bluuebunny/crossref_metadata_2025 huggingface dataset:
The outcomes of right-sided and left-sided colonic diverticulitis following non-operative management: a systematic review and meta-analysis
Authors: Huang Sih-Shiang , Sung Chih-Wei , Wang Hsiu-Po , Lien Wan-Ching
Published: November 2022

Background

There is no sufficient overview of outcomes in right-sided and left-sided colonic diverticulitis (CD) following non-operative management. This systematic review was conducted to evaluate the recurrence/treatment failure in right-sided and left-sided CD.

Methods

A systematic review was conducted following PRISMA guidelines. MEDLINE, Embase, and Cochrane Library from inception to Dec 2021 were searched. The study characteristics, recurrence/treatment failure, and risk factors for recurrence/treatment failure were extracted. Proportional meta-analyses were performed to calculate the pooled recurrent/treatment failure rate of right-sided and left-sided CD using the random effect model. Logistic regression was applied for the factors associated with the recurrence/treatment failure.

Results

Thirty-eight studies with 10,129 patients were included, and only two studies comprised both sides of CD. None of the studies had a high risk of bias although significant heterogeneity existed. The pooled recurrence rate was 10% (95% CI 8–13%, I2 = 86%, p < 0.01) in right-sided and 20% (95% CI 16–24%, I2 = 92%, p < 0.01) in left-sided CD. For the uncomplicated CD, the pooled recurrence rate was 9% (95% CI 6–13%, I2 = 77%, p < 0.01) in right-sided and 15% (95% CI 8–27%, I2 = 97%, p < 0.01) in the left-sided. Age and gender were not associated with the recurrence of both sides. The treatment failure rate was 5% (95% CI 2–10%, I2 = 84%, p < 0.01) in right-sided and 4% (95% CI 2–7%, I2 = 80%, p < 0.01) in left-sided CD. The risk factors for recurrence and treatment failure were limited.

Conclusion

Non-operative management is effective with low rates of recurrence and treatment failure for both right-sided and left-sided CD although left-sided exhibits a higher recurrence. The recurrence rates did not differ between patients receiving antibiotics or not in uncomplicated CD. Age and sex were not associated with the recurrence although other risk factors were dispersing. Further risk factors for recurrence and treatment failure would be investigated for precise clinical decision-making and individualized strategy.
Small nodules (≤ 6 mm in diameter) of multiple primary lung cancers: prevalence and management
Authors: Cheng Hua , Li Wen-hao , Li Xiao-jian , Zhong Hong-cheng , Wang Xiao-jin , Lin Yu-jing , Liu Xue-guo , Wu Xiang-wen , Cao Qing-dong
Published: November 2022

Background

Synchronous multiple primary lung cancers associated with small non-dominant nodules are commonly encountered. However, the incidence, follow-up, and treatment of small non-dominant tumors have been but little studied. We explored the prevalence and management of small non-dominant tumors and factors associated with interval growth.

Methods

This observational, consecutive, retrospective single-center study enrolled patients diagnosed with synchronous multiple primary lung cancers and small non-dominant tumors (≤ 6 mm in diameter) who underwent resection of the dominant tumor. The incidence, follow-up, and management of small non-dominant tumors and predictors of nodule growth were analyzed.

Results

There were 88 patients (12% of all lung cancer patients) with pathological diagnoses of synchronous multiple primary lung cancers. A total of 131 (18%) patients were clinically diagnosed with at least one small (≤ 6 mm in diameter) multiple primary lung cancer non-dominant tumor. 94 patients with 125 small-nodule non-dominant tumors clinically diagnosed as multiple primary lung cancers were followed-up for at least 6 months. A total of 29 (29/125, 23.2%) evidenced small pulmonary nodules (≤ 6 mm in diameter) that exhibited interval growth on follow-up computed tomography (CT). On multivariate analysis, a part-solid nodule (compared to a pGGN) (OR 1.23; 95% CI 1.08–1.40) or a solid nodule (compared to a pGGN) (OR 3.50; 95% CI 1.94–6.30) predicted small nodule interval growth.

Conclusion

We found a relatively high incidence of multiple primary lung cancers with small non-dominant tumors exhibiting interval growth on follow-up CT, suggesting that resection of non-dominant tumors at the time of dominant tumor resection, especially when the nodules are part-solid or solid, is the optimal treatment.
Warburg effect in colorectal cancer: the emerging roles in tumor microenvironment and therapeutic implications
Authors: Zhong Xinyang , He Xuefeng , Wang Yaxian , Hu Zijuan , Huang Huixia , Zhao Senlin , Wei Ping , Li Dawei
Published: November 2022

Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related death worldwide. Countless CRC patients undergo disease progression. As a hallmark of cancer, Warburg effect promotes cancer metastasis and remodels the tumor microenvironment, including promoting angiogenesis, immune suppression, cancer-associated fibroblasts formation and drug resistance. Targeting Warburg metabolism would be a promising method for the treatment of CRC. In this review, we summarize information about the roles of Warburg effect in tumor microenvironment to elucidate the mechanisms governing Warburg effect in CRC and to identify novel targets for therapy.
How symptoms of prolonged grief disorder, posttraumatic stress disorder, and depression relate to each other for grieving ICU families during the first two years of bereavement
Authors: Wen Fur-Hsing , Prigerson Holly G. , Chou Wen-Chi , Huang Chung-Chi , Hu Tsung-Hui , Chiang Ming Chu , Chuang Li-Pang , Tang Siew Tzuh
Published: November 2022

Background

Bereaved ICU family surrogates are at risk of comorbid prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression. Knowledge about temporal relationships between PGD, PTSD, and depression is limited by a lack of relevant studies and diverse or inappropriate assessment time frames given the duration criterion for PGD. We aimed to determine the temporal reciprocal relationships between PGD, PTSD, and depressive symptoms among ICU decedents’ family surrogates during their first 2 bereavement years with an assessment time frame reflecting the PGD duration criterion.

Methods

This prospective, longitudinal, observational study examined PGD, PTSD, and depressive symptoms among 303 family surrogates of ICU decedents from two academic hospitals using 11 items of the Prolonged Grief Disorder-13, the Impact of Event Scale—Revised, and the depression subscale of the Hospital Anxiety and Depression Scale, respectively, at 6, 13, 18, and 24 months post-loss. Cross-lagged panel modeling was conducted: autoregressive coefficients indicate variable stability, and cross-lagged coefficients indicate the strength of reciprocal relationships among variables between time points.

Results

Symptoms (autoregressive coefficients) of PGD (0.570–0.673), PTSD (0.375–0.687), and depression (0.591–0.655) were stable over time. Cross-lagged standardized coefficients showed that depressive symptoms measured at 6 months post-loss predicted subsequent symptoms of PGD (0.146) and PTSD (0.208) at 13 months post-loss. PGD symptoms did not predict depressive symptoms. PTSD symptoms predicted subsequent depressive symptoms in the second bereavement year (0.175–0.278). PGD symptoms consistently predicted subsequent PTSD symptoms in the first 2 bereavement years (0.180–0.263), whereas PTSD symptoms predicted subsequent PGD symptoms in the second bereavement year only (0.190–0.214). PGD and PTSD symptoms are bidirectionally related in the second bereavement year.

Conclusions

PGD, PTSD, and depressive symptoms can persist for 2 bereavement years. Higher PGD symptoms at 6 months post-loss contributed to the exacerbation of PTSD symptoms over time, whereas long-lasting PTSD symptoms were associated with prolonged depression and PGD symptoms beyond the first bereavement year. Identification and alleviation of depression and PGD symptoms as early as 6 months post-loss enables bereaved surrogates to grieve effectively and avoid the evolution of those symptoms into long-lasting PGD, PTSD, and depression.
Population-based estimate for the correlation of the Oncotype Dx Breast Recurrence Score® result and Ki-67 IHC MIB-1 pharmDx in HR+, HER2−, node-positive early breast cancer
Authors: Crager Michael , Wijayawardana Sameera R. , Gruver Aaron M. , Blacklock Andrea , Russell Christy , Baehner Frederick L. , Sapunar Francisco
Published: November 2022

Background

The United States Food and Drug Administration recently approved a Ki-67 immunohistochemistry (IHC) assay to identify patients with early breast cancer at high disease recurrence risk. The Oncotype Dx Breast Recurrence Score® assay has been validated in hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) invasive breast cancer (IBC) to predict chemotherapy benefit and distant recurrence risk, regardless of nodal status. This study assessed the correlation between Recurrence Score® (RS) results and the Ki-67 IHC MIB-1 pharmDx assay.

Methods

HR+, HER2−, N1 IBC samples with RS results were examined by Ki-67 IHC; 311 specimens were collected, including 275 without regard to RS (“unselected RS”) and 36 more with RS 26–100; 12 were lymph node negative upon pathology report review, and one had no Ki-67 score, leaving 262 unselected RS and 298 total samples. Spearman rank correlation was calculated using the unselected samples and a weighted rank correlation using all samples. A receiver operating characteristic (ROC) curve for predicting high RS (26–100) from Ki-67 was constructed.

Results

The Spearman rank correlation between Ki-67 and RS results was moderately positive (unselected RS samples: 0.396; 95% confidence interval [CI] 0.288–0.493; all samples: 0.394; 95% CI 0.294–0.486). While 71% of samples with RS 26–100 had Ki-67 ≥ 20%, 75% with RS 0–25 had Ki-67 < 20%. ROC area under the curve was 0.792 (95% CI 0.725–0.859).

Conclusions

The moderately positive correlation is consistent with previous analyses suggesting the Oncotype Dx® assay and Ki-67 IHC MIB-1 assay should not be used interchangeably in clinical practice.
Solving an integral equation via generalized controlled fuzzy metrics
Authors: Mani Gunaseelan , Gnanaprakasam Arul Joseph , Dinmohammadi Abdollah , Parvaneh Vahid , Mohammadi Babak
Published: November 2022

The purpose of this manuscript is to obtain some fixed point results in generalized controlled fuzzy metric spaces. Our results generalize and extend many of the previous findings in the same approach. Moreover, two examples to support our theorems are obtained. Finally, to examine and strengthen the theoretical results, the existence and uniqueness of the solution to a nonlinear integral equation is studied as a kind of application.
Climate change scenarios in Zambia: modeling farmers’ adaptation
Authors: Stadtbäumer Charlotte , Ruesink Brigitte , Gronau Steven
Published: November 2022

Background

At the center of the Sustainable Development Goals (SDG) by the United Nations is climate change. Analyzing adaptation processes is fundamental to enhance resilience in the poorest parts of the world. The analysis harmonizes top-down and bottom-up approaches by integrating general circulation models into the method of mathematical optimization. The article designs a quantitative farm planning model for rural Zambia and focuses on optimal allocation of land, labor and cultivation methods. Our research takes advantage of recent survey data of 277 Zambian households from 2018. The model simulates a baseline scenario, 2 climate change scenarios and 7 variations of farmers’ land availability, labor capacity and off-farm work possibility. This results in 21 possible future outcomes and farmer adaptations.

Results

Climate change negatively affects future livelihoods at the study site. A dry climate decreases a farmer’s wealth by around 30% and a wet climate by nearly 20%. However, simulations show households are able to sustain their livelihood through adaptation processes at the farm level. Farmers’ variation in land size for crop cultivation indicates the strongest livelihood impacts in response to climate change. Increasing the land for cultivation is the best response, whereas a reduction of labor supply at the farm leads to households being more vulnerable to a changing climate. Off-farm employments reveal significant potential for climate change adaptation. An increase in work opportunities at a refugee camp nearby has a significant positive effect on rural livelihoods, without reducing the households’ farm production. The refugee camp, however, may imply future land competition.

Conclusions

The study concludes climate change has a serious impact on farm yields and requires land and labor adjustments to prevent losses in wealth. Altering the cropping mix, reallocating planting times or changing farming techniques are meaningful instruments to respond to climate change at the study site. Agricultural intensification can increase the productivity per hectare and the mix of on- and off-farm work indicates income diversification as possible response to climate change. The analysis is specified to a rural farm context in Zambia, but is applicable to similar settings in sub-Saharan Africa and useful for local policy implementations towards climate change adaptation.
DD-KARB: data-driven compliance to quality by rule based benchmarking
Authors: Besharati Mohammad Reza , Izadi Mohammad
Published: November 2022

The problem of compliance checking and assessment is to ensure that the design or implementation of a system meets some desired properties and complies with some rules or regularities. This problem is a key issue in several human and engineering application domains such as organizational management and e-governance, software and IT industries, and software and systems quality engineering. To deal with this problem, some different approaches and methods have been proposed. In addition to the approaches such as formal methods, mathematical proofs, and logical evaluations, benchmarking can be used for compliance assessment. Naturally, a set of benchmarks can shape an applied solution to compliance assessment. In this paper we propose KARB solution system, i.e. keeping away compliance Anomalies through Rule-based Benchmarking. In fact, in our proposed method the rule-based benchmarking means evaluating the conformity of an under-compliance system to a set of rules. In this solution approach, the under-compliance system is specified symbolically (using formal and logical descriptions). Also, the desired rules are specified formally as the semantic logic in the evaluation process. After reviewing the proposed method, a case study was conducted to demonstrate and analyze the KARB solution. The IR-QUMA study (Iranian Survey on Quality in Messenger Apps) was then conducted to evaluate the quality of some messenger applications. According to the evaluation results, the hybrid DD-KARB method (with a combination of semantics-awareness and data-drivenness) is more effective than solo methods and can compute a good estimation for the messenger application user quality scores. Therefore, DD-KARB can be considered as a method for quality benchmarking in this technical context.
Crustal structure beneath earthquake swarm in the Noto peninsula, Japan
Authors: Nakajima Junichi
Published: November 2022

We carried out seismic tomography study to reveal three-dimensional (3D) seismic velocity structures in the Noto peninsula, Japan, where swarm-like seismic activity started in December 2020. The obtained results reveal a highly heterogeneous structure in the crust. The most striking feature is the existence of a low-velocity anomaly in the lower crust beneath the Noto earthquake swarm. Although the data set used in this study cannot resolve the upper mantle structure, previous regional tomographic studies suggest that a low-velocity anomaly exists at depths of 50–150 km around the Noto peninsula that is probably interpreted as a fluid-rich region. We infer that fluids have been supplied from the uppermost mantle to the lower crust over a geological time scale and a large volume of fluids have accumulated below the seismogenic zone beneath the Noto peninsula. A further upward migration of fluids to the upper crust, which may have suddenly started in December 2020, probably triggers numerous earthquakes at depths of 10–15 km. Since major active faults exist at shallower extensions of the hypocenters of the Noto earthquake swarm, we consider that the earthquake swarm occurs along pre-existing and weak fault planes. Dense temporary seismic observations will highlight a smaller-scale (5–10 km) 3D seismic velocity model and finer hypocenter distribution, which provide additional information for better understanding of the generation mechanisms of the Noto earthquake swarm.

Graphical Abstract
Wave propagation of meteotsunamis and generation of free tsunamis in the sloping area of the Japan Trench for the 2022 Hunga–Tonga volcanic eruption
Authors: Tonegawa Takashi , Fukao Yoshio
Published: November 2022

Meteotsunamis (forced waves) triggered by atmospheric disturbances of Lamb waves due to the 2022 Hunga–Tonga volcanic eruption have been observed in coastal areas surrounding the Pacific Ocean. However, the spatiotemporal evolution of the wavefield of meteotsunamis and meteotsunami-induced free waves remains elusive. Here, we show the detailed spatial distribution of the propagation velocities and directions of these waves in the bathymetric slope area between the Japan Trench and nearshore, using a dense array of 150 absolute pressure gauges deployed at water depths of 100–8000 m. Records show that free wave components (i.e., tsunamis) were generated when the forced wave was propagating over the slope area. Amplitudes of the generated free waves are large in the southern half of the slope area, where the equi-arrival time contour lines are densely paralleled. Such amplifications occur due to the relationship between the incoming direction of Lamb waves and the gradient of the bathymetric slope. This indicates that, if meteotsunamis excited by Lamb waves due to future volcanic eruptions come from different directions to this region, a different spatial pattern of free wave amplification on a regional scale is obtained in the bathymetric slope areas.

Graphical Abstract
Clinical applications of concentrated growth factors membrane for sealing the socket in alveolar ridge preservation: a randomized controlled trial
Authors: Liu Yumeng , Li Xiaoming , Jiang Changwei , Guo Huiying , Luo Guisheng , Huang Yangyang , Yuan Changyong
Published: November 2022

The purpose of this study was to evaluate the efficacy of concentrated growth factor (CGF) membrane for the sealing of alveolar socket in alveolar ridge preservation (ARP). A total of 22 patients with 24 alveolar sockets were recruited and divided randomly into CGF group and Bio-Gide collagen membrane group. The soft tissue wound healing rate was calculated using intraoral scanner at 3, 7, and 14 days after ARP, and the bone resorption volume at 1, 3, and 5 mm below the alveolar ridge was measured by CBCT at 6 months postoperation. The keratinized gingival width was also measured before and 6 months after ridge preservation. In terms of soft tissue healing rate, the CGF group exhibited significant higher than that of Bio-Gide group at both 7 and 14 days after surgery (P < 0.05). However, there was no significantly different in bone resorption rate and the width of keratinized gingival after 6 months (P > 0.05). Therefore, the use of CGFs membranes for wound closure in ARP is a reliable method, but more clinical data are needed to prove it.
Health insurance coverage and modern contraceptive use among sexually active women in Nigeria: Further analysis of 2018 Nigeria Demographic Health Survey
Authors: Bolarinwa Obasanjo Afolabi , Babalola Taiwo Oladapo , Adebayo Oladayo Abayomi , Ajayi Kobi V.
Published: November 2022

Background

Studies have shown that affordable health insurance can influence healthcare visits and increase the choice of medication uptake in sub-Saharan Africa. However, there is a need to document the influence of health insurance coverage and modern contraceptive use in order to encourage its uptake. Thus, this study examined the influence of health insurance coverage on modern contraceptive use among sexually active women in Nigeria.

Methods

The secondary dataset utilised in this study were derived from the 2018 Nigeria Demographic and Health Survey (NDHS). Data analyses were restricted to 24,280 women of reproductive age 15–49 years who were sexually active in the survey dataset. Weighted bivariate and multivariable logistic regression models were used to examine the influence of health insurance coverage on modern contraceptive use while controlling for possible confounders. A Significant level of alpha was determined at p < 0.05 using STATA 16.0.

Results

The prevalence of health insurance coverage and modern contraceptive use among sexually active women in Nigeria were 25.47% and 13.82%, respectively. About 1 out of every 4 sexually active women covered by health insurance were using a modern contraceptive, while 86.50% of the women not covered by health insurance were not using any modern contraceptive method. After adjusting for socio-demographic characteristics, the odds of using any modern contraceptive were significantly higher for sexually active women who were covered by any health insurance [aOR = 1.28; 95% (CI = 1.01–1.62)] compared to sexually active women not covered by health insurance in Nigeria.

Conclusion

The study demonstrated that health insurance coverage is a significant driver of health service utilization, including modern contraceptive use. Health insurance benefits are recommended to be expanded to cover a broader spectrum of family planning services in Nigeria. More research is required to understand the influence of different health insurance schemes and the use of modern family planning methods in Nigeria.
Geographical weighted regression analysis of delayed antenatal care initiation and its factors among all reproductive-aged women in Ethiopia, 2016
Authors: Tareke Abiyu Abadi , Gashu Kassahun Dessie , Endehabtu Berhanu Fikadie
Published: November 2022

Background

Delayed antenatal care is when the first visit is carried out after 12 gestational weeks. Despite the fact that many studies have been conducted on antenatal care initiation, little attention has been paid to its spatial pattern. Therefore, this study examine geographical weighted regression analysis of delayed antenatal care initiation and its factors among all reproductive-aged women in Ethiopia.

Objective

To assess geographical weighted regression analysis of delayed antenatal care initiation and its factors among all reproductive-aged women in Ethiopia, 2016.

Methods

This study was grounded on the 2016 Ethiopian Demographic Health Survey. It incorporated extracted sample size of 4740 (weighted) reproductive-aged women. ArcGIS version 10.8 and SaTScan™ version 9.7 software were employed to investigate geographic information. To distinguish factors associated with hotspot areas, local and global models were fitted.

Result

the geographic pattern of Delayed antenatal care initiation was clustered (Moran’s I = 0.38, p < 0.001). Kuldorff’s spatial scan statistics discovered three significant clusters. The most likely cluster (LLR = 66.13, p < 0.001) was situated at the zones of SNNP and Oromia regions. In the local model, being uneducated, being poor wealth, having an unwanted pregnancy, and having higher birth order were factors associated with spatial variation of delayed antenatal care.

Conclusion

The spatial pattern of delayed antenatal care in Ethiopia is clustered. Maternal education, wealth status, pregnancy desirability, and birth order were predictor variables of spatial variation of delayed antenatal care. Therefore, designing a hotspot area-based interventional plan could help to improve early ANC initiation.
PET/MR: primary inferior vena cava leiomyosarcoma
Authors: Ronchi Brunela , Peña Gustavo Agustin , Sacchi Carlos
Published: November 2022

Positron emission tomography (PET) combined with a magnetic resonance (MR) scanner (PET/MR) with 18F-fluorodeoxyglucose (FDG) tracer is being used in quite a few nuclear medicine centers. The aim of this study is to illustrate two uncommon cases of primary inferior vena cava leiomyosarcoma which were formerly evaluated with anatomical images such as computed tomography and ultrasound. These techniques were inferior in the definition of the tumor and its characteristics. F-18 FDG PET/MR was essential and provided all the necessary information: its origin, local extension, anatomo-metabolic behavior, form of presentation, and distant metastasis in one single diagnostic technique. PET/MR accurately contributed to the diagnosis in a shortened period of time and, therefore, in the prognosis of this disease with greater benefits.
SCN5A p.P1725L variant that showed ventricular fibrillation and recurrent pericarditis, and a family member with sick sinus syndrome
Authors: Yamamoto Hiroaki , Itamoto Chieko , Hayashi Minato , Kohno Tsunesuke , Yagihara Nobue
Published: November 2022

Background

In Brugada syndrome (BrS), the arrhythmogenic substrate is suggested to be located in the epicardial surface of the right ventricle outflow tract. Postmortem examinations of BrS described epicardial and interstitial fibrosis, the causes of which remain unclear.

Case presentation

We present a family in whom the proband is a case of aborted sudden cardiac death from ventricular fibrillation (VF) without spontaneous Brugada-type electrocardiogram, and his mother underwent pacemaker implantation due to sick sinus syndrome. The proband showed recurrent acute pericarditis two consecutive years before the VF episode. These events occurred twice in mid-spring, the same season when the lethal arrhythmia occurred.

Conclusions

This case suggests a possibility in the pathogenesis of epicardial fibrosis of BrS that the RVOT lesions induced by SCN5A mutations have not only fibrotic characteristics but also in some patients, inflammatory characteristics which may be manifested as repeated mild pericarditis or occult pericarditis.
Anti-NMDAR encephalitis with seizure-like activity and hemiplegia - a case report and literature review
Authors: Hu Junjie , Zhao Cailei , Zhao Xia , Fang Yu , Zhang Huiting , Cao Dezhi , Liao Jianxiang
Published: November 2022

Background

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis accounts for the vast majority of cases of autoimmune encephalitis. Its common clinical symptoms are psychiatric symptoms, behavioral dysfunction, seizures, speech impairment, cognitive impairment, movement disorders, decreased consciousness, and autonomic instability. This report was aimed to provide evidence for anti-NMDAR encephalitis with seizure-like activity, based on the clinical presentations, brain magnetic resonance imaging (MRI), and electroencephalogram (EEG) recordings.

Case presentation

We report a 11-year-old girl who suffered epigastric pain after vigorous physical activity. She felt weakness of the muscles. She had syncope only once and urinary incontinence on the way to the hospital and vomited at the arrival. The entire procedure lasted approximately 15 min. The next night she had recurrent headache attacks along with irritability, like someone “tapping” to the right occipital region. She experienced numbness in the left upper limbs and shallowing of the frontal lines on the left side. Holter monitoring showed normal findings, but brain MRI, EEG recording, and cerebrospinal fluid (CSF) antibody testing showed abnormal results. The patient was finally diagnosed with anti-NMDAR encephalitis. After treatment with glucocorticoids and acyclovir, she fully recovered and was discharged from the hospital.

Conclusions

Although the patient presented with pain and impaired limb movements, she did not have respiratory or (and) circulatory failure, and the symptoms entirely resolved. Early accurate diagnosis and timely treatment are essential for patients with anti-NMDAR encephalitis.
Analysis of prognostic factors in patients with brain metastases affecting survival
Authors: Gupta Sweety , Singh Sumit , Chophy Atokali , Nair Sharanya , Ahuja Rachit , Kusum K. , Joseph Deepa , Arora Rajnish , Gupta Amit , Gupta Manoj
Published: November 2022

Introduction

Brain metastases (BM) are associated with dismal prognosis as they cause significant morbidity and affect the quality of life of patients. Management of BM depends on the following factors: age, patient performance, size and the number of lesions, location of the tumor, comorbidities, primary tumor type, and extracranial disease burden. In the present study, the pattern of occurrence, clinical characteristics, treatment outcome of brain metastases, and factors, tumor characteristics, and treatment that may impact BM patients’ overall survival were analyzed.

Methods

Retrospective analysis of medical records of 116 patients with histologically proven primary site solid tumors with brain metastases was done in the present study. Clinicoradiological and pathological parameters were documented. The relationship between variables and outcome was assessed by univariate analysis using the Cox proportional regression model to reach a significance of p < 0.05, to determine independent predictors of overall survival.

Results

One hundred sixteen patients of BM from various solid malignancies were included. Age ranged from 18 to 81 years (median 53.5). One hundred four patients received WBRT with a dose range of 8–40Gy/1–15fr, 7 received SRS with a dose of 18–24Gy depending on the size of the metastatic lesion, and 2 received SRT 27–33Gy/3fr. At the time of final analysis, 47 patients with BM had expired, 60 were lost to follow-up, and 9 were alive. Median survival was 8.25 (0.5–32.5 months) months. Female gender (χ2 = 8.423; p = 0.015), RPA I (χ2 = 9.353; p = 0.05), and metachronous BM (χ2 = 3.793; p = 0.03) were associated with better survival. Patients with age 41–50 years, adenocarcinoma lung histology, and supratentorial location survived more than 2 years but did not show any statistical significance.

Conclusion

Brain metastases portend a very dismal prognosis. Certain clinicoradiological and pathologic factors have been identified to affect survival. More prospective multicentric trials, with a larger sample size, need to be conducted to assess the benefit of radiation in patients with limited life expectancy and identify prognostic and predictive factors for survival.
Unexpected septic pulmonary embolism imaging with 18-F FDG PET/CT in an infective endocarditis case: case report
Authors: Akgun Elife , Akyel Resit
Published: November 2022

Background

Infective endocarditis (IE) is a severe disease that is diagnosed using a combination of clinical, microbiologic, and imaging criteria (modified Duke criteria). The prognosis relies on the degree of valvular involvement and crucially the presence of systemic infectious embolism. We present an educational infective endocarditis case with images of 18-F fluoro-D-glucose positron emission tomography/computed tomography (18-F FDG PET/CT) showing hypermetabolic lesions on the prosthetic tricuspid valve and papillary muscle of right ventricle. Besides these lesions, PET/CT showed an unexpected hypermetabolic extra-cardiac focus.

Case presentation

A 36-year-old male patient with IE history was underwent 18-F FDG PET/CT imaging. FDG PET revealed hypermetabolic lesions on the prosthetic tricuspid valve and papillary muscle of right ventricle. Besides these lesions, PET/CT showed an unexpected hypermetabolic focus in the lower lobe of the right lung, which was consistent with septic pulmonary embolism.

Conclusions

18-F FDG PET/CT is a valuable, noninvasive imaging modality in diagnosis of prosthetic valve IE. It could change treatment planning since detecting extra-cardiac lesions.
Many different roads lead to Rome: equivalence of time-use for activity, sedentary and sleep behaviours and dietary intake profiles among adolescents
Authors: Dumuid Dorothea , Mellow Maddison L. , Stanford Tyman E. , Chong Kar Hau , Sawyer Susan M. , Smith Ashleigh E. , Lund Rasmussen Charlotte , Wade Alexandra , Olds Timothy
Published: November 2022

Background

How we spend our time and what we eat have important implications for our health. Evidence suggests that health-equivalent behaviour change options which result in the same benefit are available within both time use (physical activities, sedentary behaviours and sleep) and diet (e.g., fruit and vegetables, snack foods). However, it is not yet known if health-equivalent choices exist across both time-use and diet behaviours. This study aimed to explore if a variety of different time-use and dietary profiles were associated with equivalent physical functioning score among adolescents.

Methods

This study used cross-sectional data from 2123 adolescent participants from the Longitudinal Study of Australian Children (LSAC) (mean age = 14.4 ± 0.5 years), including time-use diaries (min/day of sleep, self-care, screen time, quiet time, physical activity, school-related and domestic/social), diet questionnaires (serves/day of fruit and vegetables, discretionary (snack) foods and sugar-sweetened beverages) and a measure of physical functioning (PedsQL™ 4.0 physical functioning scale for teens). Multiple linear regression models were used to find the association of 24-h time-use composition (expressed as isometric log ratios) and dietary variables with physical functioning score. The models were used to estimate which time-use and diet profiles (within a feasible range from the sample average) were associated with equivalent physical functioning scores. Finally, an interactive app was developed to make the results accessible to end users.

Results

Within 30 min and 1.5 servings of the average adolescent’s time-use and dietary behaviours, 45 equivalent options were associated with a ~ 0.2 SD improvement in physical functioning scale. All options associated with this improvement in physical function involved increasing physical activity and increasing fruit and vegetable intake, whilst also reducing discretionary food intake and sugar-sweetened beverages. Most behavioural options also increased sleep and reduced time spent in self-care, screen time and quiet time activities.

Conclusions

There are a range of time-use and diet profiles that may result in equivalent benefits in physical functioning among adolescents. Communicating these options using decision tools such as interactive apps may allow for tailored interventions across both time use and diet which are based on an individual’s needs, preferences and constraints.
Successful thoracic duct identification with patent blue V during thoracic duct ligation for chylothorax: a case report
Authors: Suzuki Yamato , Yamana Koji , Ishizawa Hisato , Kawai Hiroshi , Matsuda Yasushi , Kato Ryoichi , Takagi Yasushi , Hoshikawa Yasushi
Published: November 2022

Background

Chylothorax after thoracic surgery is a rare but severe complication. When thoracic duct ligation is performed for chylothorax, identification of the leakage site and the thoracic duct course is necessary. Administering milk orally or through a nasogastric tube and injecting indocyanine green into lymph nodes and lymphatic vessels can be performed to identify the leakage site and the thoracic duct course. However, the injection of patent blue V into the inguinal lymph nodes has not been reported.

Case presentation

A 69-year-old man underwent aortic replacement surgery for an aortic aneurysm of the distal arch. On postoperative day 3, after resuming oral intake, the patient was diagnosed with chylothorax. The patient was treated with fasting and total parenteral nutrition, but the chylous pleural effusion continued at 500–1000 ml daily. A plan for thoracic duct ligation was made. We injected patent blue V into the inguinal lymph node to identify the leakage site and the thoracic duct course. The blue-stained thoracic duct was identified and ligated, but the leakage site could not be identified because of the surrounding lung adhesions. The thoracic drain was removed on day 6 post-second operation, and the chylothorax did not recur.

Conclusion

Identifying the thoracic duct course using patent blue V is useful during thoracic duct ligation for chylothorax.
Pressure and saturation changes estimated from extended elastic impedance properties using time-lapse seismic data: Enfield Field, NW Australia
Authors: Shevchenko Sergey , Pennington Wayne D.
Published: November 2022

The extended elastic impedance (EEI) concept has been used in the oil industry primarily for lithology and fluid prediction in exploration and development projects. We present a method of reservoir monitoring that identifies and maps changes in pressure and saturation in a producing reservoir by applying EEI to time-lapse seismic data. The method uses time-lapse seismic difference data rotated to specific EEI χ angles that are optimized for the changes expected in a given reservoir. One angle is found to be appropriate to identify predicted changes in saturation, using fluid-substitution models, while the other angle is found from rock-physics assumptions or laboratory measurements of fluid-pressure changes. Our technique is tested using time-lapse seismic data from the Enfield oil field in Australia's North West Shelf, with estimates of optimal EEI rotation angles χ based on log data and Biot-Gassmann modeling for the fluid changes (χ = +42°) and on rock-physics models fit to measurements made on core samples for the pressure changes (χ = –79°). Seismic reflectivity and inversion domains were used for comparison and analysis of the final rotated volumes. We used publicly available seismic data that had been recorded and processed in 2004 and 2007 when time-lapse processing was still being developed. The low reproducibility of these seismic data and the complexity of the reservoir architecture limited the extent of our interpretation and results. Nonetheless, our qualitative and quantitative results are encouraging and supported by field production data. This technically simple approach should be useful in the analysis of time-lapse seismic data processed by modern techniques and would help in the management of reservoirs using a straightforward and readily reproduced procedure.
Workshop Review: Recent Injection Induced Seismicity Workshop marks a decade of learnings
Authors: Maxwell Shawn , Comiskey Cody
Published: November 2022

The 6th Injection Induced Seismicity Workshop, hosted by SEG and the Society of Petroleum Engineers, was held 7–9 June 2022 in Austin, Texas. The workshop series has provided the opportunity for important dialogue among induced-seismicity practitioners and subject-matter experts. The Austin workshop was no exception. The venue location underscored the importance of the increasing occurrence of induced seismicity in the Permian Basin.
Comparisons Between Different Anti-osteoporosis Medications on Postfracture Mortality: A Population-Based Study
Authors: Wu Chih-Hsing , Li Chia-Chun , Hsu Yu-Hsuan , Liang Fu-Wen , Chang Yin-Fan , Hwang Jawl-Shan
Published: November 2022

Context

Osteoporosis is becoming a global epidemic in aging societies. Anti-osteoporotic medications can prevent fractures, and their pleiotropic effect on mortality is interesting but not well compared among each other.

Objective

To provide real-world evidence on the pleiotropic effect of different anti-osteoporotic medications on all-cause mortality, stratified by fracture site, sex, and age.

Methods

This longitudinal population-based postfracture cohort study, included mega-data from subjects ≥40 years of age with osteoporotic fracture who used anti-osteoporotic medications as recorded in Taiwan's National Health Insurance Research Database from 2009 to 2017 and followed until 2018. A multivariate Cox proportional hazards model with immortal time bias was used to assess the relationship between fracture sites and mortality stratified by anti-osteoporosis medication.

Results

A total of 46 729 subjects with an average age of 74.45 years (80.0% female) and a mean follow-up period of 4.73 years were enrolled. In the total fracture group, compared with raloxifene and bazedoxifene, we found that alendronate/risedronate (hazard ratio [HR] 0.83; 95% CI, 0.79-0.88), denosumab (HR 0.86; 95% CI, 0.81-0.91), and zoledronic acid (HR 0.78; 95% CI, 0.73-0.84) resulted in significantly lower mortality. Similar trends were observed in the hip, vertebral, or nonhip/nonvertebral fracture groups. Subjects receiving long-acting zoledronic acid showed the lowest mortality in the subanalysis according to sex or age over 65 years.

Conclusion

This real-world mega-data study suggests that the usage of osteoporotic medication, especially a long-acting regimen, may lower postfracture mortality.
Inside the β Cell: Molecular Stress Response Pathways in Diabetes Pathogenesis
Authors: Kulkarni Abhishek , Muralidharan Charanya , May Sarah C , Tersey Sarah A , Mirmira Raghavendra G
Published: November 2022

The pathogeneses of the 2 major forms of diabetes, type 1 and type 2, differ with respect to their major molecular insults (loss of immune tolerance and onset of tissue insulin resistance, respectively). However, evidence suggests that dysfunction and/or death of insulin-producing β-cells is common to virtually all forms of diabetes. Although the mechanisms underlying β-cell dysfunction remain incompletely characterized, recent years have witnessed major advances in our understanding of the molecular pathways that contribute to the demise of the β-cell. Cellular and environmental factors contribute to β-cell dysfunction/loss through the activation of molecular pathways that exacerbate endoplasmic reticulum stress, the integrated stress response, oxidative stress, and impaired autophagy. Whereas many of these stress responsive pathways are interconnected, their individual contributions to glucose homeostasis and β-cell health have been elucidated through the development and interrogation of animal models. In these studies, genetic models and pharmacological compounds have enabled the identification of genes and proteins specifically involved in β-cell dysfunction during diabetes pathogenesis. Here, we review the critical stress response pathways that are activated in β cells in the context of the animal models.
LBSUN129 Adipose Tissue Analysis Toolkit (at-at): An Imagej Plugin For Automated Analysis Of Adipocyte Number, Size, And Pericellular Fibrosis In Histological Sections
Authors: Robino Jacob J , Bu Dawei , Field Bianca C , Scherer Philipp E , Roberts Charles T , Varlamov Oleg
Published: November 2022

Obesity-induced pathological expansion of white adipose tissue (WAT) involves adipocyte hypertrophy that occurs in tandem with the development of pericellular fibrosis. Other pathophysiological states, such as cancer and HIV, are also associated with fibrotic transformation of WAT depots. Aging, obesity, inactivity, and estrogen deficiency are also associated with an increase in bone marrow adiposity. Disease-associated changes in WAT morphology are typically assessed using histochemical analysis of WAT sections. However, manual analysis of large histological sections of WAT or bone marrow adipose tissue can be very time-consuming, while digital tools for the analysis of adipocyte size and pericellular fibrosis are limited. In response to this need, we have developed the Adipose Tissue Analysis Toolkit (AT-AT), a plugin for the open-source image analysis software ImageJ. AT-AT employs both local and global differentials in pixel intensity to threshold background apart from adipocyte-free tissue without user input. The AT-AT accurately captures adipocyte perimeter, maximum diameter, minimum diameter, and density per square millimeter of tissue in histological sections stained with common histological dyes, and performs automatic analysis of adipocyte cross-sectional area as well as pericellular fibrosis. AT-AT enables fully-automated analysis of batches of histological images using either default or user-defined adipocyte detection parameters including minimum circularity as well as minimum and maximum cross-sectional area. Likewise, users may set parameters for the thresholding algorithms, including the number of localized thresholds to be calculated in each image. AT-AT's thresholding techniques confer uniquely high resistances to both false-negative and false-positive detection events by comparison to other open-source adipocyte analysis software. They also enable superior measurement of adipocyte morphology, especially in the case of low-magnification images. AT-AT features several quality-of-life features, including automatic summarization of batch-collected data, the implementation of its thresholding algorithms as independent ImageJ commands, and an optional histogram builder. AT-AT can enhance the rigor and reproducibility of adipose tissue research. AT-AT will become available as a plugin for ImageJ in the fall of 2022.

Presentation: Sunday, June 12, 2022 12:30 p.m. - 2:30 p.m.
OR23-3 Hunger Hormone Asprosin Activates Orexigenic Neurons via SK Currents
Authors: Feng Bing , Greenway Frank , Harms Jerney , Liu Hesong , Wang Chunmei , Xu Pingwen , He Yanlin
Published: November 2022

Neurons that co-express the orexigenic agouti-related protein (AgRP) and neuropeptide Y (NPY) are indispensable for normal feeding behavior. Firing activities of AgRP/NPY neurons dynamically fluctuate with energy status and coordinate appropriate feeding behavior to meet nutritional demands. We previously demonstrated that asprosin, a recently discovered fasting-induced glucogenic and orexigenic hormone, crosses the blood-brain barrier and directly activates the orexigenic AgRP/NPY neurons via a cyclic cAMP-dependent pathway. However, intrinsic mechanisms on how asprosin regulates AgRP/NPY neural activities during the fed-to-fasted transition are not fully understood. In the satiated mice with low circulating levels of asprosin, we found that AgRP/NPY neurons expressed high levels of the small conductance calcium-activated potassium channel 3 (SK3) and were inhibited by SK3-mediated potassium currents. Conversely, in 24 hour-fasting mice with high levels of asprosin, AgRP/NPY neurons expressed low levels of SK3 and were activated via inhibition of SK3-mediated potassium currents. Notably, the stimulatory effects of asprosin on AgRP/NPY neurons were blunted in mice with SK3 selectively deleted in the AgRP/NPY neurons, further supporting a mediating role of SK3.

Moreover, we also identified protein tyrosine phosphatase receptor δ (Ptprd), a membrane-bound phosphatase receptor, as the orexigenic asprosin-receptor. Deletion of Ptprd in AgRP/NPY neurons abolished asprosin's stimulatory effect on SK3-mediated currents and protected mice from diet-induced obesity.

Lastly, increased circulating levels of asprosin promoted hyperphagia, body weight gain, and glucose intolerance. On the other hand, anti-asprosin antibody treatment decreased food intake and body weight by inhibiting AgRP/NPY and other orexigenic hypothalamic neurons via SK currents stimulation.

In summary, our data support a model that asprosin acts on Ptprd expressed by AgRP/NPY neurons to inhibit SK3 current, further activating AgRP/NPY neurons to increase food intake and body weight. Our findings also provided preclinical evidence that asprosin-neutralizing antibodies could be used to treat obesity.

Presentation: Monday, June 13, 2022 11:45 a.m. - 12:00 p.m.