replication of BoDV-1. Specifically, we found that the expression of miR-505 was significantly down-regulated in rat primary neurons stably infected with BoDV-1. Overexpression of miR-505 can inhibit the replication of BoDV-1 in cells. Bioinformatics analysis and dual luciferase reporter gene detection confirmed that during BoDV-1 infection, the high-mobility group protein B1 (HMGB1) that mediates autophagy is the direct target gene of miR-505. The expression of HMGB1 was up-regulated after BoDV-1 infection, and overexpression of miR-505 could inhibit the expression of HMGB1. Autophagy-related detection found that after infection with BoDV-1, the expression of autophagy-related proteins and autophagy-related marker LC3 in neuronal cells was significantly up-regulated. Autophagy flow experiments and transmission electron microscopy also further confirmed that BoDV-1 infection activated HMGB1-mediated autophagy. Further regulating the expression of miR-505 found that overexpression of miR-505 significantly inhibited HMGB1-mediated autophagy. The discovery of this mechanism may provide new ideas and directions for the prevention and treatment of BoDV-1 infection in the future.
JWA deficiency accelerates aging through disrupting intestinal epithelial homeostasis via Notch1/PPARγ/Stat5 axis
Authors: Li Xiong , Liu Jingwen , Wang Luman , Zhou Yan , Wen Yifan , Ding Kun , Zou Lu , Liu Xia , Li Aiping , Wang Yun , Fu Heling , Huang Min , Ding Guoxian , Zhou Jianwei
Published: January 2022

Aging usually suppresses the renewal and regeneration of intestinal epithelium. The imbalance of intestinal epithelial homeostasis may also be a promoter for aging. JWA responds to oxidative stress and repairs damaged DNA; it participates in multiple cellular processes like cell proliferation and differentiation. Here we identified JWA as a new aging-associated gene, whose deletion-accelerated aging in mice was related to intestinal epithelium atrophy. We further knocked out intestinal epithelial JWA and found it disrupted intestinal epithelial homeostasis, thus promoting aging in mice. Mechanistically, we discovered that JWA deficiency promoted Notch1 ubiquitination degradation via ERK/Fbxw7 cascade and interfered with the PPARγ/Stat5 signal axis. This reduced the intestinal stem cell function and altered the intestinal epithelial cell lineage distribution, finally suppressing the renewal and regeneration of intestinal epithelium. Our results demonstrated that JWA is a new aging-associated gene essential for the renewal and regeneration of intestinal epithelium. We also provide a new idea that maintaining intestinal epithelial homeostasis may be a potential anti-aging strategy in humans or mammals.