bluuebunny/crossref_metadata_2025 huggingface dataset:
Alterations of gut microbiome and effects of probiotic therapy in patients with liver cirrhosis: A systematic review and meta-analysis
Authors: Huang Long , Yu Qingsheng , Peng Hui , Zhen Zhou
Published: December 2022

Background:

Alterations in the gut microbiome usually occur in liver cirrhosis. Gut microbiome dysregulation damages the liver and accelerates the development of liver fibrosis. Probiotic treatment has gradually become a major method for improving the prognosis of liver cirrhosis and reducing its complications. However, alterations in the gut microbiome have revealed different results, and the therapeutic effects of various probiotics are inconsistent.

Methods:

We searched the PubMed, Medline, EMBASE, ScienceDirect, and Cochrane databases up to August 2022 and conducted a systematic review and meta-analysis of 17 relevant studies.

Results:

The counts of Enterobacter (standardized mean difference [SMD] −1.79, 95% confidence interval [CI]: −3.08 to −0.49) and Enterococcus (SMD −1.41, 95% CI: −2.26 to −0.55) increased significantly in patients with cirrhosis, while the counts of Lactobacillus (SMD 0.63, 95% CI: 0.12–1.15) and Bifidobacterium (SMD 0.44, 95% CI: 0.12–0.77) decreased significantly. Blood ammonia (weighted mean difference [WMD] 14.61, 95% CI: 7.84–21.37) and the incidence of hepatic encephalopathy (WMD 0.40, 95% CI: 0.27–0.61) were significantly decreased in the probiotic group. As for mortality (MD 0.75, 95% CI: 0.48–1.16) and the incidence of spontaneous bacterial peritonitis (WMD −0.02, 95% CI: −0.07 to 0.03), no significant differences were found between the probiotic and placebo groups.

Conclusion:

In summary, the gut microbiome in cirrhosis manifests as decreased counts of Lactobacillus and Bifidobacterium and increased counts of Enterobacter and Enterococcus. Targeted supplementation of probiotics in cirrhosis, including Lactobacillus combined with Bifidobacterium or Bifidobacterium alone, can reduce blood ammonia and the incidence of hepatic encephalopathy. The effect is similar to that of lactulose, but it has no obvious effect on mortality and spontaneous bacterial peritonitis.
Combination of Chinese medicinal formulas and chemotherapy for triple-negative breast cancer strengthens body resistance to eliminate pathogenic factors
Authors: Zhang Yiyi , Mo Jing-Wen , Lu Hai-Zhen , Han Ling-Ling , Liu Chengjiang , Zhou Yi
Published: December 2022

Background:

To evaluate the efficacy and safety of strengthening the body’s resistance to eliminate pathogenic factors in Chinese medicinal formulas combined with chemotherapy (hereafter referred to as combined therapy [CT]) in triple-negative breast cancer.

Methods:

By searching the 7 electronic databases, PubMed, EMBASE, Web of Science, Cochrane Library, Chinese Academic Journal, Wanfang Database, and Chinese Science and Technology Journal, from the beginning of the establishment to April 2022 to identify eligible randomized controlled trial studies.

Results:

The meta-analysis showed that compared with chemotherapy, CT can effectively improve the objective remission rate (risk ratio [RR]: 1.39; 95% confidence interval [CI]: 1.28, 1.52; P < .00001, I
2 = 3%), reduce the recurrence rate (RR: 0.33; 95% CI: 0.14, 0.78; P = .01, I
2 = 0%) metastasis rate (RR: 0.48; 95% CI: 0.31, 0.73; P = .0006, I
2 = 0%) and the incidence of toxic and side reactions, lower tumor marker levels, regulated T lymphocyte subset changes, and increased average progression-free survival (standardized mean difference: 2.78; 95% CI: 1.41, 4.14; P < .0001, I
2 = 97%), and improve the quality of life (RR: 1.55; 95% CI: 1.21, 1.99; P = .0005, I
2 = 52%).

Conclusion:

This study suggests that CT appears to be an effective and safe treatment approach. Although this conclusion requires further confirmation owing to insufficient quality of the included trials.
Efficacy and safety of traditional Chinese medicine retention enema in the treatment of anal sinusitis: A protocol for systematic review and meta-analysis
Authors: Jiang Chunlai , Lu Jinwu
Published: December 2022

Background:

Anal sinusitis is an acute or chronic inflammation of the anal sinus, anal flap, and anal glands. There are many traditional Chinese medicine (TCM) therapies for anal sinusitis, and most of them can achieve satisfactory results. Retention enema is one effective treatment for anal sinusitis. Although a number of studies have shown the effectiveness of retention enema with TCM in treating anal sinusitis, the results are inconsistent. Therefore, a meta-analysis was carried out in this study to evaluate the efficacy and safety of retention enema with TCM in the treatment of anal sinusitis.

Methods:

Randomized controlled trials on TCM retention enema for treating anal sinusitis were retrieved from PubMed, EMBASE, The Cochrane Library, CNKI, WanFang databases and VIP databases. The search time limit was from the database establishment to November 15, 2022. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Risk of bias was assessed using the Cochrane Risk of Bias Tool (RoB 2.0). The meta-analysis was conducted by RevMan 5.3.

Results:

The results of this study will be published in a peer-reviewed publication.

Conclusion:

This systematic review and meta-analysis will provide evidence for the efficacy and safety of TCM retention enema in the treatment of anal sinusitis.
Regional variation of medical expenditures attributable to hypertension in China’s middle-aged and elderly population
Authors: Sheng Huilin , Dong Weihua , He YunZhen , Sui Mengyun , Li Hongzheng , Liu Ziyan , Wang Huiying , Chen Zhi , Xue Long
Published: December 2022

Background:

Hypertension is a prevalent and costly health condition in China. Little is known about variation of the inpatient and outpatient expenditures attributable to hypertension between prefecture-level administrative regions (PARs) and the drivers of such variation among China’s middle-aged and elderly population.

Methods:

We obtain data from China Health and Retirement Longitudinal Survey between 2011 and 2015, panel tobit models were used in our study to estimate differences across 122 PARs. Expenditure variation was explained by the characteristics of individuals and regions, including measures of healthcare supply.

Results:

The cost of treatment for patients with hypertension varies greatly geographically, with the highest outpatient and inpatient costs being 77 and 102 times the lowest, respectively. After adjustment for the individual and PAR character, there are associations between expenditure and region bed density.

Conclusion:

There were significant regional differences in the outpatient and inpatient costs of middle-aged and elderly patients with hypertension in China, the difference between individuals may be an important reason, which has little to do with regional economic development differences, but is related to regional bed density.
How international are the editorial boards in the field of foot and ankle surgery?: A STROBE-compliant cross-sectional study
Authors: Jia Zhiwei , Liu Donghua , Xu Jiao , Wang Qiang , Yin Shi , Zhang Longyu , Li Xingxuan , Qian Bo , Wu Yaohong , Wen Tianlin
Published: December 2022

Very low proportions of publications from low- and middle-income countries (LAMIC) have been proved in multiple fields. Some researchers from these countries believe that there is a biased attitude of editors against their studies. Under-representation of editorial board members from LAMIC were revealed in many research fields. However, it has not been investigated in the field of foot and ankle surgery. The current study aimed to analyze the composition of the editorial board members in leading foot and ankle journals, and to provide the international representation of editorial boards in the field of foot and ankle surgery. Five leading journals in the field of foot and ankle surgery were included. The editorial board members were collected from the official websites of these journals. The countries of board members were classified based on World Bank. The board compositions of the journals were analyzed. In total, 229 editorial board members were identified. These editors were from 29 countries. The United States (29.69%) had the greatest number of editors, followed by the United Kingdom (20.52%), Australia (8.30%), Italy (6.11%), and Germany (5.68%). When the editors were classified by regions, 49.34% of board members were from Europe & Central Asia, followed by North America (31.44%), East Asia & Pacific (14.41%), Latin America & Caribbean (2.62%), and Middle East & North Africa (2.18%). No editors were from South Asia and Sub-Saharan Africa. A total of 217 editors (94.76%) were from high-income countries, followed by upper-middle-income countries (3.06%), and lower-middle-income countries (2.18%). No members were from low-income countries. There is a lack of international representation on editorial boards of leading foot and ankle journals. Editorial board members in the field of foot and ankle surgery are largely composed by editors from high-income countries with sever under-representation of LAMIC.
Comparison of next-generation sequencing with traditional methods for pathogen detection in cases of lower respiratory tract infection at a community hospital in Eastern China
Authors: Yang Yi , Zhu Xingxing , Sun Yahong , Qian Kun , Liu Zhihao
Published: December 2022

Lower respiratory tract infection (LRTI) is still a threat to human health. Metagenomics next-generation sequencing (NGS) provides an efficient and unbiased way to identify LRTI pathogens, and has been shown to have several advantages over traditional methods. However, its application is currently limited in low-resource settings. Our aim was to collect and analyze data on LRTI cases at a county-level community hospital in Eastern China over one year, in order to compare the efficiency of NGS and traditional methods including culture, nucleic acid amplification and antibody techniques. We performed NGS of bronchoalveolar lavage fluid (BALF) for pathogen identification in 71 patients with LRTI. We compared the detection rates, identified pathogens, and turnaround time of NGS with traditional methods. Pathogens were detected using traditional methods in 19 cases, and the results were compared with those obtained with the NGS technique in 60 cases. The pathogen detection rate of NGS (84.5%) was much higher than that of the traditional methods (26.8%). Moreover, with the traditional methods considered the gold standard, the consistency rate between NGS and traditional methods was 68.4%. For the 19 cases in which the traditional method was used, the main pathogens included invasive Aspergillus (5 cases), Pseudomonas aeruginosa (3 cases), Candida albicans (3 cases), and Staphylococcus aureus (2 cases). Among the 60 cases detected by NGS, the main pathogens included Mycobacterium (12 cases), Streptococcus pneumoniae (5 cases), Klebsiella pneumoniae (3 cases), P. aeruginosa (3 cases), Haemophilus influenzae (3 cases), and S. aureus (3 cases), Aspergillus (9 cases), Pneumocystis jiroveci (5 cases), C. albicans (3 cases), Human Papilloma Virus (9 cases), Epstein-Barr virus (8 cases), and parvovirus (6 cases). In addition, 2 cases of chlamydia and 1 case of mycoplasma infection were detected by NGS. The time taken to perform the NGS tests was significantly shorter than that taken with the traditional method. NGS analysis of bronchoalveolar lavage fluid, in combination with traditional pathogen detection methods, can improve the efficiency of pathogen detection. More attention should be paid to the regional epidemic characteristics of infectious pathogens in LRTI.
Reoperation of epicanthal reconstruction using a modified reverse skin-redraping method
Authors: Chung Yoon Jae , Park Bo Young
Published: December 2022

With the increasing adoption of medial epicanthoplasty or reconstruction procedures, the number of patients undergoing reoperations is also increasing. However, the surgical techniques useful for reoperations and the potential difficulties during reoperations have not been adequately elucidated. We aimed to describe the use of our modified reverse skin-redraping technique to improve cosmetic outcomes in patients who had previously undergone epicanthal reconstruction. From January 2014 to January 2021, we performed reoperations using our modified reverse skin-redraping technique in patients who had previously undergone epicanthal reconstruction. The main reason for the reoperations was cosmesis. The patients’ ages ranged from 21 to 46 years (average, 28.7 years), and the follow-up periods ranged from 6 to 12 months. A total of 389 patients (311 females and 78 males) underwent reoperations, of which 324 patients (83%) underwent 1 reconstructive surgery and 65 (17%) underwent reconstructive surgeries more than twice after primary epicanthoplasty. The postoperative intercanthal distances could be increased or decreased depending on the preoperative design. After reoperation, 22 patients (5.6%) required additional reoperation. Reoperation of epicanthoplasty is technically challenging. The scarred round shape of the medial epicanthus during the reoperation poses difficulties, and the optimal technique to be used remains unknown. We believe that selection of an individualized restoration method that suits the purpose of surgery is important for patients who require reoperations. In this respect, we suggest that our modified reverse skin-redraping method is a suitable option for improving esthetic outcomes.
A preoperative parathyroid scan is important for the total removal of the transplanted parathyroid tissue in recurrent secondary hyperthyroidism: A case report and literature review
Authors: Guo Xin-Ling , Yin Wen-Yao
Published: December 2022

Rationale:

Secondary hyperparathyroidism was one of mineral and bone disorders owing to chronic kidney disease. Patients who suffer from secondary hyperparathyroidism would receive medical treatment or parathyroidectomy with or without autotransplantation (AT). However, some patients receiving parathyroidectomy with AT have recurrent hyperparathyroidism, which impacts their lives. Patients with recurrent hyperparathyroidism may present persistent hypercalcemia and hyperphosphatemia, which would cause cardiovascular disease, like atherosclerosis.

Patient concerns:

A 63-year-old female of Asian descent with chronic kidney disease who suffered from recurrent hyperparathyroidism for twice. The patient underwent parathyroidectomy with AT in the left thigh when secondary hyperparathyroidism happened. After 3 months, recurrent hyperparathyroidism happened.

Diagnosis:

The patient was diagnosed with recurrent hyperparathyroidism due to chronic kidney disease with hyperparathyroidism status post parathyroidectomy with AT in the left thigh. Our patient also suffered from mineral and bone disorder.

Intervention:

Two parathyroid adenoma in the left thigh were found. However, one of them was too small to found in the operation. Therefore, autograftectomy of the large one was performed. However, hyperparathyroidism happened again. This time, the autograftectomy was performed under dual phase Tc-99m MIBI (99m Tc-methoxy isobutyl isonitrile) parathyroid scintigraphy and it succeeded.

Outcomes:

After secondary autograftectomy, the value of intact parathyroid hormone was surveyed immediately and dropped by two-third followed by gradual reduction in the following weeks. The calcemia and phosphatemia were back to normal gradually.

Lessons:

In our case, importance of scintigraphy in the parathyroidectomy was confirmed.
An unusual pseudolymphoma in the context of necrotizing fasciitis: A case report
Authors: Dislich Bastian , Hoch Dennis , Dirnhofer Stefan , Novak Urban , Banz Yara
Published: December 2022

Rationale:

The diagnosis of lymphoma in routine diagnostics can be challenging due to clinical, morphological and immunphenotypical overlap with unusual reactive processes termed “pseudolymphomas.”

Patient concerns:

45-year-old male that underwent surgical debridement for a necrotizing fasciitis of the thigh with concomitant excision of a regional lymph node.

Diagnoses:

The lymph node demonstrated an architecture-effacing activation and proliferation of lymphoblasts and was initially misdiagnosed as an aggressive lymphoma. Only in consideration of the clinical context and with the help of additional immunohistochemical and molecular analyses the final diagnosis of a reactive lymphadenopathy could be made.

Interventions:

No further therapy was required after the final diagnosis of a reactive lymphadenopathy was made.

Outcomes:

The clinical follow-up was unremarkable, with no evidence of residual disease after 6 months.

Lessons:

This case report adds the parafollicular activation and proliferation of blasts and plasmablasts in the drainage area of an active infection to the spectrum of “pseudolymphomas” and reiterizes the importance of placing histopathological findings in the proper context.
C.487C>T mutation in PAX4 gene causes MODY9: A case report and literature review
Authors: Zhang Di , Chen Congli , Yang Wenli , Piao Yurong , Ren Li , Sang Yanmei
Published: December 2022

Rationale:

Maturity-onset diabetes of the young (MODY) is a group of autosomal dominant monogenic diabetes mellitus with a wide range of clinical manifestations that require distinct treatment strategies. MODY9 (OMIM # 612225) is a rare type of MODY, caused by a mutation in the Paired box gene 4 (PAX4).

Patient concern:

A 19-months boy was admitted to the department of endocrinology at Beijing Children’s Hospital due to excessive water drinking, polyuria for over half a month, and wheezing for 3 days.

Diagnose:

The whole-exon sequencing analysis demonstrated that the child carried the heterozygous missense mutation of c.487>T in the 7th exon region of PAX4 gene and diagnosed MODY9.

Intervention:

The patient was treated with fluid therapy, ketosis correction, insulin, and anti-infection treatment.

Outcomes:

After 17 days in the hospital, the blood glucose levels remained stable and the patient was discharged.

Lessons:

In Chinese children, the heterozygous mutation of c.487C>T in the PAX4 gene can lead to the occurrence of MODY9.Gene sequencing analysis is of great significance in the diagnosis and classification of MODY.
Association of hormone replacement therapy and the risk of knee osteoarthritis: A meta-analysis
Authors: Hou Wen-Yuan , Zhu Cai-Yu , Gu Yi-Fan , Zhu Lei , Zhou Zheng-Xin
Published: December 2022

Background:

The relationship between hormone replacement therapy (HRT) and osteoarthritis is controversial in epidemiological studies. With the aim of better understanding the effect of HRT use, this first meta-analysis was implemented to explore the association of HRT and knee OA.

Methods:

A series of data is retrieved from Web of Science, PubMed, and Embase databases to observe the association of HRT and knee osteoarthritis up to December 2021. Two separated reviewers chose the research, extracted the data, and evaluated the study quality. Pooled estimates of 95% CI and HRs were acquired through a random-effects model.

Results:

Finally, there existed 13 pieces of research, containing one case-control research, four cross-sectional pieces of research, as well as eight cohort pieces of research, involving 2573,164 participants. The overall results showed that the use of HRT was related to a raised risk of knee OA (HR = 1.24, 95% CI 1.07–1.45). And the pooled analysis showed a statistically significant raised risk of knee joint replacement (HR = 1.30, 95% CI 1.09–1.54) when using HRT. In addition, the outcome exhibits the raised knee OA risk for the present users of HRT (HR = 1.40, 95% CI 1.16–1.68) according to HRT status. In the past users of HRT, the augment of knee OA risk was not statistically evident (HR = 1.16, 95% CI 0.94–1.42).

Conclusion:

We observed that HRT use was related to a raised knee OA risk. Furthermore, future studies might focus on relevant mechanistic to verify our observed associations.
Extension of decompression to C2 doesn’t affect the spinal sagittal parameters compared with standard open-door laminoplasty
Authors: Wang Wenxuan , Xue Chenhui , Ma Xun , Feng Haoyu , Ma Zhuo , Guan Xiaoming , Chen Xu , Zhang Xin
Published: December 2022

We modified and extended laminoplasty to the upper cervical spine on patients with canal stenosis associated with upper cervical spinal ossified lesions. However, whether the extended decompression range of laminoplasty can cause further effects on cervical stability is rarely studied at present.

A retrospective study to analyze the relationship between the surgical levels and cervical sagittal parameters effects was performed in patients with cervical spondylosis myelopathy who had undergone posterior cervical expansive open-door laminoplasty with/without extending to C2.

In total, 64 patients were divided into 2 groups according to the surgical levels. Radiologic outcomes of occipito-cervical angle (C0-2 Cobb angle), CL C27 Cobb angle, cervical sagittal vertical alignment, T1-Slope (T1S), T1S minus CL (T1S–CL), spino-cranial angle and center of the sella turcica–C7 SVA (St-SVA) were evaluated on lateral X-rays of the cervical spine at pre-operation, post-operation, and 2-year follow-up. The patient’s health-related quality of life was obtained including neck disability index, Japanese orthopaedic association scores, and visual analog scale.

Changes in sagittal parameters were observed in both groups after surgery. T1S, cervical sagittal vertical alignment, and T1S-CL significantly increased and CL decreased in 2 groups of patients postoperative. After a 2-year follow-up period, the C0-2 Cobb angle was found to increase compared to preoperative records. In addition, there were no significant differences in spino-cranial angle and st-SVA between preoperative and 2 years follow-up measurements. Health-related quality of life was improved in both groups and was not significantly different.

Herein, the parameters indicated a tilting forward of the lower cervical spine and a more lordotic upper cervical spine to maintain a horizontal gaze in patients. However, C2 to 7 laminoplasty was performed to achieve satisfactory clinical results without significantly changing the spinal sagittal parameters.
Association of hypernatremia with outcomes of COVID-19 patients: A systematic review and meta-analysis
Authors: Shrestha Abhigan Babu , Sapkota Unnat Hamal , Shrestha Sajina , Aryal Manjil , Chand Swati , Thapa Sangharsha , Chowdhury Faisal , Salman Abdullah , Shrestha Shumneva , Shah Sangam , Jaiswal Vikash
Published: December 2022

Background:

This systematic review and meta-analysis aimed to assess the association of hypernatremia with the outcomes of COVID-19 patients.

Methods:

We performed a systematic literature search on PubMed, Google Scholar, and Science Direct until October 2021 and found a total of 131 papers. With meticulous screening finally, 17 papers met the inclusion criteria. COVID-19 patients with sodium levels greater than the reference level were the study population and the outcome of interest was the poor outcome; such as mortality, mechanical ventilation, intensive care unit (ICU) admission, and prolonged hospital stay. The pooled estimate was calculated as the odds ratio (OR).

Results:

There were 19,032 patients with hypernatremia in the 17 studies included. An overall random effect meta-analysis showed that hypernatremia was associated with mortality (OR: 3.18 [1.61, 6.28], P < .0001, I
2 = 91.99%), prolong hospitalization (OR: 1.97 [1.37, 2.83], P < .001, I
2 = 0.00%) and Ventilation (OR: 5.40 [1.89, 15.42], P < .001, I
2 = 77.35%), ICU admission (OR: 3.99 [0.89, 17.78], P = .07, I
2 = 86.79%). Meta-regression analysis showed the association of age with the ICU outcome of hypernatremia patients. Whereas, other parameters like male, hypertension, chronic kidney disease, and diabetes mellitus did not significantly influence the odds ratio.

Conclusion:

Hypernatremia was markedly associated with poor outcomes in patients with COVID-19. Hence, a blood ionogram is warranted and special attention must be given to hypernatremia COVID-19 patients.
HFA-PEFF score as an independent predictor of 2-year mortality in liver cirrhosis patients
Authors: Dimitroglou Yannis , Tsartsalis Dimitrios , Vasilieva Larisa , Patsourakos Dimitrios , Kalompatsou Argyro , Alexopoulou Alexandra , Tousoulis Dimitris , Tsioufis Konstantinos , Aggeli Constantina
Published: December 2022

Background and aims

Cardiovascular complications of liver cirrhosis include high cardiac output heart failure with reduced afterload and diastolic dysfunction. Heart Failure Association Pre-test assessment, Echocardiography and natriuretic peptide, Functional testing, Final etiology (HFA-PEFF) (values 0–6) is a diagnostic tool for heart failure. It is a cluster of echocardiographic and biochemical parameters. The purpose of this prospective study was to assess if HFA-PEFF score is associated with the severity of liver disease and to determine its prognostic significance in patients with cirrhosis.

Methods

Patients with cirrhosis without an acute event were enrolled. A comprehensive echocardiography study was conducted, brain natriuretic peptide and N-terminal-pro-B-type Natriuretic Peptide levels were measured and HFA-PEFF score was calculated. All patients were prospectively followed up after enrollment. The study end-point was defined as the composite of all-cause death.

Results

Seventy-two consecutive patients [median age 59 years (inter-quartile range: 52–65), 72.2% males, Model for End-stage Liver Disease (MELD) 12.9 (8.5–16.3)] were included. The 52.8% had a high HFA-PEFF score (5 or 6) and the 47.2% intermediate/low score (0–4). HFA-PEFF score was correlated with MELD score (rho = 0.566, P < 0.001), but not with age, SBP and heart rate. The median follow-up was 24.2 (9.5–38.8) months. The 1- and 2-year cumulative mortality was higher in patients with high HFA-PEFF compared to those with intermediate/low (log-rank P < 0.001 for both). The predicted 2-year probability of survival in high vs intermediate/low HFA-PEFF was found to be a prognostic factor of death even when adjusted for age, gender and MELD score [hazard ratio = 3.539 (1.134–11.046), P = 0.029].

Conclusion

HFA-PEFF score is high among patients with liver cirrhosis, especially those with advanced liver disease. HFA-PEFF score is associated with survival even when adjusting for cirrhosis severity.
Fib-4 index predicts prognosis after achievement of sustained virologic response following direct-acting antiviral treatment in patients with hepatitis C virus infection
Authors: Ideno Naomi , Nozaki Akito , Chuma Makoto , Ogushi Katsuaki , Hara Koji , Moriya Satoshi , Fukuda Hiroyuki , Numata Kazushi , Maeda Shin
Published: December 2022

Objective(s)

Toinvestigate liver carcinogenesis and other causes of death by collecting clinical data, including the Fib-4 index, from patients with successfully eradicated hepatitis C virus (HCV) by direct-acting antivirals (DAA) treatment.

Methods

Patients (n = 690), who achieved a sustained virologic response (SVR) between 2014 and 2021, were identified and followed up for approximately 6.8 years; 71 incident hepatocellular carcinoma (HCC) cases were identified. The Fib-4 index was calculated at DAA-treatment initiation and HCV eradication, and its relationship with carcinogenesis and prognosis was analyzed.

Results

The Fib-4 index was initially calculated and divided into three groups: Fib-4<1.45, 1.45 ≤ Fib-4<3.25, and 3.25 ≤ Fib-4 to develop HCC over time. On analysis, no carcinogenic cases were observed at Fib-4<1.45. In patients with a Fib-4 index ≥3.25, the initial HCC carcinogenic rate was higher than that in patients with Fib-4=1.45–3.25, and a significant difference was obtained between the two groups [P = 0.0057 (<1.45 vs. >3.25); P = 0.0004 (<1.45–3.25 vs. >3.25)]. Regarding all 18 death and Fib-4 at treatment initiation, a significant difference was observed after stratification into two groups [Fib-4 < 3.25 and 3.25 ≤ Fib-4; P = 0.0136 (<3.25 vs. ≥3.25)]. Significant differences were obtained in another analysis of 13 deaths, not due to HCC.

Conclusions

The high Fib-4 index calculated at baseline and SVR12 significantly correlated not only with liver carcinogenesis but also with all mortality rates, including those due to causes other than liver cancer. Our findings suggest that improving liver fibrosis by eradicating HCV improves prognosis related to all etiologies.
A review of edible plant-derived natural compounds for the therapy of liver fibrosis
Authors: Xu Wenjuan , Wang Longde , Niu Yuanyuan , Mao Lanfang , Du Xiaojuan , Zhang Ping , Li Zhengju , Li Hongfang , Li Ning
Published: December 2022

Liver fibrosis has a high incidence worldwide and is the common pathological basis of many chronic liver diseases. Liver fibrosis is caused by the excessive deposition of extracellular matrix and concomitant collagen accumulation in livers and can lead to the development of liver cirrhosis and even liver cancer. A large number of studies have provided evidence that liver fibrosis can be blocked or even reversed by appropriate medical interventions. However, the antifibrosis drugs with ideal clinical efficacy are still insufficient. The edible plant-derived natural compounds have been reported to exert effective antifibrotic effects with few side-effects, representing a kind of promising source for the treatment of liver fibrosis. In this article, we reviewed the current progress of the natural compounds derived from dietary plants in the treatment of liver fibrosis, including phenolic compounds (capsaicin, chlorogenic acid, curcumin, ellagic acid, epigallocatechin-3-gallate, resveratrol, sinapic acid, syringic acid, vanillic acid and vitamin E), flavonoid compounds (genistein, hesperidin, hesperetin, naringenin, naringin and quercetin), sulfur-containing compounds (S-allylcysteine, ergothioneine, lipoic acid and sulforaphane) and other compounds (betaine, caffeine, cucurbitacin B, lycopene, α-mangostin, γ-mangostin, ursolic acid, vitamin C and yangonin). The pharmacological effects and related mechanisms of these compounds in in-vivo and in-vitro models of liver fibrosis are focused.
Debriefing Among Hospice Professionals During a Pandemic
Authors: Knott Holly , Dambrino Kathryn L. , Busby Steven , Rasmussen Amy
Published: December 2022

Although the hospice industry cannot afford to lose professionals to compassion fatigue and burnout, work challenges related to the COVID-19 pandemic potentially place hospice professionals at an increased risk. Reflective debriefing has been recommended to provide emotional support to battle job dissatisfaction, compassion fatigue, and burnout. The purpose of this study was to provide reflective debriefing sessions to hospice professionals and identify common themes reported about their professional and personal experiences during the COVID-19 pandemic. A qualitative descriptive design using focus groups set up as reflective debriefing sessions based on the Gibbs' Reflective Cycle was used. Debriefing sessions were recorded and transcribed for coding, followed by identification of themes. A total of 26 themes emerged from the data collected from the debriefing sessions. A postsurvey found that 96.0% of participants found the debriefing session helpful. Furthermore, 92.3% of participants answered they would like to regularly debrief at their workplace. During the pandemic, hospice professionals are at an increased risk of compassion fatigue and burnout from changes in the work, patient, and person environments caused by the pandemic. To address the unprecedented challenges hospice professionals are facing, it is imperative that employers provide them with emotional support.
Diagnosis of Metastatic Lymph Nodes in Patients With Hepatocellular Carcinoma Using Dual-Energy Computed Tomography
Authors: Mo Huiqiang , Huang Ruisui , Wei Xue , Huang Lifeng , Huang Jianning , Chen Jiong , Qin Mi , Lu Wei , Yu Xiaofang , Liu Manrong , Ding Ke
Published: December 2022

Objective

Our study aimed to investigate the role of quantitative parameters derived from dual-energy computed tomography (DECT) in discriminating metastatic from nonmetastatic lymph nodes in hepatocellular carcinoma (HCC).

Methods

Forty-two patients (34 males; mean age, 53.7 years) with HCC underwent unenhanced computed tomography scans and triple-phase DECT scans of the upper abdomen. A total of 72 suspected lymph nodes were resected, including 43 nonmetastatic and 29 metastatic lymph nodes. The maximum short-axis diameter of the lymph nodes, iodine concentration, normalized iodine concentration (NIC), and slope of the spectral curve were analyzed for the HCC primary lesions and the suspected lymph nodes. Lymph node metastasis was confirmed by pathologic examination.

Results

A maximum short-axis diameter of >10 mm had a sensitivity and a specificity of 75.9% (22/29) and 53.5% (23/43) in diagnosing metastatic lymph nodes. The iodine concentration, NIC, and slope of the spectral curve of the nonmetastatic lymph nodes were significantly higher than those of the primary HCC lesions and the metastatic lymph nodes (all P < 0.05). Among all the analyzed spectral parameters, the NIC in the arterial phase had the highest sensitivity and specificity of 88.4% and 86.2% in diagnosing metastatic lymph nodes.

Conclusions

The arterial phase NIC of DECT has superior diagnostic performance than the traditional lymph node size in diagnosing metastatic lymph nodes in HCC.
Prior infection- and/or vaccine-induced protection against Omicron BA.1, BA.2 and BA.4/BA.5-related hospitalisations in older adults: a test-negative case-control study in Quebec, Canada
Authors: Carazo Sara , Skowronski Danuta M. , Brisson Marc , Sauvageau Chantal , Brousseau Nicholas , Fafard Judith , Gilca Rodica , Talbot Denis , Ouakki Manale , Febriani Yossi , Deceuninck Geneviève , De Wals Philippe , De Serres Gaston
Published: December 2022

Background

Due to severe outcomes, elderly adults 60 years or older are prioritized for COVID-19 vaccination but accumulated SARS-CoV-2 infection and vaccination likely modifies their risk. We estimated vaccine effectiveness against omicron-associated hospitalisation among elderly adults, by number of doses, prior infection history and time since last immunological event.

Methods

We conducted a test-negative case-control study among symptomatic elderly adults tested for SARS-CoV-2 in Quebec, Canada during BA.1-, BA.2- and BA.4/5-dominant periods. Relative to unvaccinated, infection-naïve participants, we compared COVID-19 hospitalisation risk by mRNA vaccine dose and/or prior infection (pre-omicron or omicron) history.

Findings

During BA.1, BA.2 and BA.4/5 periods, two- vs. four-dose vaccine effectiveness alone against hospitalisation was: 78% (95%CI:75-80) vs. 96% (95%CI:93-98); 60% (95%CI:50-97) vs. 84% (95%CI:81-87); and 40% (95%CI:30-49) vs. 68% (95%CI:63-72), respectively, consistent with longer median time since second vs fourth dose. By respective period, effectiveness of pre-omicron vs. omicron infection alone against hospitalisation was: 93% (95%CI:80-97) vs. [not estimable]; 88% (95%CI:50-97) vs. 96% (95%CI:68-99); and 69% (95%CI:30-85) vs. 90% (95%CI:79-95). Regardless of doses (2-5) or prior infection type, hybrid protection was ≥90%, lasting at least 6-8 months during the BA.4/5 period. Prior omicron infection alone reduced BA.4/5 hospitalisation risk by >80% for at least 6-8 months.

Interpretation

Elderly adults with history of both prior SARS-CoV-2 infection and ≥2 vaccine doses appear well-protected for a prolonged period against omicron hospitalisation, including BA.4/5. Ensuring infection-naïve older adults remain up-to-date with vaccination may further reduce COVID-19 hospitalisations most efficiently.

Funding

Ministère de la Santé et des Services sociaux du Québec.
EFFECTIVENESS OF CASIRIVIMAB-IMDEVIMAB AND SOTROVIMAB MONOCLONAL ANTIBODY TREATMENT AMONG HIGH-RISK PATIENTS WITH SARS-CoV-2 INFECTION: A REAL-WORLD EXPERIENCE
Authors: Murugapandian Sangeetha , Gungor Ahmet B. , Al-Obaidi Mohanad , Thajudeen Bijin , Wong Ryan C. , Mansour Iyad , Zangeneh Tirdad T. , Johnson Katherine M. , Low-Adegbija Nicole E. , Alam Ruhaniyah , Gonzalez-Negrete Elvira , Sandıkçı Burhaneddin , Gupta Gaurav , Bedrick Edward J. , Saridogan Turcin , Mendoza Katherine , Tanriover Bekir
Published: December 2022

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can evade neutralizing antibodies, raising concerns about the effectiveness of anti-spike monoclonal antibodies (mAb).

METHODS

This study reports a retrospective data analysis in Banner Health Care System. Out of 109,788 adult patients who tested positive for COVID-19, the study cohort was split into patients who received Casirivimab-Imdevimab (Cas-Imd) (N=10,836; Delta-predominant period 6/2021-11/2021) and Sotrovimab (N=998; Omicron-predominant period 12/2021-1/2022) mAb compared to propensity-matched control groups (N=10,836 and N=998), respectively. Index date was the date of mAb administration or the date of positive COVID-19 testing. The primary and secondary outcomes were the incidence of composite outcome (all-cause hospitalization and/or mortality) and ICU admission at 30-days following index date, respectively.

RESULTS

Compared to the propensity-matched untreated control cohort, the Cas-Imd mAb reduced the composite outcome (from 7.5% to 3.7%; difference: -3.8% [95% CI: (-4.4%, -3.2%)], p <0.01) regardless of their vaccination status, while Sotrovimab mAb did not (5.0% vs. 3.8%; difference: -1.2% [95% CI: (-3.1%, 0.7%)], p =0.22). In terms of the secondary outcome, similarly Cas-Imd mAb decreased ICU admission during the first hospitalization (from 1.5% to 0.5%; difference: -1.0% [95% CI: (-1.3%, -0.7%)], p <0.01) compared to the control group, whereas Sotrovimab mAb did not (0.9% vs. 0.6%; difference: -0.3% [95% CI: (-1.2%, 0.6%)], p =0.61). Comparing the periods, the Omicron-predominant period was associated with lower composite outcome than that during the Delta-predominant period.

CONCLUSIONS

Cas-Imd mAb was effective against the SARS-CoV-2 Delta variant, however sotrovimab lacked efficacy in patients with SARS-CoV-2 Omicron-predominant period.

Key Points

This retrospective propensity matched analysis showed that treatment with Cas-Imd mAb was effective against the SARS-CoV-2 Delta variant to reduce the all-cause hospitalization and mortality within 30 days, by contrast sotrovimab mAb utilization lacked the efficacy against SARS-CoV-2 Omicron variant.
Mouse helpers ensure maternal-infant survival
Authors: Schuster Luisa , Henderson Renee , Ivan Violet J. , Caslin Asha , Kaur Gurket , Sankar Shreya , Ananth Deepasri , Kirk Matilda , Khatri Latika , Leone Paola , Adolph Karen E. , Froemke Robert C. , Mar Adam
Published: December 2022

Parental care is required for offspring health and survival, as infants are largely helpless and require near-continual oversight for extensive periods. Parents must balance caretaking behaviors with other activities for their own survival such as thermoregulation and foraging, necessarily involving consequential decision-making and periods of pup neglect. We built a new system for long-term continuous recordings of mouse homecage behaviors, monitoring single wild-type or oxytocin receptor knockout (OXTR-KO) dams and offspring over four litters. Here we show that experienced female mouse mothers use behavioral mechanisms to ensure maternal and infant survival of other consociating animals. Many wild-type mothers had high litter survival rates (‘high-pup-survival’ dams), but about a third of wild-types had little to no pups survive (‘low-pup-survival’ dams), and this did not change across litters. Low-pup-survival dams generally avoided pups and nests. However, if low-pup-survival dams were temporarily co-housed with a high-pup-survival dam and her litter, their litter survival rates then enduringly increased due to enhanced attention toward pups and nests. In contrast, almost all singly-housed OXTR-KOs died in childbirth and their pups perished after prolonged parturition. Co-housing with another female prevented maternal and infant mortality, with the other female removing and cleaning pups from the pregnant dam. These results show that even under well-controlled housing conditions, mouse maternal care can be remarkably variable, with continued nest rebuilding as a major factor for post-parturition litter survival. While some single mothers continually lose their litters or die in labor, maternal and infant survival can improve through interactions with other experienced females.
Techniques for Developing Reliable Machine Learning Classifiers Applied to Understanding and Predicting Protein:Protein Interaction Hot Spots
Authors: Chen Jiaxing , Kuhn Leslie A. , Raschka Sebastian
Published: December 2022

With machine learning now transforming the sciences, successful prediction of biological structure or activity is mainly limited by the extent and quality of data available for training, the astute choice of features for prediction, and thorough assessment of the robustness of prediction on a variety of new cases. Here we address these issues while developing and sharing protocols to build a robust dataset and rigorously compare several predictive classifiers using the opensource Python machine learning library, scikit-learn. We show how to evaluate whether enough data has been used for training and whether the classifier has been overfit to training data. The most telling experiment is 500-fold repartitioning of the training and test sets, followed by prediction, which gives a good indication of whether a classifier performs consistently well on different datasets. An intuitive method is used to quantify which features are most important for correct prediction.

The resulting well-trained classifier,hotspotter, can robustly predict the small subset of amino acid residues on the surface of a protein that are energetically most important for binding a protein partner: the interaction hot spots.Hotspotterhas been trained and tested here on a curated dataset assembled from 1,046 non-redundant alanine scanning mutation sites with experimentally measured change in binding free energy values from 97 different protein complexes; this dataset is available to download. The accessible surface area of the wild-type residue at a given site and its degree of evolutionary conservation proved the most important features to identify hot spots. A variant classifier was trained and validated for proteins where only the amino acid sequence is available, augmented by secondary structure assignment. This version ofhotspotterrequiring fewer features is almost as robust as the structure-based classifier. Application to the ACE2 receptor, which mediates COVID-19 virus entry into human cells, identified the critical hot spot triad of ACE2 residues at the center of the small interface with the CoV-2 spike protein.Hotspotterresults can be used to guide the strategic design of protein interfaces and ligands and also to identify likely interfacial residues for protein:protein docking.
Coproduction in evaluating a dual diagnosis tool with youth in a residential mental health service
Authors: Kroes Simon , Myers Kevan , McLoughlan Grace , O'Connor Sarah , Keily Erin , Petrakis Melissa
Published: December 2022

Purpose

The purpose of this study was to utilise a lived experience (LE) informed/co-designed approach to explore the service-user experience of using the reasons for use package (RFUP) within a youth residential rehabilitation mental health setting.

Design/methodology/approach

LE researchers (those who have lived through mental illness or distress), Master of social work students, a community of mental health service manager, community of mental health researchers, dual diagnosis service researchers and university-based researchers collaborated on the project. The study used an exploratory, qualitative approach of semi-structured interviews to invite young people's experiences of the resource. The research team conducted a collaborative thematic analysis drawing on the range of perspectives.

Findings

Through five interviews with young people, key themes identified included: client factors and extra-therapeutic events, relationship factors, technique/model factors/delivery and outcomes/things noticed.

Practical implications

The RFUP was a useful clinical tool with the young people in this pilot as it improved awareness of reasons for drug use and impact on mental health, service user to staff relationship, quality of the resource, mode of delivery and participant self-knowledge.

Originality/value

Young people valued the supportive role that the RFUP played in facilitating positive relationships with their workers.
Food discourse: ethics and aesthetics on Instagram
Authors: Irimiás Anna Rita , Volo Serena
Published: December 2022

Purpose

The aim of the study is threefold: understanding the interconnections amongst visual and verbal multimodal communication strategies used in food discourse; identifying the themes of celebrity chef's food discourse with respect to pro-environmental behaviour; and providing a methodological framework to visually analyse food-themed videos.

Design/methodology/approach

This study uses mise-en-scène and critical discourse and multimodal analyses to gain insights on food discourse from 20 videos shared by a Michelin starred chef on social media platforms.

Findings

Results show that a pro-environmental cooking philosophy challenges the normative discourse on food and educates general audiences and foodies alike. Mise-en-scène and discourse analyses of Instagram visual content reveal that leftovers are central to the ethical message and are intertwined – through the aesthetic of the videos-with concepts of inclusivity, diversity and nourishment.

Practical implications

Chefs, and restaurants, are encouraged to recognise their responsibility as role models, thus able to influence the societal production of food discourse.

Originality/value

The findings provide new insights into the role of a celebrity chef in promoting sustainable food preparation and consumption.