1
|
Investigation of microglial diversity in a LRRK2 G2019S mouse model of Parkinson's disease. Neurobiol Dis 2024; 195:106481. [PMID: 38527708 DOI: 10.1016/j.nbd.2024.106481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/15/2024] [Accepted: 03/21/2024] [Indexed: 03/27/2024] Open
Abstract
Microglia contribute to the outcomes of various pathological conditions including Parkinson's disease (PD). Microglia are heterogenous, with a variety of states recently identified in aging and neurodegenerative disease models. Here, we delved into the diversity of microglia in a preclinical PD model featuring the G2019S mutation in LRRK2, a known pathological mutation associated with PD. Specifically, we investigated the 'dark microglia' (DM) and the 'disease-associated microglia' (DAM) which present a selective enrichment of CLEC7A expression. In the dorsal striatum - a region affected by PD pathology - extensive ultrastructural features of cellular stress as well as reduced direct cellular contacts, were observed for microglia from old LRRK2 G2019S mice versus controls. In addition, DM were more prevalent while CLEC7A-positive microglia had extensive phagocytic ultrastructural characteristics in the LRRK2 G2019S mice. Furthermore, our findings revealed a higher proportion of DM in LRRK2 G2019S mice, and an increased number of CLEC7A-positive cells with age, exacerbated by the pathological mutation. These CLEC7A-positive cells exhibited a selective enrichment of ameboid morphology and tended to cluster in the affected animals. In summary, we provide novel insights into the occurrence and features of recently defined microglial states, CLEC7A-positive cells and DM, in the context of LRRK2 G2019S PD pathology.
Collapse
|
2
|
Immunophenotypic characterization of leukemic stem cells in acute myeloid leukemia using single tube 10-colour panel by multiparametric flow cytometry: Deciphering the spectrum, complexity and immunophenotypic heterogeneity. Int J Lab Hematol 2024. [PMID: 38456256 DOI: 10.1111/ijlh.14250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/30/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Despite extensive research, comprehensive characterization of leukaemic stem cells (LSC) and information on their immunophenotypic differences from normal haematopoietic stem cells (HSC) is lacking. Herein, we attempted to unravel the immunophenotypic (IPT) characteristics and heterogeneity of LSC using multiparametric flow cytometry (MFC) and single-cell sequencing. MATERIALS AND METHODS Bone marrow aspirate samples from patients with acute myeloid leukaemia (AML) were evaluated using MFC at diagnostic and post induction time points using a single tube-10-colour-panel containing LSC-associated antibodies CD123, CD45RA, CD44, CD33 and COMPOSITE (CLL-1, TIM-3, CD25, CD11b, CD22, CD7, CD56) with backbone markers that is, CD45, CD34, CD38, CD117, sCD3. Single-cell sequencing of the whole transcriptome was also done in a bone marrow sample. RESULTS LSCs and HSCs were identified in 225/255 (88.2%) and 183/255 (71.6%) samples, respectively. Significantly higher expression was noted for COMPOSITE, CD45RA, CD123, CD33, and CD44 in LSCs than HSCs (p < 0.0001). On comparing the LSC specific antigen expressions between CD34+ (n = 184) and CD34- LSCs (n = 41), no difference was observed between the groups. More than one sub-population of LSC was demonstrated in 4.4% of cases, which further revealed high concordance between MFC and single cell transcriptomic analysis in one of the cases displaying three LSC subpopulations by both methods. CONCLUSION A single tube-10-colour MFC panel is proposed as an easy and reproducible tool to identify and discriminate LSCs from HSCs. LSCs display both inter- and intra-sample heterogeneity in terms of antigen expressions, which opens the facets for single cell molecular analysis to elucidate the role of subpopulations of LSCs in AML progression.
Collapse
|
3
|
A Case of Budd-Chiari Syndrome Secondary to Tumor Thrombosis. Cureus 2024; 16:e55330. [PMID: 38562314 PMCID: PMC10982124 DOI: 10.7759/cureus.55330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Budd-Chiari syndrome (BCS) is a rare constellation of conditions due to obstruction of venous flow from anatomical levels ranging from the hepatic veins to the confluence of the inferior vena cava (IVC) and right atrium. The resulting retrograde flow of blood leads to hepatomegaly, ascites, and liver failure among other features. Our case highlights the clinical features, diagnostic challenges, and management of a patient with a tumor thrombus from a metastatic prostate adenocarcinoma in a 67-year-old male leading to BCS. This patient, with a past history of prostate adenocarcinoma and aortic valve replacement on chronic warfarin anticoagulation, presented with acutely worsening abdominal pain and a distended abdomen, and imaging revealed an IVC filling defect. Subsequent imaging with a piflufolastat prostate-specific PET showing increased uptake in the IVC elucidated the diagnosis of tumor thrombosis. Management considerations include aggressive therapy and optimization of quality of life. The patient was offered both options, and options including surgical shunting, bypasses, and anticoagulation were discussed. After shared decision-making, the patient and family opted to choose the pathway of palliative radiation and anticoagulation.
Collapse
|
4
|
Bio-evaluation of poly(lactic-co-glycolic) acid nanoparticles loaded with radiolabelled rifampicin. Br J Clin Pharmacol 2023; 89:3702-3714. [PMID: 37553758 DOI: 10.1111/bcp.15875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/23/2023] [Accepted: 07/20/2023] [Indexed: 08/10/2023] Open
Abstract
AIMS The poly(lactic-co-glycolic) acid (PLGA) nanoparticles of tubercular drugs have been demonstrated to have a sustained release profile over 7 days. There is no information on the location or mode of release of these nanoparticles in living systems. Therefore, we have planned the study to explore the pharmacokinetics and biodistribution of PLGA rifampicin nanoparticles in healthy human volunteers. We aim to study the distribution pattern of PLGA-loaded nano-formulation of radiolabelled rifampicin in humans. METHODS Rifampicin was labelled with 99m Tc by indirect method and nanoparticles were prepared by a single emulsion evaporation method. To investigate the pharmacokinetics and biodistribution of nanoparticles, a single dose of 450 mg of rifampicin was administered orally to healthy human volunteers divided into two different groups. RESULTS Following a single oral dosage of the rifampicin nanoformulation, the pharmacokinetic (PK) parameters were significantly different between the nanoparticle and conventional groups: area under the concentration-time curve (AUC = 113.8 vs. 58.6; P < .001), mean residence time (MRT = 16.2 vs. 5.8; P < .01) and elimination rate constant (Ke = 0.04 vs. 0.10; P < .05). Also, Single-photon emission computed tomography/computed tomography (SPECT/CT) images revealed biodistribution of nanoparticles in the distal portions of the intestine, which is consistent with our dosimetry analysis. CONCLUSIONS Significant difference in PK parameters and biodistribution of nanoparticles in spleen and lymph nodes with maximum deposition were observed in the large intestine. The nanoparticle distribution pattern may be advantageous for the treatment of intestinal or lymph node tuberculosis (TB) and has the potential to result in a lower dose of rifampicin nanoformulation for the treatment of pulmonary TB.
Collapse
|
5
|
Helicase-like transcription factor (HLTF)-deleted CDX/TME model of colorectal cancer increased transcription of oxidative phosphorylation genes and diverted glycolysis to boost S-glutathionylation in lymphatic intravascular metastatic niches. PLoS One 2023; 18:e0291023. [PMID: 37682902 PMCID: PMC10490896 DOI: 10.1371/journal.pone.0291023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
Helicase-like transcription factor (HLTF) also known as SMARCA3, protects genome integrity. A tumor suppressor, HLTF is expressed in tumor cells but not in the tumor microenvironment (TME) in early-stage colorectal cancer (CRC). With disease progression, there is high concordance between epigenetic silencing of HLTF in CRC cells and negligible HLTF expression in the TME. We developed a cell line-derived xenograft (CDX) model and show for the first time that HLTF-deletion in cancer cells and the TME results in metabolic reprogramming that mitigates oxidative stress in lymphatic intravascular metastatic niches. The two metabolic pathways that derive energy from glucose-glycolysis and oxidative phosphorylation (OXPHOS)-are variously utilized by cancer cells depending upon the TME. HIF-1α, a master regulator of glycolysis, was eliminated from a role in reprogramming metabolism to satisfy CDX energetic requirements by RNAseq and spatial transcriptomics. Variability in the gut microbiome, with a putative role in altered metabolism, was also eliminated. HLTF-deleted cancer cells recovered from DNA damage at a transcriptomic level induction of DNA repair and OXPHOS genes linked to an amoeboid-associated phenotype at the tumor border (confocal microscopy). HLTF-deleted cancer and endothelial cells of lymphatic (PDPN) intravascular niches in the TME shared a site-specific protein S-glutathionylation signature (2D DIGE, MALDI-TOF/TOF mass spectrometry) for three glycolytic enzymes (PGK1 Cys379/380, PGAM1 Cys55, ENOA1 Cys119) that diverted glycolysis in support of continued glutathione biosynthesis. The collective absence of HLTF/Hltf from tumor and TME achieved redox homeostasis throughout the CDX and promoted metastasis.
Collapse
|
6
|
Helicase-like transcription factor (Hltf)-deletion activates Hmgb1-Rage axis and granzyme A-mediated killing of pancreatic β cells resulting in neonatal lethality. PLoS One 2023; 18:e0286109. [PMID: 37624843 PMCID: PMC10456192 DOI: 10.1371/journal.pone.0286109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/09/2023] [Indexed: 08/27/2023] Open
Abstract
Epigenetic mechanisms are integral to pancreatic β cell function. Promoter hypermethylation of the helicase like-transcription factor (HLTF) gene-a component of the cellular DNA damage response that contributes to genome stability-has been implicated in age-associated changes in β cells. To study HLTF, we generated global and β cell-specific (β) Hltf knockout (KO) immune competent (IC) and immune deficient (ID) Rag2-/IL2- mice. IC global and β Hltf KO mice were neonatal lethal whereas ID global and β Hltf KO newborn mice had normal survival. This focused our investigation on the effects of Rag2 interruption with common gamma chain interruption on β cell function/survival. Three-way transcriptomic (RNAseq) analyses of whole pancreata from IC and ID newborn β Hltf KO and wild type (Hltf +/+) controls combined with spatially resolved transcriptomic analysis of formalin fixed paraffin embedded tissue, immunohistochemistry and laser scanning confocal microscopy showed DNA damage caused by β Hltf KO in IC mice upregulated the Hmgb1-Rage axis and a gene signature for innate immune cells. Perforin-delivered granzyme A (GzmA) activation of DNase, Nme1, showed damaged nuclear single-stranded DNA (γH2AX immunostaining). This caspase-independent method of cell death was supported by transcriptional downregulation of Serpinc1 gene that encodes a serine protease inhibitor of GzmA. Increased transcriptional availability of complement receptors C3ar1 and C5ar1 likely invited crosstalk with Hmgb1 to amplify inflammation. This study explores the complex dialog between β cells and immune cells during development. It has implications for the initiation of type I diabetes in utero when altered gene expression that compromises genome stability invokes a localized inflammatory response.
Collapse
|
7
|
Solitary Intestinal Lymphangiectasia Causing Transient Intussusception. Cureus 2023; 15:e44206. [PMID: 37767268 PMCID: PMC10521876 DOI: 10.7759/cureus.44206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Lymphangiectasia is the benign malformation of lymphatic channels associated with either focal or diffuse dilation of vessels and impaired lymph drainage. This malformation has the potential to create a cystic mass due to the accumulation of lymphatic fluid. While rare in adults, intussusception, the telescoping of the proximal bowel into the distal bowel, can be caused by a mass within the bowel. In this case, a near-obstructing cystic colon mass developed in a 74-year-old man; this was later found to be a large lymphangiectasia. In addition, this near-obstructing colonic lymphangiectasia served as the lead point in a colo-colonic intussusception. Due to this complication, the mass was immediately removed by a laparoscopic oncologic right-extended hemicolectomy which proved to be both diagnostic and therapeutic.
Collapse
|
8
|
Turning Back The Clock; A Unique Case of Reversible Pulmonary Hypertension. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
|
9
|
Killer cell immunoglobulin-like receptor three domains long cytoplasmic tail 1 gene *007 may modulate disease progression of human immunodeficiency virus-1 infection in the Japanese population. Int J Immunogenet 2023; 50:48-52. [PMID: 36807537 DOI: 10.1111/iji.12617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/19/2023] [Accepted: 02/06/2023] [Indexed: 02/19/2023]
Abstract
One of the KIR allele, KIR3DL1*007, was associated with the progression to acquired immunodeficiency syndrome and not with the susceptibility to HIV-1 infection in the Japanese and Indian populations, implying that KIR3DL1*007-positive NK cells might eliminate HIV-infected cells less effectively than NK cells bearing the other KIR3DL1 alleles or KIR3DS1 alleles.
Collapse
|
10
|
Targets' Coping Responses to Workplace Bullying with Moderating Role of Perceived Organizational Tolerance: A Two-Phased Study of Faculty in Higher Education Institutions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1083. [PMID: 36673836 PMCID: PMC9859087 DOI: 10.3390/ijerph20021083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
This study aims to examine the relationship between workplace bullying and Exit-Voice-Loyalty-Neglect (EVLN) coping responses with Perceived Organizational Tolerance (POT) of bullying as moderator using the integrated model of reactance and learned helplessness theory. The data has been collected from junior faculty in higher education institutes of Punjab. The study has been conducted in two phases, with phase 1 including identifying targets of workplace bullying using cut-off scores and phase 2 studying the perceived organizational tolerance. The results show that junior faculty chooses neglect as a coping response and that the level of perceived organizational tolerance moderates the relationship between workplace bullying and exit-voice-neglect. This study contributes to existing literature by employing integration of theories and using multi-level research design. It also is an addition to the literature on the coping response of targets to workplace bullying in higher education and is a rare attempt at operationalizing perceived organizational tolerance and its relation with workplace bullying.
Collapse
|
11
|
BDL-SP: A Bio-inspired DL model for the identification of altered Signaling Pathways in Multiple Myeloma using WES data. Am J Cancer Res 2023; 13:1155-1187. [PMID: 37168334 PMCID: PMC10164815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/23/2023] [Indexed: 05/13/2023] Open
Abstract
Identification of the genomic features responsible for the progression of Multiple Myeloma (MM) cancer from its precancerous stage MGUS can improve the understanding of the disease pathogenesis and, in devising suitable preventive and treatment measures. We have designed an innovative AI-based model, namely, the Bio-inspired Deep Learning architecture for the identification of altered Signaling Pathways (BDL-SP) to discover pivotal genomic biomarkers that can potentially distinguish MM from MGUS. The proposed BDL-SP model comprehends gene-gene interactions using the PPI network and analyzes genomic features using a deep learning (DL) architecture to identify significantly altered genes and signaling pathways in MM and MGUS. For this, whole exome sequencing data of 1174 MM and 61 MGUS patients were analyzed. In the quantitative benchmarking with the other popular machine learning models, BDL-SP performed almost similar to the two other best performing predictive ML models of Random Forest and CatBoost. However, an extensive post-hoc explainability analysis, capturing the application specific nuances, clearly established the significance of the BDL-SP model. This analysis revealed that BDL-SP identified a maximum number of previously reported oncogenes, tumor-suppressor genes, and actionable genes of high relevance in MM as the top significantly altered genes. Further, the post-hoc analysis revealed a significant contribution of the total number of single nucleotide variants (SNVs) and genomic features associated with synonymous SNVs in disease stage classification. Finally, the pathway enrichment analysis of the top significantly altered genes showed that many cancer pathways are selectively and significantly dysregulated in MM compared to its precursor stage of MGUS, while a few that lost their significance with disease progression from MGUS to MM were actually related to the other disease types. These observations may pave the way for appropriate therapeutic interventions to halt the progression to overt MM in the future.
Collapse
|
12
|
Potential Role of 68Ga-NOTA-Duramycin PET/CT Imaging for Early Response Evaluation in a Lymphoma Patient: A Case Report. Clin Nucl Med 2023; 48:e19-e21. [PMID: 36469075 DOI: 10.1097/rlu.0000000000004462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
ABSTRACT Duramycin, a 19 amino acids peptide, is known for its potential to target phosphatidylethanolamine. During cell death (apoptosis), rearrangement of membrane phospholipids results in the externalization of phosphatidylethanolamine to the outer leaflet of the cell membrane, which can be imaged using 68Ga-NOTA-duramycin. We report 68Ga-NOTA-duramycin imaging in a 50-year-old man with biopsy-proven diffuse large B-cell lymphoma planned for anthracycline-based chemotherapy. 68Ga-NOTA-duramycin PET/CT imaging along with 18F-FDG PET/CT was performed before and after 2 cycles of chemotherapy. The tracer avidity in interim 68Ga-NOTA-duramycin PET/CT showed its diagnostic potential to assess early response to chemotherapy.
Collapse
|
13
|
Ginger Root Extract Improves GI Health in Diabetic Rats by Improving Intestinal Integrity and Mitochondrial Function. Nutrients 2022; 14:4384. [PMID: 36297069 PMCID: PMC9611027 DOI: 10.3390/nu14204384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/30/2022] [Accepted: 10/11/2022] [Indexed: 12/06/2022] Open
Abstract
Background Emerging research suggests hyperglycemia can increase intestinal permeability. Ginger and its bioactive compounds have been reported to benefit diabetic animals due to their anti-inflammatory and antioxidant properties. In this study, we revealed the beneficial effect of gingerol-enriched ginger (GEG) on intestinal health (i.e., barrier function, mitochondrial function, and anti-inflammation) in diabetic rats. Methods Thirty-three male Sprague Dawley rats were assigned to three groups: low-fat diet (control group), high-fat-diet (HFD) + streptozotocin (single low dose 35 mg/kg body weight (BW) after 2 weeks of HFD feeding) (DM group), and HFD + streptozotocin + 0.75% GEG in diet (GEG group) for 42 days. Glucose tolerance tests (GTT) and insulin tolerance tests (ITT) were conducted at baseline and prior to sample collection. Total pancreatic insulin content was determined by ELISA. Total RNA of intestinal tissues was extracted for mRNA expression using qRT-PCR. Results Compared to the DM group, the GEG group had improved glucose tolerance and increased pancreatic insulin content. Compared to those without GEG (DM group), GEG supplementation (GEG group) increased the gene expression of tight junction (Claudin-3) and antioxidant capacity (SOD1), while it decreased the gene expression for mitochondrial fusion (MFN1), fission (FIS1), biogenesis (PGC-1α, TFAM), mitophagy (LC3B, P62, PINK1), and inflammation (NF-κB). Conclusions Ginger root extract improved glucose homeostasis in diabetic rats, in part, via improving intestinal integrity and mitochondrial dysfunction of GI health.
Collapse
|
14
|
Amyloidosis-related echo features and mortality in patients with multiple myeloma. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
Patients with multiple myeloma (MM) are at increased risk of developing AL amyloidosis. It was determined by screening fat pad and bone marrow biopsy that 38% MM patients had amyloidosis at time of diagnosis and the majority were asymptomatic (1). However, whether amyloidosis-related echo features in MM affect survival remains unknown (1, 2).
Purpose
The goals of our study are to: 1) characterize prevalence of amyloidosis-related echo features in patients with multiple myeloma, 2) investigate whether decrease in longitudinal strain affect survival outcomes.
Methods
Patients diagnosed with MM between Jan 1, 2000 and Dec 31, 2017 at our institution were identified through Clinical Looking Glass. Those with echo within 1 year after myeloma diagnosis and left ventricular ejection fraction (LVEF) greater than 40% were included. Global longitudinal strain (GLS) and LVEF measurements were done using EchoGo (Ultromics, Oxford, UK). The average of GLS obtained from apical 4-chamber and apical 2-chamber views was used for analysis, with decreased GLS defined as absolute value less than 18%. Statistical analysis was conducted with STATA13, using Chi square test and Kruskal-Wallis for univariable analysis and Cox regression model for survival analysis.
Results
From a total cohort of 909 patients, 252 met inclusion criteria, of which 59 (23.4%) patients had decreased average GLS (see Table 1). Patients' mean age was 63±11 years, 44.8% were male and most were Black (42.7%) and the rest Hispanic (33.3%) and White (7.9%). Median follow up time was 4.25 years. The group with decreased GLS had lower percentage of females (22% vs 51.8%, p<0.01), higher percentage of previous MI (11.9% vs 1.6%, p<0.01) and more prior diagnosis of heart failure (20.3% vs 1.6%, p<0.01).
Among patients with decreased GLS, five-year mortality rate was 63.3% compared to 46.0% in those with preserved GLS (p<0.036). Median survival time was 3.9 years among those with reduced GLS and 4.3 years in those without (see Figure 1; p<0.01). Reduced GLS correlated with decreased survival (HR 1.6, p=0.03) even after adjusting for demographic variables (age, gender, race), history of MI, history of CHF, Charlson comorbidity index, myeloma RISS stage, and LVEF (≥50% vs 40–50%).
Forty-seven (18.6%) patients had end diastolic inter-ventricular septum (IVSd) thickness ≥1.2cm. Median GLS in patients with increased IVSd thickness was 19% compared to 21% in those without (p=0.01). Nine patients had the apical sparing strain pattern for amyloidosis.
Total of 158 patients had bone marrow specimen stained with Congo-red with 7 (4.4%) testing positive. Median GLS was 19% in the group staining positive for Congo-red compared 21% in the group with negative stain (p=0.03).
Conclusions
Decrease in GLS on baseline echo correlates with increased mortality in patients with MM and may be due to subclinical cardiac amyloidosis.
Funding Acknowledgement
Type of funding sources: None.
Collapse
|
15
|
Correlation of changes in subclonal architecture with progression in the MMRF CoMMpass study. Transl Oncol 2022; 23:101472. [PMID: 35777247 PMCID: PMC9253848 DOI: 10.1016/j.tranon.2022.101472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 06/03/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022] Open
Abstract
Multiple myeloma (MM) is a heterogeneous plasma cell proliferative disorder that arises from its premalignant precursor stages through a complex cascade of interactions between clonal mutations and co-evolving microenvironment. The temporo-spatial evolutionary trajectories of MM are established early during myelomatogenesis in precursor stages and retained in MM. Such molecular events impact subsequent disease progression and clinical outcomes. Identification of clonal sweeps of actionable gene targets in MM could reveal potential vulnerabilities that may exist in early stages and thus potentiate prognostication and customization of early therapeutic interventions. We have evaluated clonal evolution at multiple time points in 76 MM patients enrolled in the MMRF CoMMpass study. The major findings of this study are (a) MM progresses predominantly through branching evolution, (b) there is a heterogeneous spectrum of mutational landscapes that include unique actionable gene targets at diagnosis compared to progression, (c) unique clonal gains/ losses of mutant driver genes can be identified in patients with different cytogenetic aberrations, (d) there is a significant correlation between co-occurring oncogenic mutations/ co-occurring subclones e.g., with mutated TP53+SYNE1, NRAS+MAGI3, and anticorrelative dependencies between FAT3+FCGBP gene pairs. Such co-trajectories may synchronize molecular events of drug response, myelomatogenesis and warrant future studies to explore their potential for early prognostication and development of risk stratified personalized therapies in MM.
Collapse
|
16
|
EP-555 The telescoping sigmoid – a rare presentation of acute large bowel obstruction. Br J Surg 2022. [DOI: 10.1093/bjs/znac245.130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Background
Adult bowel intussusception is a rare cause of bowel obstruction (1–5%) and requires urgent treatment, usually emergency surgery.
Aim
We wish to highlight the diagnosis and management of the rare entity of acute bowel obstruction secondary to intussusception with our adult patient with sigmoid colon intussusception.
Case presentation
We present a 65 years old male who attended with constipation, abdominal discomfort and per-rectal bleeding. Clinical examination revealed multiple subcutaneous lipomas, mild LUQ tenderness and large ‘lump’ 10 cm from anal verge on rigid sigmoidoscopy. CT abdomen/pelvis showed intussusception of the sigmoid into the rectum with a large ‘polyp’ as the lead point. On- table Flexible sigmoidoscopy was unsuccessful in reducing the intussusception. We proceeded to laparotomy with reduction of intussusception, high anterior resection with end- to- end stapled anastomosis. He made an excellent recovery. Post-operative histology which was reviewed in detail in MDT did not reveal any neoplastic/lipomatous lesion to account for the intussusception. The patient was very well on outpatient review.
Conclusion
Adult bowel intussusception is rare (5% of all intussusceptions), especially in the left colon. When it does occur, it is usually secondary to lipoma, neoplasm, or nodal mass acting as a lead point. These patients can be diagnostically challenging due to lack of clear obstructive symptoms on presentation. Early diagnosis (via a CT scan) and treatment of adult colonic intussusception (usually via surgery) is necessary to avoid serious complications such as bowel perforation/peritonitis. Postoperative histology review is also imperative to plan any appropriate further management.
Collapse
|
17
|
A Unified Computational Framework for a Robust, Reliable, and Reproducible Identification of Novel miRNAs From the RNA Sequencing Data. FRONTIERS IN BIOINFORMATICS 2022; 2:842051. [PMID: 36304305 PMCID: PMC9580950 DOI: 10.3389/fbinf.2022.842051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
In eukaryotic cells, miRNAs regulate a plethora of cellular functionalities ranging from cellular metabolisms, and development to the regulation of biological networks and pathways, both under homeostatic and pathological states like cancer.Despite their immense importance as key regulators of cellular processes, accurate and reliable estimation of miRNAs using Next Generation Sequencing is challenging, largely due to the limited availability of robust computational tools/methods/pipelines. Here, we introduce miRPipe, an end-to-end computational framework for the identification, characterization, and expression estimation of small RNAs, including the known and novel miRNAs and previously annotated pi-RNAs from small-RNA sequencing profiles. Our workflow detects unique novel miRNAs by incorporating the sequence information of seed and non-seed regions, concomitant with clustering analysis. This approach allows reliable and reproducible detection of unique novel miRNAs and functionally same miRNAs (paralogues). We validated the performance of miRPipe with the available state-of-the-art pipelines using both synthetic datasets generated using the newly developed miRSim tool and three cancer datasets (Chronic Lymphocytic Leukemia, Lung cancer, and breast cancer). In the experiment over the synthetic dataset, miRPipe is observed to outperform the existing state-of-the-art pipelines (accuracy: 95.23% and F1-score: 94.17%). Analysis on all the three cancer datasets shows that miRPipe is able to extract more number of known dysregulated miRNAs or piRNAs from the datasets as compared to the existing pipelines.
Collapse
|
18
|
Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
Collapse
|
19
|
Abstract
The testis must create and maintain an immune privileged environment to protect maturing germ cells from autoimmune destruction. The establishment of this protective environment is due, at least in part, to Sertoli cells. Sertoli cells line the seminiferous tubules and form the blood-testis barrier (BTB), a barrier between advanced germ cells and the immune system. The BTB compartmentalizes the germ cells and facilitates the appropriate microenvironment necessary for spermatogenesis. Further, Sertoli cells modulate innate and adaptive immune processes through production of immunoregulatory compounds. Sertoli cells, when transplanted ectopically (outside the testis), can also protect transplanted tissue from the recipient’s immune system and reduce immune complications in autoimmune diseases primarily by immune regulation. These properties make Sertoli cells an attractive candidate for inflammatory disease treatments and cell-based therapies. Conversely, the same properties that protect the germ cells also allow the testis to act as a reservoir site for infections. Interestingly, Sertoli cells also have the ability to mount an antimicrobial response, if necessary, as in the case of infections. This review aims to explore how Sertoli cells act as a double-edged sword to both protect germ cells from an autoimmune response and activate innate and adaptive immune responses to fight off infections.
Collapse
|
20
|
Nuclear medicine in the management of superficial skin abnormalities and institutional experience. Nucl Med Commun 2022; 43:625-630. [PMID: 35362693 DOI: 10.1097/mnm.0000000000001549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Keloid, hypertrophic scars and basal cell carcinoma (BCC) falls under the category of non-melanoma skin cancer. Intralesional steroids, external beam radiation therapy, 5-Fluorouracil, cryotherapy, laser, etc are the available treatment options. However, recurrence has been reported with each type of treatment mode. In the present article, various treatment modes have been discussed and institutional experience of Rhenium-188 skin patches for the treatment of keloids and BCC has been discussed.
Collapse
|
21
|
Abstract
Skin tissue wound healing proceeds through four major stages, including hematoma formation, inflammation, and neo-tissue formation, and culminates with tissue remodeling. These four steps significantly overlap with each other and are aided by various factors such as cells, cytokines (both anti- and pro-inflammatory), and growth factors that aid in the neo-tissue formation. In all these stages, advanced biomaterials provide several functional advantages, such as removing wound exudates, providing cover, transporting oxygen to the wound site, and preventing infection from microbes. In addition, advanced biomaterials serve as vehicles to carry proteins/drug molecules/growth factors and/or antimicrobial agents to the target wound site. In this review, we report recent advancements in biomaterials-based regenerative strategies that augment the skin tissue wound healing process. In conjunction with other medical sciences, designing nanoengineered biomaterials is gaining significant attention for providing numerous functionalities to trigger wound repair. In this regard, we highlight the advent of nanomaterial-based constructs for wound healing, especially those that are being evaluated in clinical settings. Herein, we also emphasize the competence and versatility of the three-dimensional (3D) bioprinting technique for advanced wound management. Finally, we discuss the challenges and clinical perspective of various biomaterial-based wound dressings, along with prospective future directions. With regenerative strategies that utilize a cocktail of cell sources, antimicrobial agents, drugs, and/or growth factors, it is expected that significant patient-specific strategies will be developed in the near future, resulting in complete wound healing with no scar tissue formation.
Collapse
|
22
|
Curriculum restructuring at Texas Tech Health Science Center Medical School: Evaluation and lessons learned. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.r3111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
23
|
Tregs: The Sertoli cell’s secret weapon in transplant survival. THE JOURNAL OF IMMUNOLOGY 2022. [DOI: 10.4049/jimmunol.208.supp.175.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Abstract
Advanced germ cells develop after central tolerance is established and express non-self antigen but are not destroyed by the immune system. They owe their survival in part to the physical and immunological barrier created by Sertoli cells (SC). The protective nature of SC has sparked interest in the field of transplant immunology as a way to prevent transplant rejection. Indeed, SC prolong the survival of various co-transplanted tissues. However, exactly how SC achieve this protection remains largely unexplored, as does their effectiveness in female recipients. Data from transplantation studies indicates that T regulatory cells (Tregs) are critical in graft survival. This study aims to determine if SC survive at comparable rates in males and females, and if SC survival is dependent on Tregs. Therefore, we transplanted SC from B6 mice into allogeneic BALB/c male and female immunosuppressive drugs. At day 20, all SC grafts survived in male recipients and at least 67% survived in female recipients. In both males and females, Tregs were detected in high numbers in surviving grafts. To further explore their role in SC graft survival, Tregs were depleted in male graft recipients. Analysis of SC grafts at day 20 showed that 57% of SC grafts survived and saw a return of Tregs, as detected through flow cytometry. Tregs remained depleted in the rejected grafts. Together, this data indicates that Tregs must be present for SC grafts to survive and that SC themselves may induce Tregs. To conclude, SC survive allotransplantation in males and females, possibly through the activation of Tregs.
Supported by CH Foundation, NIAID
Collapse
|
24
|
OC-0618 Comprehensive 3D verification of SRS treatments with virtual spherical phantom EPID dosimetry. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02640-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
25
|
Seeking the Sertoli cell complement inhibitory signature to prolong transplant survival. THE JOURNAL OF IMMUNOLOGY 2022. [DOI: 10.4049/jimmunol.208.supp.175.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Abstract
Clinical transplantation can treat various illnesses, although without the use of toxic immunosuppressants transplanted tissue is rejected by the immune system. Complement, an enzymatic cascade that leads to cytolysis by insertion of the membrane attack complex (MAC), is a significant component in transplant rejection. Interestingly, Sertoli cells (SC) survive long-term after transplantation across immune barriers without immunosuppression. This study used allotransplant (between same species) and xenotransplant (between different species) models to investigate the role of complement inhibition in SC extended survival. Since SC were resistant to in vitro complement killing, mouse or pig SC were transplanted into mice or rats, respectively. Grafts were collected and analyzed for MAC. MAC was not detected on SC transplants, indicating that SC inhibit complement before MAC deposition, possibly through expression of complement inhibitory proteins (CIP). Bioinformatic analyses of mouse or pig SC identified expression of 13 CIP. After expression of two key CIP, CD46 and CD55, were knocked down, SC were killed by complement in vitro. Taken together, these data indicate that the SC complement inhibitory signature is critical for SC graft survival. Understanding SC complement inhibition is important as it could lead to improved transplant survival with a decreased requirement of harsh immunosuppressants, making this procedure more attainable for patients.
Supported by grants from the CH foundation, the South Plains Foundation, and the Mary Lou Clements-Mann Scholarship
Collapse
|
26
|
Characterizing the mutational landscape of MM and its precursor MGUS. Am J Cancer Res 2022; 12:1919-1933. [PMID: 35530275 PMCID: PMC9077084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 03/02/2022] [Indexed: 06/14/2023] Open
Abstract
Mutational Signatures and Tumor mutational burden (TMB) have emerged as prognostic biomarkers in cancer genomics. However, the association of TMB with overall survival (OS) is still unknown in newly diagnosed multiple myeloma (NDMM) patients. Further, the change in the mutational spectrum involving both synonymous and non-synonymous mutations as MGUS progresses to MM is unexplored. This study addresses both these aspects via extensive evaluation of the mutations in MGUS and NDMM. WES data of 1018 NDMM patients and 61 MGUS patients collected from three different global regions were analyzed in this study. Single base substitutions, mutational signatures and TMB were inferred from the variants identified in MGUS and MM patients. The cutoff value for TMB was estimated to divide patients into low TMB and high TMB (hypermutators) groups. This study finds a change in the mutational spectrum with a statistically significant increase from MGUS to MM. There was a statistically significant increase in the frequency of all the three categories of variants, non-synonymous (NS), synonymous (SYN), and others (OTH), from MGUS to MM (P<0.05). However, there was a statistically significant rise in the TMB values for TMB_NS and TMB_SYN only. We also observed that 3' and 5'UTR mutations were more frequent in MM and might be responsible for driving MGUS to MM via regulatory binding sites. NDMM patients were also examined separately along with their survival outcomes. The frequency of hypermutators was low in MM with poor OS and PFS outcome. We observed a statistically significant rise in the frequency of C>A and C>T substitutions and a statistically significant decline in T>G substitutions in the MM patients with poor outcomes. Additionally, there was a statistically significant increase in the TMB of the patients with poor outcome compared to patients with a superior outcome. A statistically significant association between the APOBEC activity and poor overall survival in MM was discovered. These findings have potential clinical relevance and can assist in designing risk-adapted therapies to inhibit the progression of MGUS to MM and prolong the overall survival in high-risk MM patients.
Collapse
|
27
|
Are we ‘prescribing’ MCAs correctly? A mixed method study investigating the appropriateness of MCAs initiated from hospitals within a large NHS trust. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022. [DOI: 10.1093/ijpp/riac019.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Medication non-adherence is a significant public health issue and a drain on NHS resources, therefore an important issue for patients, policy makers and healthcare professionals. Non-adherence results in poorer health outcomes and increased hospital admissions (1). Multi-compartment compliance aids (MCAs) are being utilised as a ‘cure all’ for all causes of non-adherence when an evidence base for overall benefit is sparse. Evidence highlights that MCA introduction may only be beneficial in a few select cohorts (2).
Aim
The study aim was to assess the appropriateness and patients’ opinions of newly initiated MCAs for patients over 65 in hospital.
Methods
A retrospective longitudinal cohort study investigated patients (≥65 years) newly initiated on MCAs in hospital. Ward-based pharmacists identified new MCA initiations between October 2020 and March 2021 across four hospital sites in a large NHS trust. Factor analysis of the data was used to identify the rationale and appropriateness of MCA initiation using UK-based assessment toolkits (NHS Tayside and ‘All in Order’ criteria by the University of East Anglia).
Semi-structured interviews were conducted in a sample of patients prospectively via questionnaire. Interviews focussed on patients’ confidence managing their medications, ability to recall their medication regime and their opinions of MCA initiation into their care.
Results
Thirty new MCA initiations were identified during the data collection period with 87% (n=26) identified as inappropriate initiations according to UK-based assessment tools. Only one initiation was found to have a formal MCA assessment undertaken. Approximately two-thirds of MCAs were initiated for the introduction of home-carers via social care (67%; n=20). The next most common reasons for initiation were family requests (13%; n=4) and perceived cognitive impairment by healthcare professionals (13%; n=4), with a further 2 MCAs initiated for mobility issues (n=1) and lack of confidence (n=1). Over a third of MCA initiations (37 %; n=11) were prescribed <4 medications. Healthcare professional initiation requests commonly came from occupational therapists (37%; n=11); however, only 18% (n=2) of these were found to be appropriate. Overall, patient opinions on MCAs varied. Those with less confidence in their medicines were more in favour of their initiation; however, those more involved and understanding of their medication regime were less accepting of MCA introduction.
Conclusion
A significant number of MCAs are being started for inappropriate reasons according to validated UK toolkits e.g. initiations for social care input, lack of polypharmacy and family request. Only one initiation was linked to a documented formal assessment implying further guidance and training is required for the multidisciplinary team to ensure appropriate, evidence-based provision of MCAs. Involving the patient/carer as part of a patient- centred care assessment is essential to ensure there is understanding of how to use an MCA and to reduce unwarranted ‘over-prescribing’ of MCAs to inappropriate patient groups. Individual patient -centred assessments may combat perceived medication non-adherence as having a ‘catch all’ solution. The small sample size of this study limits the ability to draw firm conclusions, especially regarding patient opinions on MCAs.
References
(1) Watson SJ, Aldus CF, Bond C, Bhattacharya D. Systematic review of the health and societal effects of medication organisation devices. BMC health services research. 2016 Dec;16(1):1-3.
(2) Mahtani KR, Heneghan CJ, Glasziou PP, Perera R. Reminder packaging for improving adherence to self-administered long-term medications. Cochrane Database of Systematic Reviews. 2011(9).
Collapse
|
28
|
Protein biomarkers in gynecological cancers: The need for translational research towards clinical applications. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2022. [DOI: 10.1016/j.gine.2021.100735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
29
|
Transcortical resection of a giant bilobed falcine meningioma. Br J Neurosurg 2022:1-4. [PMID: 35174752 DOI: 10.1080/02688697.2022.2034744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 01/11/2022] [Accepted: 01/23/2022] [Indexed: 11/02/2022]
Abstract
INTRODUCTION Falcine meningiomas present significant surgical challenges because they often involve the falx bilaterally, are concealed by a significant amount of normal brain parenchyma and are frequently deep in location and in close proximity to the anterior cerebral arteries. Many prefer the interhemispheric approach for these lesions, but this operative corridor is not without risk as venous infarctions and cortical injury can occur. CLINICAL PRESENTATION We present an alternative technique utilizing a transcortical approach to resect a giant, bilobed falcine meningioma in a 68-year-old female who presented with progressive abulia, urinary incontinence, and bilateral lower extremity weakness over 2 years. A unilateral right frontal craniotomy and a corticectomy through the right superior frontal gyrus was used to safely resect the entire tumor. The patient tolerated the procedure well and was discharged home without issue. Pathology demonstrated that the lesion was an atypical meningioma and she subsequently received adjuvant fractionated radiotherapy. At 2-year follow-up, she has no neurologic deficits, never developed any postoperative seizures and has not had any evidence of tumor recurrence. CONCLUSION The transcortical approach can be used as a safe alternative for resecting falcine meningiomas without adding significant undue risk to the patient.
Collapse
|
30
|
POS-241 FRAILTY: COROLLARY OR CAUSALITY OF MALNUTRITION. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
31
|
Erratum: Constraints on dark matter-nucleon effective couplings in the presence of kinematically distinct halo substructures using the DEAP-3600 detector [Phys. Rev. D
102
, 082001 (2020)]. Int J Clin Exp Med 2022. [DOI: 10.1103/physrevd.105.029901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
32
|
First Direct Detection Constraints on Planck-Scale Mass Dark Matter with Multiple-Scatter Signatures Using the DEAP-3600 Detector. PHYSICAL REVIEW LETTERS 2022; 128:011801. [PMID: 35061499 DOI: 10.1103/physrevlett.128.011801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/15/2021] [Accepted: 11/16/2021] [Indexed: 06/14/2023]
Abstract
Dark matter with Planck-scale mass (≃10^{19} GeV/c^{2}) arises in well-motivated theories and could be produced by several cosmological mechanisms. A search for multiscatter signals from supermassive dark matter was performed with a blind analysis of data collected over a 813 d live time with DEAP-3600, a 3.3 t single-phase liquid argon-based detector at SNOLAB. No candidate signals were observed, leading to the first direct detection constraints on Planck-scale mass dark matter. Leading limits constrain dark matter masses between 8.3×10^{6} and 1.2×10^{19} GeV/c^{2}, and ^{40}Ar-scattering cross sections between 1.0×10^{-23} and 2.4×10^{-18} cm^{2}. These results are interpreted as constraints on composite dark matter models with two different nucleon-to-nuclear cross section scalings.
Collapse
|
33
|
Commentary: An Update of Neuroanesthesia for Intraoperative Brain Mapping Craniotomy. Neurosurgery 2022; 90:e1-e2. [PMID: 33733271 DOI: 10.1093/neuros/nyab065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 11/12/2022] Open
|
34
|
2021 Canadian Surgery Forum01. Design and validation of a unique endoscopy simulator using a commercial video game03. Is ethnicity an appropriate measure of health care marginalization?: A systematic review and meta-analysis of the outcomes of diabetic foot ulceration in the Aboriginal population04. Racial disparities in surgery — a cross-specialty matched comparison between black and white patients05. Starting late does not increase the risk of postoperative complications in patients undergoing common general surgical procedures06. Ethical decision-making during a health care crisis: a resource allocation framework and tool07. Ensuring stability in surgical training program leadership: a survey of program directors08. Introducing oncoplastic breast surgery in a community hospital09. Leadership development programs for surgical residents: a review of the literature10. Superiority of non-opioid postoperative pain management after thyroid and parathyroid operations: a systematic review and meta-analysis11. Timing of ERCP relative to cholecystectomy in patients with ductal gallstone disease12. A systematic review and meta-analysis of randomized controlled trials comparing intraoperative red blood cell transfusion strategies13. Postoperative outcomes after frail elderly preoperative assessment clinic: a single-institution Canadian perspective14. Selective opioid antagonists following bowel resection for prevention of postoperative ileus: a systematic review and meta-analysis15. Peer-to-peer coaching after bile duct injury16. Laparoscopic median arcuate ligament release: a video abstract17. Retroperitoneoscopic approach to adrenalectomy19. Endoscopic Zenker diverticulotomy: a video abstract20. Variability in surgeons’ perioperative management of pheochromocytomas in Canada21. The contribution of surgeon and hospital variation in transfusion practice to outcomes for patients undergoing elective gastrointestinal cancer surgery: a population-based analysis22. Perioperative transfusions for gastroesophageal cancers: risk factors and short- and long-term outcomes23. The association between frailty and time alive and at home after cancer surgery among older adults: a population-based analysis24. Psychological and workplace-related effects of providing surgical care during the COVID-19 pandemic in British Columbia, Canada25. Safety of venous thromboembolism prophylaxis in endoscopic retrograde cholangiopancreatography: a systematic review26. Complications and reintervention following laparoscopic subtotal cholecystectomy: a systematic review and meta-analysis27. Synchronization of pupil dilations correlates with team performance in a simulated laparoscopic team coordination task28. Receptivity to and desired design features of a surgical peer coaching program: an international survey9. Impact of the COVID-19 pandemic on rates of emergency department utilization due to general surgery conditions30. The impact of the current COVID-19 pandemic on the exposure of general surgery trainees to operative procedures31. Association between academic degrees and research productivity: an assessment of academic general surgeons in Canada32. Laparoscopic endoscopic cooperative surgery (LECS) for subepithelial gastric lesion: a video presentation33. Effect of the COVID-19 pandemic on acute care general surgery at an academic Canadian centre34. Opioid-free analgesia after outpatient general surgery: a pilot randomized controlled trial35. Impact of neoadjuvant immunotherapy or targeted therapies on surgical resection in patients with solid tumours: a systematic review and meta-analysis37. Surgical data recording in the operating room: a systematic review of modalities and metrics38. Association between nonaccidental trauma and neighbourhood socioeconomic status during the COVID-19 pandemic: a retrospective analysis39. Laparoscopic repair of a transdiaphragmatic gastropleural fistula40. Video-based interviewing in medicine: a scoping review41. Indocyanine green fluorescence angiography for prevention of anastomotic leakage in colorectal surgery: a cost analysis from the hospital payer’s perspective43. Perception or reality: surgical resident and faculty assessments of resident workload compared with objective data45. When illness and loss hit close to home: Do health care providers learn how to cope?46. Remote video-based suturing education with smartphones (REVISE): a randomized controlled trial47. The evolving use of robotic surgery: a population-based analysis48. Prophylactic retromuscular mesh placement for parastomal hernia prevention: a retrospective cohort study of permanent colostomies and ileostomies49. Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: a retrospective cohort study on anastomotic complications50. A lay of the land — a description of Canadian academic acute care surgery models51. Emergency general surgery in Ontario: interhospital variability in structures, processes and models of care52. Trauma 101: a virtual case-based trauma conference as an adjunct to medical education53. Assessment of the National Surgical Quality Improvement Program Surgical Risk Calculator for predicting patient-centred outcomes of emergency general surgery patients in a Canadian health care system54. Sustainability of a narcotic reduction initiative: 1 year following the Standardization of Outpatient Procedure (STOP) Narcotics Study55. Barriers to transanal endoscopic microsurgery referral56. Geospatial analysis of severely injured rural patients in a geographically complex landscape57. Implementation of an incentive spirometry protocol in a trauma ward: a single-centre pilot study58. Impostor phenomenon is a significant risk factor for burnout and anxiety in Canadian resident physicians: a cross-sectional survey59. Understanding the influence of perioperative education on performance among surgical trainees: a single-centre experience60. The effect of COVID-19 pandemic on current and future endoscopic personal protective equipment practices: a national survey of 77 endoscopists61. Case report: delayed presentation of perforated sigmoid diverticulitis as necrotizing infection of the lower limb62. Investigating disparities in surgical outcomes in Canadian Indigenous populations63. Fundoplication is superior to medical therapy for Barrett esophagus disease regression and progression: a systematic review and meta-analysis64. Development of a novel online general surgery learning platform and a qualitative preimplementation analysis65. Hagfish slime exudate as a potential novel hemostatic agent: developing a standardized assessment protocol66. The effect of the first wave of the COVID-19 pandemic on surgical oncology case volumes and wait times67. Safety of same-day discharge in high-risk patients undergoing ambulatory general surgery68. External validation of the Codman score in colorectal surgery: a pragmatic tool to drive quality improvement69. Improved morbidity and gastrointestinal restoration rates without compromising survival rates for diverting loop ileostomy with colonic lavage versus total abdominal colectomy for fulminant Clostridioides difficile colitis: a multicentre retrospective cohort study70. Potential access to emergency general surgical care in Ontario71. Immersive virtual reality (iVR) improves procedural duration, task completion and accuracy in surgical trainees: a systematic review01. Clinical validation of the Canada Lymph Node Score for endobronchial ultrasound02. Venous thromboembolism in surgically treated esophageal cancer patients: a provincial population-based study03. Venous thromboembolism in surgically treated lung cancer patients: a population-based study04. Is frailty associated with failure to rescue after esophagectomy? A multi-institutional comparative analysis of outcomes05. Routine systematic sampling versus targeted sampling of lymph nodes during endobronchial ultrasound: a feasibility randomized controlled trial06. Gastric ischemic conditioning reduces anastomotic complications in patients undergoing esophagectomy: a systematic review and meta-analysis07. Move For Surgery, a novel preconditioning program to optimize health before thoracic surgery: a randomized controlled trial08. In case of emergency, go to your nearest emergency department — Or maybe not?09. Does preoperative SABR increase the risk of complications from lung cancer resection? A secondary analysis of the MISSILE trial10. Segmental resection for lung cancer: the added value of near-infrared fluorescence mapping diminishes with surgeon experience11. Toward competency-based continuing professional development for practising surgeons12. Stereotactic body radiotherapy versus surgery in older adults with NSCLC — a population-based, matched analysis of long-term dependency outcomes13. Role of adjuvant therapy in esophageal cancer patients after neoadjuvant therapy and curative esophagectomy: a systematic review and meta-analysis14. Evaluation of population characteristics on the incidence of thoracic empyema: an ecological study15. Determining the optimal stiffness colour threshold and stiffness area ratio cut-off for mediastinal lymph node staging using EBUS elastography and AI: a pilot study16. Quality assurance on the use of sequential compression stockings in thoracic surgery (QUESTs)17. The relationship between fissureless technique and prolonged air leak for patients undergoing video-assisted thoracoscopic lobectomy18. CXCR2 inhibition as a candidate for immunomodulation in the treatment of K-RAS-driven lung adenocarcinoma19. Assessment tools for evaluating competency in video-assisted thoracoscopic lobectomy: a systematic review20. Understanding the current practice on chest tube management following lung resection among thoracic surgeons across Canada21. Effect of routine jejunostomy tube insertion in esophagectomy: a systematic review and meta-analysis22. Recurrence of primary spontaneous pneumothorax following bullectomy with pleurodesis or pleurectomy: a retrospective analysis23. Surgical outcomes following chest wall resection and reconstruction24. Outcomes following surgical management of primary mediastinal nonseminomatous germ cell tumours25. Does robotic approach offer better nodal staging than thoracoscopic approach in anatomical resection for non–small cell lung cancer? A single-centre propensity matching analysis26. Competency assessment for mediastinal mass resection and thymectomy: design and Delphi process27. The contemporary significance of venous thromboembolism (deep venous thrombosis [DVT] and pulmonary embolus [PE]) in patients undergoing esophagectomy: a prospective, multicentre cohort study to evaluate the incidence and clinical outcomes of VTE after major esophageal resections28. Esophageal cancer: symptom severity at the end of life29. The impact of pulmonary artery reconstruction on postoperative and oncologic outcomes: a systematic review30. Association with surgical technique and recurrence after laparoscopic repair of paraesophageal hernia: a single-centre experience31. Enhanced recovery after surgery (ERAS) in esophagectomy32. Surgical treatment of esophageal cancer: trends in surgical approach and early mortality at a single institution over the past 18 years34. Adverse events and length of stay following minimally invasive surgery in paraesophageal hernia repair35. Long-term symptom control comparison of Dor and Nissen fundoplication following laparoscopic para-esophageal hernia repair: a retrospective analysis36. Willingness to pay: a survey of Canadian patients’ willingness to contribute to the cost of robotic thoracic surgery37. Radiomics in early-stage lung adenocarcinoma: a prediction tool for tumour immune microenvironments38. Effectiveness of intraoperative pyloric botox injection during esophagectomy: how often is endoscopic intervention required?39. An artificial intelligence algorithm for predicting lymph node malignancy during endobronchial ultrasound40. The effect of major and minor complications after lung surgery on length of stay and readmission41. Measuring cost of adverse events following thoracic surgery: a scoping review42. Laparoscopic paraesophageal hernia repair: characterization by hospital and surgeon volume and impact on outcomes43. NSQIP 5-Factor Modified Frailty Index predicts morbidity but not mortality after esophagectomy44. Trajectory of perioperative HRQOL and association with postoperative complications in thoracic surgery patients45. Variation in treatment patterns and outcomes for resected esophageal cancer at designated thoracic surgery centres46. Patient-reported pretreatment health-related quality of life (HRQOL) predicts short-term survival in esophageal cancer patients47. Analgesic efficacy of surgeon-placed paravertebral catheters compared with thoracic epidural analgesia after Ivor Lewis esophagectomy: a retrospective noninferiority study48. Rapid return to normal oxygenation after lung surgery49. Examination of local and systemic inflammatory changes during lung surgery01. Implications of near-infrared imaging and indocyanine green on anastomotic leaks following colorectal surgery: a systematic review and meta-analysis02. Repeat preoperative endoscopy after regional implementation of electronic synoptic endoscopy reporting: a retrospective comparative study03. Consensus-derived quality indicators for operative reporting in transanal endoscopic surgery (TES)04. Colorectal lesion localization practices at endoscopy to facilitate surgical and endoscopic planning: recommendations from a national consensus Delphi process05. Black race is associated with increased mortality in colon cancer — a population-based and propensity-score matched analysis06. Improved survival in a cohort of patients 75 years and over with FIT-detected colorectal neoplasms07. Laparoscopic versus open loop ileostomy reversal: a systematic review and meta-analysis08. Posterior mesorectal thickness as a predictor of increased operative time in rectal cancer surgery: a retrospective cohort study09. Improvement of colonic anastomotic healing in mice with oral supplementation of oligosaccharides10. How can we better identify patients with rectal bleeding who are at high risk of colorectal cancer?11. Assessment of long-term bowel dysfunction in rectal cancer survivors: a population-based cohort study12. Observational versus antibiotic therapy for acute uncomplicated diverticulitis: a noninferiority meta-analysis based on a Delphi consensus13. Radiotherapy alone versus chemoradiotherapy for stage I anal squamous cell carcinoma: a systematic review and meta-analysis14. Is the Hartmann procedure for diverticulitis obsolete? National trends in colectomy for diverticulitis in the emergency setting from 1993 to 201515. Sugammadex in colorectal surgery: a systematic review and meta-analysis16. Sexuality and rectal cancer treatment: a qualitative study exploring patients’ information needs and expectations on sexual dysfunction after rectal cancer treatment17. Video-based interviews in selection process18. Impact of delaying colonoscopies during the COVID-19 pandemic on colorectal cancer detection and prevention19. Opioid use disorder associated with increased anastomotic leak and major complications after colorectal surgery20. Effectiveness of a rectal cancer education video on patient expectations21. Robotic-assisted rectosigmoid and rectal cancer resection: implementation and early experience at a Canadian tertiary centre22. An online educational app for rectal cancer survivors with low anterior resection syndrome: a pilot study23. The effects of surgeon specialization on the outcome of emergency colorectal surgery24. Outcomes after colorectal cancer resections in octogenarians and older in a regional New Zealand setting — What are the predictors of mortality?25. Long-term outcomes after seton placement for perianal fistulae with and without Crohn disease26. A survey of patient and surgeon preference for early ileostomy closure following restorative proctectomy for rectal cancer — Why aren’t we doing it?27. Crohn disease independently associated with longer hospital admission after surgery28. Short-stay (≤ 1 d) diverting loop ileostomy closure can be selectively implemented without an increase in readmission and complication rates: an ACS-NSQIP analysis29. A comparison of perineal stapled rectal prolapse resection and the Altemeier procedure at 2 Canadian academic hospitals30. Mental health and substance use disorders predict 90-day readmission and postoperative complications following rectal cancer surgery31. Early discharge after colorectal cancer resection: trends and impact on patient outcomes32. Oral antibiotics without mechanical bowel preparation prior to emergency colectomy reduces the risk of organ space surgical site infections: a NSQIP propensity score matched study33. The impact of robotic surgery on a tertiary care colorectal surgery program, an assessment of costs and short-term outcomes — a Canadian perspective34. Should we scope beyond the age limit of guidelines? Adenoma detection rates and outcomes of screening and surveillance colonoscopies in patients aged 75–79 years35. Emergency department admissions for uncomplicated diverticulitis: a nationwide study36. Obesity is associated with a complicated episode of acute diverticulitis: a nationwide study37. Green indocyanine angiography for low anterior resection in patients with rectal cancer: a prospective before-and-after study38. The impact of age on surgical recurrence of fibrostenotic ileocolic Crohn disease39. A qualitative study to explore the optimal timing and approach for the LARS discussion01. Racial, ethnic and socioeconomic disparities in diagnosis, treatment and survival of patients with breast cancer: a SEER-based population analysis02. First-line palliative chemotherapy for esophageal and gastric cancer: practice patterns and outcomes in the general population03. Frailty as a predictor for postoperative outcomes following pancreaticoduodenectomy04. Synoptic electronic operative reports identify practice variation in cancer surgery allowing for directed interventions to decrease variation05. The role of Hedgehog signalling in basal-like breast cancer07. Clinical and patient-reported outcomes in oncoplastic breast conservation surgery from a single surgeon’s practice in a busy community hospital in Canada08. Upgrade rate of atypical ductal hyperplasia: 10 years of experience and predictive factors09. Time to first adjuvant treatment after oncoplastic breast reduction10. Preparing to survive: improving outcomes for young women with breast cancer11. Opioid prescription and consumption in patients undergoing outpatient breast surgery — baseline data for a quality improvement initiative12. Rectal anastomosis and hyperthermic intraperitoneal chemotherapy: Should we avoid diverting loop ileostomy?13. Delays in operative management of early-stage, estrogen-receptor positive breast cancer during the COVID-19 pandemic — a multi-institutional matched historical cohort study14. Opioid prescribing practices in breast oncologic surgery15. Oncoplastic breast reduction (OBR) complications and patient-reported outcomes16. De-escalating breast cancer surgery: Should we apply quality indicators from other jurisdictions in Canada?17. The breast cancer patient experience of telemedicine during COVID-1918. A novel ex vivo human peritoneal model to investigate mechanisms of peritoneal metastasis in gastric adenocarcinoma (GCa)19. Preliminary uptake and outcomes utilizing the BREAST-Q patient-reported outcomes questionnaire in patients following breast cancer surgery20. Routine elastin staining improves detection of venous invasion and enhances prognostication in resected colorectal cancer21. Analysis of exhaled volatile organic compounds: a new frontier in colon cancer screening and surveillance22. A clinical pathway for radical cystectomy leads to a shorter hospital stay and decreases 30-day postoperative complications: a NSQIP analysis23. Fertility preservation in young breast cancer patients: a population-based study24. Investigating factors associated with postmastectomy unplanned emergency department visits: a population-based analysis25. Impact of patient, tumour and treatment factors on psychosocial outcomes after treatment in women with invasive breast cancer26. The relationship between breast and axillary pathologic complete response in women receiving neoadjuvant chemotherapy for breast cancer01. The association between bacterobilia and the risk of postoperative complications following pancreaticoduodenectomy02. Surgical outcome and quality of life following exercise-based prehabilitation for hepatobiliary surgery: a systematic review and meta-analysis03. Does intraoperative frozen section and revision of margins lead to improved survival in patients undergoing resection of perihilar cholangiocarcinoma? A systematic review and meta-analysis04. Prolonged kidney procurement time is associated with worse graft survival after transplantation05. Venous thromboembolism following hepatectomy for colorectal metastases: a population-based retrospective cohort study06. Association between resection approach and transfusion exposure in liver resection for gastrointestinal cancer07. The association between surgeon volume and use of laparoscopic liver resection for gastrointestinal cancer08. Immune suppression through TIGIT in colorectal cancer liver metastases09. “The whole is greater than the sum of its parts” — a combined strategy to reduce postoperative pancreatic fistula after pancreaticoduodenectomy10. Laparoscopic versus open synchronous colorectal and hepatic resection for metastatic colorectal cancer11. Identifying prognostic factors for overall survival in patients with recurrent disease following liver resection for colorectal cancer metastasis12. Modified Blumgart pancreatojejunostomy with external stenting in laparoscopic Whipple reconstruction13. Laparoscopic versus open pancreaticoduodenectomy: a single centre’s initial experience with introduction of a novel surgical approach14. Neoadjuvant chemotherapy versus upfront surgery for borderline resectable pancreatic cancer: a single-centre cohort analysis15. Thermal ablation and telemedicine to reduce resource utilization during the COVID-19 pandemic16. Cost-utility analysis of normothermic machine perfusion compared with static cold storage in liver transplantation in the Canadian setting17. Impact of adjuvant therapy on overall survival in early-stage ampullary cancers: a single-centre retrospective review18. Presence of biliary anaerobes enhances response to neoadjuvant chemotherapy in pancreatic ductal adenocarcinoma19. How does tumour viability influence the predictive capability of the Metroticket model? Comparing predicted-to-observed 5-year survival after liver transplant for hepatocellular carcinoma20. Does caudate resection improve outcomes in patients undergoing curative resection for perihilar cholangiocarcinoma? A systematic review and meta-analysis21. Appraisal of multivariable prognostic models for postoperative liver decompensation following partial hepatectomy: a systematic review22. Predictors of postoperative liver decompensation events following resection in patients with cirrhosis and hepatocellular carcinoma: a population-based study23. Characteristics of bacteriobilia and impact on outcomes after Whipple procedure01. Inverting the y-axis: the future of MIS abdominal wall reconstruction is upside down02. Progressive preoperative pneumoperitoneum: a single-centre retrospective study03. The role of radiologic classification of parastomal hernia as a predictor of the need for surgical hernia repair: a retrospective cohort study04. Comparison of 2 fascial defect closure methods for laparoscopic incisional hernia repair01. Hypoalbuminemia predicts serious complications following elective bariatric surgery02. Laparoscopic adjustable gastric band migration inducing jejunal obstruction associated with acute pancreatitis: aurgical approach of band removal03. Can visceral adipose tissue gene expression determine metabolic outcomes after bariatric surgery?04. Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: a systematic review and meta-analysis05. A prediction model for delayed discharge following gastric bypass surgery06. Experiences and outcomes of Indigenous patients undergoing bariatric surgery: a mixed-methods scoping review07. What is the optimal common channel length in revisional bariatric surgery?08. Laparoscopic management of internal hernia in a 34-week pregnant woman09. Characterizing timing of postoperative complications following elective Roux-en-Y gastric bypass and sleeve gastrectomy10. Canadian trends in bariatric surgery11. Common surgical stapler problems and how to correct them12. Management of choledocholithiasis following Roux-en-Y gastric bypass: a systematic review and meta-analysis. Can J Surg 2021; 64:S80-S159. [PMID: 35483046 PMCID: PMC8677574 DOI: 10.1503/cjs.021321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
35
|
Effect of type 1 tympanoplasty on the quality of life of patients suffering from chronic otitis media (safe type). Niger J Clin Pract 2021; 24:1641-1644. [PMID: 34782502 DOI: 10.4103/njcp.njcp_23_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Chronic otitis media (COM) remains a major public health issue and is associated with relentless discharge from the ear, pain, significant functional limitation of hearing, leading to communication problems and frequent specialist visits. Aims To assess the improvement in quality of life of patients of COM (safe type) and surgical success in terms of graft uptake and improvement in hearing. Patients and Methods A prospective questionnaire-based outcome study was directed in 100 patients with COM who were treated with Type I Tympanoplasty at our institution between May 2018 and May 2020. All patients were asked to fill Modified Chronic Otitis Media 4 (COM-4) survey before operation and 3 months after operation. Preoperative and postoperative total ear scores, audiological results, postoperative graft uptake were assessed. Results The correlation between preoperative and postoperative assessment by questionnaire was statistically critical (P < 0.001). There was significant improvement in hearing postoperatively (P < 0.001). Effective graft uptake was seen in 80%. Conclusion The current study emphasizes that Type 1 Tympanoplasty fundamentally improves quality of life of patients in terms of physical suffering, hearing loss, emotional distress postoperatively.
Collapse
|
36
|
Supralesional Ablation Volumes Are Feasible in the Posterior Fossa and May Provide Enhanced Symptomatic Relief. Oper Neurosurg (Hagerstown) 2021; 21:418-425. [PMID: 34528092 DOI: 10.1093/ons/opab332] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/18/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Laser interstitial thermal therapy (LITT) for posterior fossa lesions remains rare as the small size of the infratentorial compartment, proximity to the brainstem, and thickness/angulation of the occipital bone creates barriers to procedural success. Furthermore, evaluation of the effect of ablation volume on outcomes is limited. OBJECTIVE To analyze our institutional experience with LITT in the posterior fossa stratifying perioperative and long-term outcomes by ablation volumes. METHODS Seventeen patients with posterior fossa lesions treated with LITT from 2013 to 2020 were identified. Local progression-free survival (PFS), overall survival, steroid dependence, and edema reduction were evaluated with Kaplan-Meier analysis grouped by ablation volume. Preoperative, postoperative, and last known Karnofsky Performance Status (KPS) were compared using a matched paired t test. RESULTS No differences in pathology, preoperative KPS, or preoperative lesion volume were found between patients with total (100%-200% increase in pre-LITT lesion volume) versus radical (>200% increase in pre-LITT lesion volume) ablations. Patients who underwent radical ablation had a higher postoperative KPS (93 vs 82, P = .02) and higher KPS (94 vs 87, P = .04) and greater reduction in perilesional edema at last follow-up (P = .01). Median follow-up was 80.8 wk. CONCLUSION Despite obvious anatomical challenges, our results demonstrate that radical ablations are both feasible and safe in the posterior fossa. Furthermore, radical ablations may lead to greater decreases in perilesional edema and improved functional status both immediately after surgery and at last follow-up. Thus, LITT should be considered for patients with otherwise unresectable or radioresistant posterior fossa lesions.
Collapse
|
37
|
Branching clonal evolution patterns predominate mutational landscape in multiple myeloma. Am J Cancer Res 2021; 11:5659-5679. [PMID: 34873486 PMCID: PMC8640818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/27/2021] [Indexed: 06/13/2023] Open
Abstract
Multiple Myeloma (MM) arises from malignant transformation and deregulated proliferation of clonal plasma cells (PCs) harbouring heterogeneous molecular anomalies. The effect of evolving mutations on clone fitness and their cellular prevalence shapes the progressing myeloma genome and impacts clinical outcomes. Although clonal heterogeneity in MM is well established, which subclonal mutations emerge/persist/perish with progression in MM and which of these can be targeted therapeutically remains an open question. In line with this, we have sequenced pairwise whole exomes of 62 MM patients collected at two time points, i.e., at diagnosis and on progression. Somatic variants were called using a novel ensemble approach where a consensus was deduced from four variant callers (Illumina's Dragen, Strelka2, SomaticSniper and SpeedSeq) and actionable/druggable gene targets were identified. A marked intraclonal heterogeneity was observed. Branching evolution was observed among 72.58% patients, of whom 64.51% had low TMBs (<10) and 61.29% had 2 or more founder clones. The hypermutator patients (with high TMB levels ≥10 to ≤100) showed a significant decrease in their TMBs from diagnosis (median TMB 77.11) to progression (median TMB 31.22). A distinct temporal fall in subclonal driver mutations was identified recurrently across diagnosis to progression e.g., in PABPC1, BRAF, KRAS, CR1, DIS3 and ATM genes in 3 or more patients suggesting such patients could be treated early with target specific drugs like Vemurafenib/Cobimetinib. An analogous rise in driver mutations was observed in KMT2C, FOXD4L1, SP140, NRAS and other genes. A few drivers such as FAT4, IGLL5 and CDKN1A retained consistent distribution patterns at two time points. These findings are clinically relevant and point at consideration of evaluating multi time point subclonal mutational landscapes for designing better risk stratification strategies and tailoring time to time risk adapted combination therapies in future.
Collapse
|
38
|
Effective Organizational Justice and Organizational Citizenship Behavior Using Fuzzy Logic to Obtain the Optimal Relationship. Qual Manag Health Care 2021; 30:13-20. [PMID: 33306653 DOI: 10.1097/qmh.0000000000000288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Organizational justice (OJ) is important for organizational success; it reflects employee perceptions of fair treatment. OJ promotes employee retention and work engagement toward high performance. Organizational citizenship behavior (OCB) is a discretionary behavior, describing how employees contribute to a smoother organizational performance. OCB enhances employee satisfaction, quality of care, patients' satisfaction with hospital performance, and the use of best hospital practices. Moreover, OJ increases employee satisfaction and is perceived as a factor that encourages workers to go "above and beyond" their responsibilities, while avoiding OCB in the workplace may reduce awareness of justice. Previous efforts have shown that perceptions of a just workplace promoted OCB at different industrial companies. Still, few studies have investigated this relationship in hospitals. OBJECTIVES This study addressed this gap by investigating the significant relationships of OJ and OCB in a large Jordanian hospital. METHODS A fuzzy approach to Pearson's correlation was applied to test the formulated hypothesis, with an aim to better understand causal correlation of vague data. RESULTS A statistically significant, positive correlation existed between OJ and OCB. Maximum correlations existed between distributive justice and altruism, procedural justice, courtesy, and interactional or interpersonal justice and conscientiousness. This study showed that procedural justice was the best predictor of OCB. CONCLUSION This study revealed a correlation between OJ and OCB, reflecting the diversity of these correlation relationships, which can help decision makers to form their strategic plans.
Collapse
|
39
|
Use of Elastic Stain Technique to Detect Histologically Occult Vascular Invasion in Resected Colorectal Carcinomas at Danbury Hospital. Am J Clin Pathol 2021. [DOI: 10.1093/ajcp/aqab191.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction/Objective
Colorectal carcinoma (CRC) represents a leading cause of cancer related death in the western world and is by far the most common malignancy of the gastrointestinal tract. Vascular invasion (VI), in particular extramural VI by tumor is recognized as a feature of colorectal cancer progression, and the latter is an independent prognostic indicator of disease recurrence and survival in colorectal carcinoma. The purpose of this study is to detect VI in resected colorectal tumor samples and compare sensitivity of elastic staining to routine H&E staining at Danbury Hospital.
Methods/Case Report
A total of 50 colorectal cancer specimens from segmental colon resection or endoscopic polypectomy performed at Danbury Hospital over a 3-year period were included. Histologic sections of each tumor were assessed for the presence of VI by routine H&E staining. Superficial recuts of each tumor were subjected to elastic Von Giesen staining and reassessed for the presence of vascular invasion. Sensitivity of routine H&E staining for the detection of VI was calculated with elastic stain serving as the “gold standard”.
Results (if a Case Study enter NA)
In this study, VI by carcinoma was identified by H&E stain and/or elastic stain in 17 (34%) out of 50 cases. H&E stain and elastic stain detected VI in 12 (24%) and 16 (32%) out of 50 cases, respectively. There was a single case for which H&E stain showed vascular invasion that was not confirmed by elastic stain, representing a false negative for the H&E technique. Elastic staining detected VI in 5 cases for which the corresponding H&E stain was falsely negative for VI. Overall, vascular invasion status (absent or present) was concordant in 44 (88 %) of the 50 cases. With elastic stain deemed the “gold standard” for VI detection, the sensitivity, specificity, negative predictive value, and positive predictive value of H&E stain were found to be 68.7%, 97.0%, 86.8%, and 91.6%, respectively.
Conclusion
Although H & E staining of colorectal carcinoma tissue sections have a very good specificity and positive predictive value for the detection of VI, this technique suffers from a suboptimal sensitivity. For these reasons, we agree with previously published literature reports that the use of elastic stain as a supplement to H & E staining should be strongly considered for the proper evaluation and prognostication of colorectal carcinoma specimens.
Collapse
|
40
|
Commentary: Resection of a Medulla Oblongata Hemangioblastoma: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2021; 21:E436-E437. [PMID: 34409995 DOI: 10.1093/ons/opab295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 07/06/2021] [Indexed: 11/13/2022] Open
|
41
|
Pulse-shape discrimination against low-energy Ar-39 beta decays in liquid argon with 4.5 tonne-years of DEAP-3600 data. THE EUROPEAN PHYSICAL JOURNAL. C, PARTICLES AND FIELDS 2021; 81:823. [PMID: 34720726 PMCID: PMC8550104 DOI: 10.1140/epjc/s10052-021-09514-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
The DEAP-3600 detector searches for the scintillation signal from dark matter particles scattering on a 3.3 tonne liquid argon target. The largest background comes from 39 Ar beta decays and is suppressed using pulse-shape discrimination (PSD). We use two types of PSD estimator: the prompt-fraction, which considers the fraction of the scintillation signal in a narrow and a wide time window around the event peak, and the log-likelihood-ratio, which compares the observed photon arrival times to a signal and a background model. We furthermore use two algorithms to determine the number of photons detected at a given time: (1) simply dividing the charge of each PMT pulse by the mean single-photoelectron charge, and (2) a likelihood analysis that considers the probability to detect a certain number of photons at a given time, based on a model for the scintillation pulse shape and for afterpulsing in the light detectors. The prompt-fraction performs approximately as well as the log-likelihood-ratio PSD algorithm if the photon detection times are not biased by detector effects. We explain this result using a model for the information carried by scintillation photons as a function of the time when they are detected.
Collapse
|
42
|
Elevated pulmonary levels of Axin2 in mice exposed to herbicide 2,4-D with or without endotoxin. J Biochem Mol Toxicol 2021; 35:e22912. [PMID: 34463001 DOI: 10.1002/jbt.22912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 07/23/2021] [Accepted: 08/24/2021] [Indexed: 12/28/2022]
Abstract
2,4-Dichlorophenoxyacetic acid (2,4-D), a member of the phenoxy family of herbicides is commonly used in agriculture for controlling broadleaf weeds but its uncontrolled and incoherent use has been linked to incidences of lung toxicity. The present study aimed to understand the molecular mechanisms behind the 2,4-D alone or in combination with endotoxin (lipopolysaccharide [LPS]) induced pulmonary toxicity. Blood and lung samples were collected from Swiss albino mice (n = 48) following chronic exposure to high (37 mg/kg; 1/10th of LD50 ) and low (18.5 mg/kg; 1/20th of LD50 ) doses of 2,4-D alone or in combination with endotoxin (80 µg/animal). Transcriptome analysis revealed Wnt Canonical signaling as one of the top dysregulated pathways in mice lung following exposure to 2,4-D with and without endotoxin (LPS) co-exposure. Global view of differentially expressed genes showed increased messenger RNA expression of Axin2 by 0.26, 2.58, 3.14, 2.59, and 2.97 folds following exposure to LPS, high dose alone or in combination with LPS and low dose alone or in combination with LPS, respectively. The microarray data were validated using quantitative polymerase chain reaction and immunohistochemistry. Furthermore, the plasma concentration of Axin2 was elevated in the high dose group as revealed by Sandwich ELISA. The data taken together suggest a role of Axin2 to activate the Canonical Wnt signaling pathway in 2,4-D and or endotoxin-induced lung damage in mice.
Collapse
|
43
|
Multicentric Hospital-Based Surveillance of Pertussis Amongst Infants Admitted in Tertiary Care Facilities in India. Indian Pediatr 2021; 58:709-717. [PMID: 34465657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To estimate the disease and economic burden of pertussis amongst hospitalised infants in India. DESIGN Multicentric hospital-based surveillance study. PARTICIPANTS Hospitalised infants with clinical suspicion of pertussis based on predefined criteria. OUTCOME MEASURES Proportion of infants with laboratory-confirmed pertussis, economic burden of pertussis amongst hospitalised infants. RESULTS 693 clinically suspected infants were recruited of which 32 (4.62%) infants had laboratory-confirmed pertussis. Progressive cough with post-tussive emesis (50%) and pneumonia (34%) were the common clinical presentations; apnea in young infants was significantly associated with pertussis. Infants with pertussis were more likely to be younger (median age 102.5 days vs.157 days) and born preterm (42.9% vs 24.5%). Almost 30% infants with pertussis had not received vaccine for pertussis with 50% of these infants aged less than 2 months. Pertussis was associated with higher costs of hospitalisation, pharmacy and loss of working days by caregivers as compared to non-pertussis cases. CONCLUSIONS Younger infants, those born preterm and those inadequately immunised against pertussis are at higher risk of pertussis infection. Timely childhood immunisation and introduction of maternal immunisation for pertussis can help in reducing the disease burden.
Collapse
|
44
|
Commentary: The Infratemporal Retro-Eustachian Transposition of the Temporoparietal Fascial Flap for Clival Reconstruction After Endoscopic Endonasal Approach: An Anatomic Conceptual Technique. Oper Neurosurg (Hagerstown) 2021; 21:E171-E172. [PMID: 33956986 DOI: 10.1093/ons/opab147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 03/14/2021] [Indexed: 11/12/2022] Open
|
45
|
Commentary: Concomitant Embolization and Microsurgical Resection of a Giant, Hypervascular Skull Base Meningioma: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2021; 21:E99-E100. [PMID: 34015826 DOI: 10.1093/ons/opab164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 11/12/2022] Open
|
46
|
Multicentric Hospital-Based Surveillance of Pertussis Amongst Infants Admitted in Tertiary Care Facilities in India. Indian Pediatr 2021. [DOI: 10.1007/s13312-021-2276-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
47
|
Commentary: Transcondylar Odontoid Resection and Stabilization for Craniovertebral Degenerative Compression: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2021; 21:E431-E432. [PMID: 34293149 DOI: 10.1093/ons/opab271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 05/16/2021] [Indexed: 11/13/2022] Open
|
48
|
Neonatal Pig Sertoli Cells Survive Xenotransplantation by Creating an Immune Modulatory Environment Involving CD4 and CD8 Regulatory T Cells. Cell Transplant 2021; 29:963689720947102. [PMID: 32841048 PMCID: PMC7564626 DOI: 10.1177/0963689720947102] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
The acute cell-mediated immune response presents a significant barrier to
xenotransplantation. Immune-privileged Sertoli cells (SC) can prolong the
survival of co-transplanted cells including xenogeneic islets, hepatocytes, and
neurons by protecting them from immune rejection. Additionally, SC survive as
allo- and xenografts without the use of any immunosuppressive drugs suggesting
elucidating the survival mechanism(s) of SC could be used to improve survival of
xenografts. In this study, the survival and immune response generated toward
neonatal pig SC (NPSC) or neonatal pig islets (NPI), nonimmune-privileged
controls, was compared after xenotransplantation into naïve Lewis rats without
immune suppression. The NPSC survived throughout the study, while NPI were
rejected within 9 days. Analysis of the grafts revealed that macrophages and T
cells were the main immune cells infiltrating the NPSC and NPI grafts. Further
characterization of the T cells within the grafts indicated that the NPSC grafts
contained significantly more cluster of differentiation 4 (CD4) and cluster of
differentiation 8 (CD8) regulatory T cells (Tregs) at early time points than the
NPI grafts. Additionally, the presence of increased amounts of interleukin 10
(IL-10) and transforming growth factor (TGF) β and decreased levels of tumor
necrosis factor (TNF) α and apoptosis in the NPSC grafts compared to NPI grafts
suggests the presence of regulatory immune cells in the NPSC grafts. The NPSC
expressed several immunoregulatory factors such as TGFβ, thrombospondin-1
(THBS1), indoleamine-pyrrole 2,3-dioxygenase, and galectin-1, which could
promote the recruitment of these regulatory immune cells to the NPSC grafts. In
contrast, NPI grafts had fewer Tregs and increased apoptosis and inflammation
(increased TNFα, decreased IL-10 and TGFβ) suggestive of cytotoxic immune cells
that contribute to their early rejection. Collectively, our data suggest that a
regulatory graft environment with regulatory immune cells including CD4 and
CD8 Tregs in NPSC grafts could be attributed to the prolonged survival of the
NPSC xenografts.
Collapse
|
49
|
Commentary: Infra-Occipital Supra-Tentorial Approach for Resection of Low-Grade Tumor of the Left Lingual Gyrus: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2021; 21:E259-E260. [PMID: 34270754 DOI: 10.1093/ons/opab210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 05/04/2021] [Indexed: 11/14/2022] Open
|
50
|
Commentary: Total Petrosectomy for the Total Resection of Sphenopetroclival Meningioma: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2021; 21:E24-E25. [PMID: 33930165 DOI: 10.1093/ons/opab091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/24/2021] [Indexed: 11/14/2022] Open
|