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Interdisciplinary Cardiovascular and... Jun 2024Diameter-based risk stratification for elective repair of ascending aortic aneurysm fails to prevent type A dissection in many patients. Aneurysm wall stresses may...
OBJECTIVES
Diameter-based risk stratification for elective repair of ascending aortic aneurysm fails to prevent type A dissection in many patients. Aneurysm wall stresses may contribute to risk prediction; however, rates of wall stress change over time are poorly understood. Our objective was to examine aneurysm wall stress changes over three to five years and subsequent all-cause mortality.
METHODS
Male veterans with <5.5-cm ascending aortic aneurysms and computed tomography at baseline and 3 to 5-years follow-up underwent three-dimensional aneurysm model construction. Peak circumferential and longitudinal wall stresses at systole were calculated using finite element analysis. Temporal trends were assessed by mixed-effects modelling. Changes in aortic wall stresses, diameter, and length over time were evaluated as predictors of subsequent 3-year all-cause mortality by Cox proportional hazards modelling.
RESULTS
Sixty-two male veterans were included in the study. Yearly changes in geometric and biomechanical measures were 0.12 mm/yr (95% CI, 0.04-0.20) for aortic diameter, 0.41 mm/yr (0.12-0.71) for aortic length, 1.19 kPa/yr (-5.94-8.33) for peak circumferential stress, and 0.48 kPa/yr (-3.89-4.84) for peak longitudinal stress. Yearly change in peak circumferential stress was significantly associated with hazard of death-hazard ratio for peak circumferential stress growth per 10 kPa/yr, 1.27 (95% CI, 1.02-1.60; p = 0.037); hazard ratio for peak circumferential stress growth ≥ 32 kPa/yr, 8.47 (95% CI, 2.42-30; p < 0.001).
CONCLUSIONS
In this population of nonsurgical aneurysm patients, large temporal changes in peak circumferential stress, but not aortic diameter or length, was associated with all-cause mortality. Biomechanical stress and stress changes over time may be beneficial as additional risk factors for elective surgery in small aneurysms.
PubMed: 38913870
DOI: 10.1093/icvts/ivae116 -
Interdisciplinary Cardiovascular and... Jun 2024Postoperative air leakage is a major complication of lung resection, particularly right upper lobectomy. However, various surgical procedures can reduce postoperative...
OBJECTIVES
Postoperative air leakage is a major complication of lung resection, particularly right upper lobectomy. However, various surgical procedures can reduce postoperative complications and shorten the drainage period. The current study aimed to analyze the utility of bronchus-first right upper lobectomy as an alternative routine procedure.
METHODS
We retrospectively analyzed the data of 225 (53.7%) patients who underwent bronchus-first right upper lobectomy and 194 (46.3%) patients who underwent the conventional bronchus-last right upper lobectomy at our institution from 2015 to 2022. In patients with incomplete fissures who underwent bronchus-first right upper lobectomy, the bronchus was dissected firstly, followed by the pulmonary artery and vein, then, the interlobar fissure was divided. We compared the outcomes of two procedures and analyzed the surgical utility of bronchus-first right upper lobectomy.
RESULTS
The surgical outcomes and postoperative morbidity comparing bronchus-first and bronchus-last procedure were as followed: median operation time (min) 103/126 (p < 0.001), median bleeding amount (mL) 28/55 (p = 0.003), incomplete lobulation rate (%) 35.1/24.2 (p = 0.02), incidence of prolonged air leakage (%) 2.2/3.1 (p = 0.76) and rate of fellow surgeon's operation (%) 28.0/4.6 (p < 0.001). The procedure was associated with a decreased incidence of prolonged air leakage. The 4-year overall survival rates did not significantly differ between the two groups (p = 0.24).
CONCLUSIONS
Bronchus-first right upper lobectomy can prevent postoperative air leakage in patients with incomplete fissure. Additionally, as an alternative routine procedure, it is associated with a shorter surgical duration and a lower volume of blood loss regardless of interlobar fissure and operator's experience.
PubMed: 38913868
DOI: 10.1093/icvts/ivae114 -
PLoS Computational Biology Jun 2024Genome-scale metabolic models (GSMMs) offer a holistic view of biochemical reaction networks, enabling in-depth analyses of metabolism across species and tissues in...
Genome-scale metabolic models (GSMMs) offer a holistic view of biochemical reaction networks, enabling in-depth analyses of metabolism across species and tissues in multiple conditions. However, comparing GSMMs Against each other poses challenges as current dimensionality reduction algorithms or clustering methods lack mechanistic interpretability, and often rely on subjective assumptions. Here, we propose a new approach utilizing logisitic principal component analysis (LPCA) that efficiently clusters GSMMs while singling out mechanistic differences in terms of reactions and pathways that drive the categorization. We applied LPCA to multiple diverse datasets, including GSMMs of 222 Escherichia-strains, 343 budding yeasts (Saccharomycotina), 80 human tissues, and 2943 Firmicutes strains. Our findings demonstrate LPCA's effectiveness in preserving microbial phylogenetic relationships and discerning human tissue-specific metabolic profiles, exhibiting comparable performance to traditional methods like t-distributed stochastic neighborhood embedding (t-SNE) and Jaccard coefficients. Moreover, the subsystems and associated reactions identified by LPCA align with existing knowledge, underscoring its reliability in dissecting GSMMs and uncovering the underlying drivers of separation.
PubMed: 38913731
DOI: 10.1371/journal.pcbi.1012236 -
Frontiers in Oncology 2024The presence of occult nodal metastases in patients with oral tongue squamous cell carcinomas (OTSCCs) has implications for treatment. More than 30% of patients will...
OBJECTIVES
The presence of occult nodal metastases in patients with oral tongue squamous cell carcinomas (OTSCCs) has implications for treatment. More than 30% of patients will have occult nodal metastases, yet a considerable number of patients undergo unnecessary invasive neck dissection to confirm nodal status. In this work, we propose a probabilistic model for lymphatic metastatic spread that can quantify the risk of microscopic involvement at the lymph node level (LNL) given the location of macroscopic metastases and the tumor stage using the MRI method.
MATERIALS AND METHODS
A total of 108 patients of OTSCCs were included in the study. A hidden Markov model (HMM) was used to compute the probabilities of transitions between states over time based on MRI. Learning of the transition probabilities was performed via Markov chain Monte Carlo sampling and was based on a dataset of OTSCC patients for whom involvement of individual LNLs was reported.
RESULTS
Our model found that the most common involvement was that of level I and level II, corresponding to a high probability of 𝑝b1 = 0.39 ± 0.05, 𝑝b2 = 0.53 ± 0.09; lymph node level I had metastasis, and the probability of metastasis in lymph node II was high (93.79%); lymph node level II had metastasis, and the probability of metastasis in lymph node III was small (7.88%). Lymph nodes progress faster in the early stage and slower in the late stage.
CONCLUSION
An HMM can produce an algorithm that is able to predict nodal metastasis evolution in patients with OTSCCs by analyzing the macroscopic metastases observed in the upstream levels, and tumor category.
PubMed: 38912064
DOI: 10.3389/fonc.2024.1360253 -
Revista Brasileira de Ortopedia Jun 2024To identify the location of the Riché-Cannieu anastomosis (RCA) in relation to the Cardinal Kaplan Line (KCL) and the Y line. A total of 20 hands of 10...
To identify the location of the Riché-Cannieu anastomosis (RCA) in relation to the Cardinal Kaplan Line (KCL) and the Y line. A total of 20 hands of 10 recently-deceased adult male cadavers aged between 27 and 66 years were dissected for the investigation of the relationship of the most distal point of the RCA with the KCL and with the Y line, drawn from the axis of the third metacarpal head, following the longitudinal axis of the hand. In 20 limbs, the most distal point of the nerve communication was positioned distally in relation to the KCL. The Y line was positioned on the radial side in relation to the most distal point of the RCA in 14 limbs, and it was positioned on the ulnar side in relation to the Y line in 6 limbs. The crossing between the KCL and the Y line occurred proximal to the RCA in 18 limbs; in 1 hand, it was positioned distal to the intersection between these lines; and in another hand, the KCL was positioned exactly on the RCA. Knowledge of these anatomical relationships can prevent damage to nerve branches and thus also prevent paralysis of intrinsic muscles in surgical procedures in the palm of the hand.
PubMed: 38911877
DOI: 10.1055/s-0044-1785512 -
Ecology and Evolution Jun 2024Obligate mutualisms, reciprocally obligate beneficial interactions, are some of the most important mutualisms on the planet, providing the basis for the evolution of the...
Obligate mutualisms, reciprocally obligate beneficial interactions, are some of the most important mutualisms on the planet, providing the basis for the evolution of the eukaryotic cell, the formation and persistence of terrestrial ecosystems and the establishment and expansion of coral reefs. In addition, these mutualisms can also lead to the diversification of interacting partner species. Accompanying this diversification is a general pattern of a high degree of specificity among interacting partner species. A survey of obligate mutualisms demonstrates that greater than half of these systems have only one or two mutualist species on each side of the interaction. This is in stark contrast to facultative mutualisms that can have dozens of interacting mutualist species. We posit that the high degree of specificity in obligate mutualisms is driven by competition within obligate mutualist guilds that limits species richness. Competition may be particularly potent in these mutualisms because mutualistic partners are totally dependent on each other's fitness gains, which may fuel interspecific competition. Theory and the limited number of empirical studies testing for the role of competition in determining specificity suggest that competition may be an important force that fuels the high degree of specificity. Further empirical research is needed to dissect the relative roles of trait complementarity, mutualism regulation, and competition among mutualist guild members in determining mutualism specificity at local scales.
PubMed: 38911491
DOI: 10.1002/ece3.11628 -
Journal of Neuroendovascular Therapy 2024Neurofibromatosis type 1 (NF1) is associated with vascular fragility, which results in aneurysms, arteriovenous fistulas, and dissections. Here, we describe a case of...
OBJECTIVE
Neurofibromatosis type 1 (NF1) is associated with vascular fragility, which results in aneurysms, arteriovenous fistulas, and dissections. Here, we describe a case of endovascular treatment of a ruptured occipital artery aneurysm that occurred after a craniotomy in a patient with NF1.
CASE PRESENTATION
A 46-year-old man with a history of NF1 underwent a right lateral suboccipital craniotomy to remove a cavernous hemangioma in the right middle cerebellar peduncle. Severe bleeding occurred in the occipital artery during the craniotomy. Due to vessel fragility, coagulation and ligation were not possible, and pressure hemostasis was achieved using cellulose oxide and fibrin glue. On postoperative day 12, the patient developed a sudden swelling on the right side of the neck as well as tracheal compression. Contrast-enhanced CT revealed a ruptured aneurysm in the right occipital artery. Transarterial embolization was performed under general anesthesia the same day. Right external carotid angiography showed an 18-mm-diameter fusiform aneurysm in the occipital artery. The aneurysm ruptured inferiorly to form a large pseudoaneurysm with significant jet flow. An arteriovenous fistula was also observed in a nearby vein. A microcatheter was inserted into the fusiform aneurysm under proximal blood flow control, and embolization was performed using coils and -butyl-2-cyanoacrylate.
CONCLUSION
Compared to surgical repair of ruptured occipital artery aneurysms, endovascular treatment appears to be safe, effective, minimally invasive, and rapid. Ruptured occipital artery aneurysms in NF1 patients can cause neck swelling and airway compression and should be recognized as a potentially lethal condition.
PubMed: 38911485
DOI: 10.5797/jnet.cr.2023-0098 -
Frontiers in Physiology 2024Diets fed to commercial chicken breeders are high in n-6 fatty acids (n-6 FAs) and low in n-3 fatty acids (n-3 FAs). N-3 FAs are essential for embryonic brain...
Diets fed to commercial chicken breeders are high in n-6 fatty acids (n-6 FAs) and low in n-3 fatty acids (n-3 FAs). N-3 FAs are essential for embryonic brain development. In precocial birds, like chickens, brain development and brain n-3 FA accrual occur primarily before hatching. In two experiments, broiler and layer breeders were fed diets with or without flaxseed as the source of n-3 FAs from plant-based alpha-linolenic acid. Day-old broiler ( = 80) and layer ( = 96) offspring were dissected to calculate the percentage brain-to-body weight. Brain FA analyses from total lipid extracts were determined in the broiler ( = 24) and layer ( = 24) offspring brains, and the percentage FA composition and concentration (µg FAs per g brain) were calculated for each n-3 and n-6 FA. The brain size was only increased in broiler offspring from mothers fed flaxseed (χ2 = 9.22, = 0.002). In layer offspring only, the maternal flaxseed diet increased the brain concentration and percentage of n-3 FAs and decreased n-6 FAs ( < 0.05). We showed that feeding flaxseed to mothers increased the brain size in broiler offspring and altered brain FA composition in layer offspring. These results may have implications for poultry and other captive bird species fed diets low in n-3 FAs.
PubMed: 38911324
DOI: 10.3389/fphys.2024.1400611 -
Hepatobiliary Surgery and Nutrition Jun 2024Concerns over the security of laparoscopic radical operation for gallbladder cancer (GBC) persist. This systematic review and meta-analysis attempted to compare the...
BACKGROUND
Concerns over the security of laparoscopic radical operation for gallbladder cancer (GBC) persist. This systematic review and meta-analysis attempted to compare the safety and efficacy of laparoscopic surgery (LS) versus open surgery (OS) in the treatment of GBC.
METHODS
The PubMed, EMBASE, and Web of Science were searched from inception to July 18, 2022. Literature search, quality assessment, and data extraction were completed independently and in duplicate. Effect-size estimates expressed as weighted mean difference (WMD) or odds ratio (OR) with 95% confidence interval (CI) were derived under the random-effects model.
RESULTS
A total of 27 independent studies including 2,868 participants were meta-analyzed. Significance was noted for intraoperative blood loss (WMD: -117.194, 95% CI: -170.188 to 64.201, P<0.001), harvested lymph nodes (WMD: -1.023, 95% CI: -1.776 to -0.269, P=0.008), postoperative hospital stay (WMD: -3.555, 95% CI: -4.509 to -2.601, P<0.001), postoperative morbidity (OR: 0.596, 95% CI: 0.407 to 0.871, P=0.008), overall survival rate at 2-year (OR: 1.524, 95% CI: 1.143 to 2.031, P=0.004), T2 survival at 1-year (OR: 1.799, 95% CI: 1.777 to 2.749, P<0.01) and 2-year (OR: 2.026, 95% CI: 1.392 to 2.949, P<0.001), as well as T3 survival at 1-year (OR: 2.669, 95% CI: 1.564 to 4.555, P<0.001) and 2-year (OR: 2.300, 95% CI: 1.308 to 4.046, P=0.004). Subgroup analyses revealed that ethnicity, incidental GBC, sample size, and follow-up period were possible sources of heterogeneity. There was a low probability of publication bias for all outcomes except postoperative morbidity.
CONCLUSIONS
Our findings indicated that LS statistically had better 2-year survival rates, less intraoperative bleeding, shorter hospitalization times, and lower rates of complications than OS. However, the superiority and even the safety of LS still remain an open question due to the impact of incidental GBC, unaccounted heterogeneity, publication bias, lymph node dissection, and port-site metastasis.
PubMed: 38911190
DOI: 10.21037/hbsn-22-597 -
Frontiers in Endocrinology 2024This study aimed to investigate the association between weight-adjusted waist index (WWI), a novel adiposity index, and kidney stone (KS).
OBJECTIVE
This study aimed to investigate the association between weight-adjusted waist index (WWI), a novel adiposity index, and kidney stone (KS).
METHODS
Data were obtained from the National Health and Nutrition Examination Survey 2007-2018. According to the history of KS, participants were divided into the non-stone group and the stone group. Weighted multivariable logistic regression analyses were used to evaluate the correlation between WWI and KS in unadjusted, partially adjusted, and all-adjusted models. A restricted cubic spline (RCS) analysis assessed the association between continuous WWI and KS risk and obtained the risk function inflection point. Then, subgroup analysis based on the risk function inflection point was conducted to dissect the association in specific subgroups. In addition, the above analyst methods were repeatedly performed in populations after propensity score matching (PSM). The receiver operating characteristic (ROC) curve was applied to compare the ability to predict KS occurrence among WWI, visceral adiposity index (VAI), and body mass index (BMI).
RESULTS
Weighted multivariable logistic regression analyses found a positive association between continuous WWI and KS risk in the all-adjusted model [odds ratio (OR) = 1.03; 95% confidence interval (CI), 1.02-1.04; P < 0.001]. In further analysis, the Q4 WWI group was linked to the highest KS risk when compared to the Q1-Q3 group (OR = 1.06; 95% CI, 1.05-1.08, P < 0.001). RCS analysis found a linear significant correlation between continuous WWI and KS risk, and the risk function inflection point is 11.08 cm/√kg. Subgroup analysis confirmed that WWI was associated with KS risk in different groups. After PSM, increased WWI was still related to a high risk of KS. Moreover, the ROC curve demonstrated that WWI has a higher predictive ability of KS occurrence than VAI and BMI (area under curve, 0.612 vs. 0.581 vs. 0.569).
CONCLUSION
In the US adult population, elevated WWI value was associated with an increased risk of KS. Furthermore, WWI was a better predictor of KS occurrence than VAI and BMI.
Topics: Humans; Male; Female; Kidney Calculi; Middle Aged; Propensity Score; Adult; Nutrition Surveys; Body Mass Index; Waist Circumference; Risk Factors; Body Weight; Adiposity; Aged
PubMed: 38911038
DOI: 10.3389/fendo.2024.1266761