Nevin Manimala

ACS Appl Mater Interfaces. 2024 Nov 28. doi: 10.1021/acsami.4c17912. Online ahead of print.

ABSTRACT

Objective: To compare the diagnostic value of [¹⁸F]AlF-LNC1007, [¹⁸F]FDG, and [¹⁸F]AlF-NOTA-FAPI-04 PET/CT in breast cancer. Methods: 33 patients with highly suspected or already diagnosed but untreated breast cancer were enrolled in the study and underwent [¹⁸F]AlF-LNC1007 (30 patients), [¹⁸F]FDG (22 patients), and [¹⁸F]AlF-NOTA-FAPI-04 (8 patients) PET/CT. Quantitative measurements included the SUV_max and tumor-to-background ratio (TBR) for all lesions and background tissues. The Chi-square test was used for intergroup diagnostic efficacy, and the Wilcoxon test was used for intergroup SUV_max or TBR. Diagnostic efficacy for lymph node metastasis was evaluated using receiver operating characteristic (ROC) analysis. Results: Compared to [¹⁸F]FDG, [¹⁸F]AlF-LNC1007 had a higher positive predictive value (100% vs 91%, P = 0.0004) in lymph node metastases (42 vs 46) and higher sensitivity (100 vs 76%, P = 0.0003) in bone metastases (33 vs 25) but lower sensitivity (93 vs 100%, P = 0.001) in liver metastases. Apart from liver metastases, [¹⁸F]AlF-LNC1007 PET/CT had higher SUV_max in primary tumor and other metastases, with no statistical difference in TBR. Compared to [¹⁸F]AlF-NOTA-FAPI-04 PET/CT, [¹⁸F]AlF-LNC1007 had less false-positive and a higher positive predictive value in bone metastases (99 vs 95%, P = 0.0003) but had lower SUV_max(P < 0.01) in all primary and metastases lesions. The TBR difference between [¹⁸F]AlF-LNC1007 and [¹⁸F]AlF-NOTA-FAPI-04 was statistically significant only in bone metastases (5.97 vs 5.02, P = 0.001). The comparison of lymph node detection efficacy between [¹⁸F]AlF-LNC1007 and [¹⁸F]FDG PET/CT showed significant differences in SUV_max cutoff values for diagnosing lymph node metastases (2.62 vs 3.90), sensitivity (95.2% vs 66.67), and specificity (100% vs 85.00) (all P < 0.001). Conclusion: [¹⁸F]AlF-LNC1007 demonstrated superior efficacy compared to [¹⁸F]FDG and [¹⁸F]AlF-NOTA-FAPI-04 and higher uptake than [¹⁸F]FDG in primary tumor, lymph node and bone metastases, and higher TBR than [¹⁸F]AlF-NOTA-FAPI-04, especially in bone metastases. [¹⁸F]AlF-LNC1007 also showed high specificity in differentiating inflammatory and metastatic lymph nodes.

PMID:39607746 | DOI:10.1021/acsami.4c17912

J Integr Complement Med. 2024 Nov 28. doi: 10.1089/jicm.2024.0681. Online ahead of print.

ABSTRACT

Objective: Federally Qualified Health Centers (FQHCs) provide comprehensive primary care to underserved populations. While the presence of chiropractic services in these multidisciplinary systems is of growing interest, little is known. The purpose of this study is to identify and map where Doctors of Chiropractic (DCs) are employed or providing care within FQHCs and describe their employment characteristics. Methods: Websites for FQHC clinics identified by the Health Resources and Services Administration were reviewed to determine whether chiropractic services are offered and/or a DC is employed at that clinic. Identified DCs were invited to participate in a cross-sectional survey, which included questions about their employment. Analysis of survey data utilized descriptive statistics and content analysis of open-ended questions. Results: We identified 233 DCs working full- or part-time in 146 of 1537 (9.5%) FQHC systems, with two thirds of those employing more than one DC. Chiropractic services are delivered at FQHCs in 28/50 U.S. states, 75.0% of which offer a chiropractic benefit in their state Medicaid program. California had the largest concentration of FQHCs offering chiropractic services (65/146, 44.5%). Of surveys sent to 206 viable DC e-mail addresses, 101 were completed (49.0% response rate). Most DCs responded to personal (39.0%) or advertised (26.0%) solicitation for employment by the FQHC, while some DCs (14.0%) initiated the opportunity. Average employment at the FQHC was 5.1 years. Credentialing levels and compensation structures were inconsistent. DCs predominantly spend their time on clinical care (mean 88.0%) compared with administrative tasks (mean 10.4%). Conclusion: This study provides important baseline information about the presence of chiropractic within FQHCs and DCs employment characteristics. Future research should include exploring the roles DCs fulfill within FQHCs, skills necessary for successful collaboration, and barriers to incorporating chiropractic services within these systems.

PMID:39607742 | DOI:10.1089/jicm.2024.0681

J Hered. 2024 Nov 28:esae071. doi: 10.1093/jhered/esae071. Online ahead of print.

ABSTRACT

The common bed bug, Cimex lectularius, is a globally distributed pest insect of medical, veterinary, and economic importance. Previous reference genome assemblies for this species were generated from short read sequencing data, resulting in a ~650 Mb composed of thousands of contigs. Here, we present a haplotype-resolved, chromosome-level reference genome, generated from an adult Harlen strain female specimen. Using PacBio long read and Omni-C proximity sequencing, we generated a 540 Mb genome with 15 chromosomes (13 autosomes and 2 sex chromosomes – X1X2) with an N50 > 30 Mb and BUSCO > 90%. Previous karyotyping efforts indicate an XY sex chromosome system, with 2n=26 and X1X1X2X2 females and X1X2Y males; however significant fragmentation of the X chromosome has also been reported. We further use whole genome resequencing data from males and females to identify the X1 and X2 chromosomes based on sex biases in coverage. This highly contiguous reference genome assembly provides a much-improved resource for identifying chromosomal genome architecture, and for interpreting patterns of urban outbreaks and signatures of selection linked to insecticide resistance.

PMID:39607737 | DOI:10.1093/jhered/esae071

J Laparoendosc Adv Surg Tech A. 2024 Nov 28. doi: 10.1089/lap.2024.0295. Online ahead of print.

ABSTRACT

Background: Laparoscopic cholecystectomy is one of the most common surgical procedures. Several techniques of ligating the cystic duct have been compared in randomized trials, but data on comparative effectiveness are missing. Our aim was to systematically review the literature and, if appropriate, synthesize the available evidence. Methods: A systematic search of PubMed, Scopus, Ovid, and Cochrane Library was conducted to identify randomized studies comparing different ligation techniques of the cystic duct in laparoscopic cholecystectomy. Network meta-analysis synthesized evidence from all available techniques. Techniques compared were metal (MC), absorbable (AC), or polymer clips (PC), suture ligation (SL), and ultrasonic shears (US). Results: Twenty-three randomized studies with 2851 patients were included in our study. A well-connected network was formed for bile leak and a star-shaped network for operative time, with MC as the common comparator. No difference was found when SL, AC, US, or PC were compared for bile leak. Operative time was statistically significantly reduced when US were compared to MC (mean difference [MD] = -14.32 [-19.37, -9.28]), SL MD = -20.16 (-10.84, -29.47), and AC MD = -18.32 (-1.25, -35.39). The remaining techniques had similar operative times. PC had the highest probability of being the best technique P = 41.8, and SL had the highest probability P = 46.1 of being the second best for bile leak. US had a 98.1% chance of being the best technique for operative time. Conclusions: Given that all techniques demonstrate similar efficacy, the decision should be based on cost, familiarity with the technique, and environmental factors.

PMID:39607730 | DOI:10.1089/lap.2024.0295

J Palliat Med. 2024 Nov 28. doi: 10.1089/jpm.2024.0147. Online ahead of print.

ABSTRACT

Background: This analysis examined regret from participation in cancer clinical trials (CCT) and explored associations between regret and symptom burden, symptom bother, therapeutic optimism, and the importance of spiritual beliefs. Methods: This is a secondary analysis of cross-sectional data from a study of American CCT patient-participants conducted from 2015 to 2019. Descriptive statistics, bivariate associations, and logistic regression were used to evaluate regret in this sample (n = 325). Results: About 10% of the sample reported regret. Younger age, increased symptom burden, increased symptom bother, increased severe symptoms, and a lower level of therapeutic optimism were significantly associated with regret (p < 0.05) compared to those who did not experience regret. The final regression model identified that younger age, symptom burden, and therapeutic optimism significantly predicted regret (p < 0.05). Conclusions: Understanding regret among research participants may improve CCT retention and ensure ethical research practices. Symptom experiences may play a key role in experiences of regret in CCT participation.

PMID:39607718 | DOI:10.1089/jpm.2024.0147

Eur J Orthod. 2024 Dec 1;46(6):cjae060. doi: 10.1093/ejo/cjae060.

ABSTRACT

BACKGROUND: Several appliances or treatment protocols are marketed to either patients or orthodontists as being associated with improved orthodontic outcomes. However, clinical decision-making should be based on robust scientific evidence and not marketing claims or anecdotal evidence.

OBJECTIVE: To identify appliances/protocols being associated with improved outcomes of fixed appliance treatment.

SEARCH METHODS: Unrestricted literature searches in seven databases/registers for human studies until March 2024.

SELECTION CRITERIA: Randomized or quasi-randomized clinical trials on human patients of any age, sex, or ethnicity receiving comprehensive orthodontic treatment with fixed appliances and assessing occlusal outcome with either the Peer Assessment Rating (PAR) or the American Board of Orthodontics-Objective Grading System (ABO-OGS) index.

DATA COLLECTION AND ANALYSIS: Duplicate/independent study selection, data extraction, and risk of bias assessment with the Cochrane RoB 2 tool. Random-effects meta-analyses of averages or mean differences with their 95% Confidence Intervals (CI), followed by meta-regression/subgroup/sensitivity analyses and assessment of the quality of clinical recommendations with the Grades of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

RESULTS: Data from 20 small- to moderately-sized trials covering 1470 patients indicated that orthodontic treatment with fixed appliances is effective and results on average in a final PAR score of 6.0 points (95% CI 3.9-8.2 points), an absolute PAR reduction of 23.0 points (95% CI 15.6-30.4 points), a % PAR reduction of 82.6% (95% CI 70.8%-94.4%), and an absolute ABO-OGS score of 18.9 points (95% CI 11.7-26.2 points). However, very high between-study heterogeneity (I2 > 75%) was seen for both PAR and ABO-OGS. Extraction treatment was associated with significantly better occlusal outcome than non-extraction treatment with ABO-OGS (12.9 versus 16.6 points; P = .02). There was no statistically significant difference in occlusal outcome with (i) 0.018″-slot or 0.022″-slot brackets; (ii) customized or prefabricated brackets; (iii) anchorage reinforcement with temporary anchorage devices; (iv) use of vibrational adjuncts; and (v) aligners or fixed appliances (P > .05 in all instances), while small benefits were seen with indirectly bonded brackets.

CONCLUSIONS: Considerable between-study heterogeneity exists in the reported occlusal outcome of fixed appliance treatment, and different appliances or adjuncts have little effect on this. Standardization and/or automatization of the scoring procedures for PAR and ABO-OGS might help to improve consistency and reliability of outcome measurement in orthodontic trials.

REGISTRATION: PROSPERO (CRD42024525088).

PMID:39607678 | DOI:10.1093/ejo/cjae060

Minerva Urol Nephrol. 2024 Nov 28. doi: 10.23736/S2724-6051.24.05725-2. Online ahead of print.

ABSTRACT

BACKGROUND: According to the European guidelines, any urological surgery breaching the mucosa requires preoperative screening and antibiotic treatment of any asymptomatic bacteriuria (ABU).

METHODS: The aim of this study was to determine whether the preoperative antibiotic treatment duration of ABU in urological surgery impact postoperative infectious complications. National multicenter, retrospective study including all consecutive patients screened for ABU before urologic surgery in 10 centers from 1^st April 2019 to April 2023. The primary endpoint was all postoperative infectious complications occurring within 30 days after surgery. Short antibiotic treatment (SAT) of ABU was defined by 5- day regimen or less. Long antibiotic treatment (LAT) was defined by duration longer than 5 days.

RESULTS: Among the 2389 patients included, 839 (35.1%) patients had positive urine culture (UC), of whom 546 (65%) had positive mono or bimicrobial UC and 292 (34.8%) polymicrobial UC. There were 106 (4.4%) postoperative infectious complications occurring within 30 days including 62 (58.5%) in the positive UC group. In the positive UC group, 336 (40%) had received SAT, 261 (31.1%) LAT and 231 (27.5%) had not received any treatment. The 30-day surgery-related infection rates were 8.3%, 6.1% and 7.36% respectively. There was no statistical difference between SAT versus LAT in the univariate analysis (P=0.6) or in the multivariate analysis OR 1.97 [0.37, 1.86] (P=0.06).

CONCLUSIONS: Our results found no association between antibiotic treatment duration and urinary infectious complication among patients with preoperative ABU who undergo urological surgery. These results need a RCT to be confirmed.

PMID:39607671 | DOI:10.23736/S2724-6051.24.05725-2

Pharmacol Rep. 2024 Nov 14. doi: 10.1007/s43440-024-00677-3. Online ahead of print.

ABSTRACT

The protein CHI3L1 contributes to cancer development by several mechanisms, including stimulation of angiogenesis and invasion as well as immunomodulatory effects. These properties make it a potential target for the development of targeted therapies in precision medicine. In this context, the particular potential of CHI3L1 inhibition could be considered in glioblastoma multiforme (GBM), whose tumors exhibit high levels of angiogenesis and increased CHI3L1 expression. This study aims to investigate whether inhibition of CHI3L1 in spheroids used as a GBM model affects the mechanisms of invasiveness; METHODS: We analyzed the interactions between CHI3L1 and the inhibitor G721-0282 in molecular docking and molecular dynamics (in silico) and infrared spectroscopy. Uptake of G721-0282 in GBM spheroids was measured using a label-free physical cytometer. Changes in E-, N- and VE-cadherins, VCAM-1, and EGFR were analyzed by immunohistochemical reactions, Western blot, and ddPCR methods in U-87 MG cells and GBM spheroids consisting of U-87 MG glioblastoma cells, HMEC-1 endothelial cells and macrophages; RESULTS: A direct interaction between CHI3L1 and G721-0282 was confirmed. G721-0282 decreased N-cadherins and VCAM-1 in GBM spheroids, but the changes in the 2D model of U-87 MG glioblastoma cells were different; CONCLUSION: Inhibition of CHI3L1 has the potential to reduce the invasiveness of GBM tumors. The 3D model of GBM spheroids is of great significance for investigating changes in membrane proteins and the tumor microenvironment.

PMID:39607670 | DOI:10.1007/s43440-024-00677-3

Hepatol Int. 2024 Nov 28. doi: 10.1007/s12072-024-10749-4. Online ahead of print.

ABSTRACT

BACKGROUND AND AIM: Acute-on-chronic liver failure (ACLF) patients with hepatorenal syndrome (HRS-AKI) have limited response to vasoconstrictors and worse outcomes, requiring biomarkers for early detection.

METHODS: In a prospective cohort of ACLF patients (n = 240), urine NGAL was performed in patients with the clinical diagnosis of HRS-AKI, while in a subset of patients (n = 30), a complete panel of 17 urinary biomarkers was assessed for identifying terlipressin non-response (T-NR).

RESULTS: ACLF patients with HRS-AKI, aged 45.84 ± 10.6 years, 91.2% males, 74.2% with alcohol etiology, mean urine NGAL of 1541.66 ± 1684.69 ng/ml, AARC score 10.19 ± 1.86, 155 (64.5%) had T-NR at day 4. T-NR was maximal for AARC grade 3 and was associated with a higher need of dialysis (50.3% vs 5.9%; OR 16.21, 6.23-42.19) and 28-day mortality (49.0% vs. 17.9%; HR 3.42, 1.96-5.95). AARC grade 3 (OR 38.21, 2.93-497.74), (HR 5.10, 1.19-21.84) and urine NGAL (OR 11.53, 5.66-23.49; AUROC 0.97, NGAL > 900 ng/ml) (HR 1.23, 1.02-1.49) were independent predictors of T-NR and 28-day mortality, respectively. It was interesting to observe a significant elevation in renal injury and a decrease in the repair markers in T-NR (p < 0.05).

CONCLUSION: Almost 60% of patients with ACLF and HRS-AKI experience non-response to terlipressin which predicts higher mortality and need for dialysis. High NGAL above 900 ng/ml predicts T-NR with 100% specificity for T-NR. ACLF patients with HRS, with AARC grade 3 and high NGAL have a high likelihood of T-NR and should be considered for alternative therapeutic modalities.

PMID:39607651 | DOI:10.1007/s12072-024-10749-4

Acta Neurochir (Wien). 2024 Nov 28;166(1):484. doi: 10.1007/s00701-024-06373-8.

ABSTRACT

OBJECTIVE: This study aimed to identify predictive factors for cerebral infarction after bypass surgery in adult patients with moyamoya disease (MMD) using quantitative parameters in 4D-CT perfusion software.

METHODS: A total of 108 patients who underwent combined revascularization, including superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis and encephalo-duro-myo-synangiosis (EDMS), in our hospital between September 2019 and August 2023 were analyzed retrospectively. Preoperative relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), relative mean transit time (rMTT), and relative time to maximum residual function (rTmax) perfusion parameters were obtained using 4D-CT perfusion software. These quantitative parameters, combined with related clinical and angiographic factors, were statistically analyzed using univariate and multivariate regression analyses to determine the significant predictors of cerebral infarction after bypass surgery.

RESULTS: Acute cerebral infarction occurred in 12 patients postoperatively. Univariate analysis showed that a history of previous ischemic events (P = 0.024), higher Suzuki stage (P = 0.006), higher modified Rankin score (mRS) (P = 0.013), rCBV (P = 0.026), rMTT (P = 0.001), and rTmax (P < 0.001) were associated with postoperative cerebral infarction. Further multivariate regression analysis showed that a history of previous ischemic events (OR = 12.830, 95%CI = 1.854-875.672, P = 0.031) and higher rTmax (OR = 16.968, 95%CI = 2.035-141.451, P = 0.009) were independently associated with new postoperative cerebral infarction. The cutoff value for rTmax was 2.025 (AUC = 0.935).

CONCLUSIONS: Previous ischemic event history and rTmax greater than 2.025 are independent risk factors for predicting cerebral infarction after combined revascularization with high sensitivity in adult patients with MMD. These patients should be more cautious when deciding on combined revascularization.

PMID:39607649 | DOI:10.1007/s00701-024-06373-8