Modern Era Research Articles

Outcomes of pediatric liver retransplantation candidates in the modern era: Strategies are needed to avoid waitlist mortality in the United States.

Pediatric liver retransplantation (rLT) has historically shown poorer outcomes compared to primary liver transplantation (pLT). Comprehensive studies assessing outcomes for pediatric rLT candidates under the modern allocation policy are lacking. OPTN data from January 1, 2010, to December 31, 2022 were obtained; exclusion criteria included candidates ≥18years of age and those listed or transplanted for multiple organs. 7645 children met the inclusion criteria: 7162 pLT and 483 rLT candidates. The rLT candidates, despite a shorter median waitlist time to transplant (6.5d vs. 54d for pLT), had significantly higher waitlist dropout rates and worse post-transplant outcomes. Vascular complications were the most common reason for primary graft failure (PGR). The small size of the recipient was a significant risk factor. Among those retransplanted, the timing of relisting was significantly associated with outcomes, with those relisted within 30days from the pLT demonstrating considerably worse outcomes. Our findings emphasize the importance of a center's surgical expertise in performing transplants on small recipients to minimize post-operative complications leading to PGF. Once relisted, the timing of suitable organ availability was vital. The opportunity for technical variant grafts is crucial to capture every potential transplant opportunity could ultimately decide between life and death.

Religious Syncretism in Ossetian Festive Rituals

The article studies one of the aspects of Ossetian ethnic religion as an interesting ideological complex that was formed at the intersection of a number of diverse cultures of Antiquity, the Middle Ages and the modern era. Its relevance is due to the growing tendency to study the Ossetian ethnic religion as a unique “unmixed” object, and therefore the category of “syncretism”, when applied to it, often raises objections. This study, therefore, can be considered as the author’s interpretation, as an outside perspective of the cult, of which the author herself is not an adherent. The central focus of the study is the Ossetian holiday of the Yuletide cycle Bynaty-khitsau, associated in folk beliefs with demonic forces. Within the paper, the main elements of its ritual are identified and compared with similar elements in Christianity, Judaism and Zoroastrianism. This is the first time this problem is addressed in this manner. The methodological foundation of the study is the classification of historical types of religious syncretism, as proposed by E.V. Belyaeva. In addition, as the research is synchronic, it is carried out within the framework of the structuralism of C. Lévi-Strauss, which views all cultural systems (language, mythology, religion, art, customs, traditions) as sign systems.

The Church at the End of Russia: Historical and Ethnographic Context of Building

The article is devoted to the ethnographic aspects of building a modern Orthodox church, the deeds and personality of its investor and constructor. This is the first time an Orthodox church is considered as a social and cultural object from the perspective of historical and anthropological methods, and the actions of its creator — as a response to the social and cultural requirements and demands of the modern era. The author considers the significance of the Church of the Intercession of the Holy Virgin in Kondratyevo as a symbol of ethnic and cultural local identity. The construction of a votive Orthodox church is a unique phenomenon in modern construction. Narratives about the construction of the Church of the Intercession, including motifs about miracles, which formed among the village church parish, eventually become a cultural text for the entire pan-Russian tradition. The personality and religiosity of the investor and the creator of the Church of the Intercession are considered. His personality is studied within the problem of “personality and history”, “personality and individuality in culture”. The author compares the process of building the Church to the spiritual perfection of its creator; his moral growth — to the construction of the church, and its construction itself is described as a spiritual process. The Church of the Intercession — a church at the end of Russia nowadays fulfills protective and defensive functions as well as canonical ones due to its location at the state border. Its significance as a symbol of ethnic and cultural identity in the changing historical context is increasing.

Analisis Penggunaan Ragam Bahasa Generasi Z pada Film “Mencuri Raden Saleh”

Language growth goes hand in hand with technological advances. Generation Z, a generation born and living in the modern era, has a different communication style, such as the use of new terms, a relaxed language style, and the habit of combining Indonesian with English. This study aims to analyze how Generation Z's language variety describes their communication characteristics, and how this language can strengthen the relationship between each character in the film Mencuri Raden Saleh. In this study, the researcher used a descriptive qualitative research method approach and focused on the object of new vocabulary or slang terms, loanwords, and the typical communication style of Generation Z. This film contains many interesting things that can be studied, one of which lies in the language style used, which reflects the way young people communicate. Based on sociolinguistic theory, the social identity theory of Henri Tajfel and John Turner, and the Sapir-Whorf linguistic relativity theory, this study explains that Generation Z's language variety shows their social identity, reflects the culture of this generation, and influences the way they think, interact, and form lifestyles. In the context of Generation Z, the language style they use often shows their cultural identity and preferences, one of which is the use of slang or a relaxed way of communicating. This analysis shows that non-standard language not only functions as a means of communication, but also as a means of building character

Innovation of an Expert System for Diagnosing Allergic Diseases in Children using the Web-based Certainty Factor Method

In this modern era, the development of computer technology has increased so rapidly. Currently the computer is a tool in helping to overcome all the problems encountered by humans, including in the field of health. With the existence of technology, of course, it will greatly facilitate the community to get health services and consultations. One of the technological developments is an expert system. An expert system is a branch of artificial intelligence (Artificial Intelligence), which is an application designed to use a computer that tries to imitate the reasoning process of an expert or expert in solving specific problems and making decisions or conclusions because to solve a problem and save it. in the knowledge base for processing. This expert system was created to assist experts in deciding diseases based on existing symptoms. The Certainty Factor method is a theory that can be used to solve uncertainty problems. Certainty Factor (CF) is a value to measure expert confidence. Certainty Factor was introduced by Shortliffe Buchanan in making the MYCIN expert system to show the amount of trust. This method can work well when there are problems that start from gathering and then gathering information and then being able to find conclusions that can be drawn from that information. The Certainty Factor method will be applied to accurately determine allergic health in children. If this method is applied, it can minimize the presence of allergic diseases suffered by dangerous children. And when you have an allergy, it can be treated immediately.

Pendampingan Edukasi Pemasaran Komunitas Pengusaha Keripik Gadung Berbasis Digital Marketing dan E-Commerce Desa Begagan Limo Kecamatan Gondang Mojokerto

The educational support program for digital marketing and e-commerce for the community of gadung chips entrepreneurs in Bagagan Limo Village, Gondang District, Mojokerto aims to enhance their marketing capabilities to reach a broader and more efficient market. This program provides entrepreneurs with an understanding of basic digital marketing concepts, ranging from social media utilization to e-commerce platforms, to expand their market reach. The assistance is carried out through training and hands-on practice, allowing participants to implement the knowledge gained in marketing their products online. The education provided covers various aspects of digital marketing, such as social media content management, website optimization, and the use of e-commerce platforms for product sales. This is intended to help gadung chips entrepreneurs not only rely on the local market but also penetrate broader markets, including international markets, through digital platforms. Furthermore, the support program teaches effective and cost-efficient marketing techniques, considering the importance of leveraging digital media in the modern era. Through this program, it is expected that gadung chips entrepreneurs in Bagagan Limo Village can develop their businesses, increase their income, and create new business opportunities. The implementation of digital marketing and e-commerce is expected to have a positive impact on improving the competitiveness of gadung chips products, as well as introducing local products to the global market. The desired outcome is the creation of a more inclusive and sustainable business ecosystem in the village.

Penanaman Nilai-nilai Moderasi Beragama Siswa melalui Pembelajaran Aqidah Akhlaq di MA Bahauddin Ngelom Sidoarjo

The issue of religious moderation is important. School education plays a vital role in the process of instilling these values ​​of moderation. The urgency is reinforced by the influence of the modern era and the challenges of increasingly rampant urban society. In a case study, a phenomenon of educational institutions in urban areas was found that still maintain the content of ethical and moral education and insert moderation content. Of the many institutions that are competing to strengthen these values, MA Bahauddin Ngelom Sidoarjo is one of them. In addition to reasons from the urban space side that make it very possible for multicultural problems to occur, MA Bahauddin is also a private institution that is of interest to many applicants. The purpose of this study is to narrate how to instill the values ​​of religious tolerance through Aqidah Akhlak lessons at MA Bahauddin along with supporting and inhibiting factors. This study is a qualitative study and the data collection method is through interviews, personal documents, memos, and other official documents. This study has produced several conclusions, including; First, the instillation of religious tolerance values ​​in students' aqidah akhlaq learning at MA Bahauddin Ngelom Sidoarjo is going well and effectively, as evidenced by the systematic stages in learning aqidah akhlaq including the introduction of tolerance values, instillation through learning and experience, internalization of tolerance values, reinforcement and appreciation. Second, supporting factors in the process of instilling tolerance values ​​through learning Aqidah Akhlak at MA Bahauddin include the existence of government policies related to religious tolerance in educational institutions, the existence of adequate learning facilities and resources, support from the head of the madrasah and madrasah stakeholders, literature on aqidah akhlaq materials that emphasize the value of religious tolerance, inclusive madrasah management, and a tolerant surrounding community environment. While some inhibiting factors are the level of differences in students' abilities and emotional maturity, differences in the origins of previous schools, limited time in learning aqidah akhlak, some students pay less attention and are sleepy during learning.

Chimeric Antigen Receptor-T Cells in the Modern Era of Chronic Lymphocytic Leukemia Treatment

Pathway inhibitors targeting Bruton tyrosine kinase (BTK) and B-cell lymphoma-2 (BCL-2) have dramatically changed the treatment landscape for both treatment-naïve and relapsed/refractory chronic lymphocytic leukemia (CLL). However, with increased utilization, a growing number of patients will experience progressive disease on both agents. This subgroup of “double refractory” patients has limited treatment options and poor prognosis. Chimeric antigen receptor (CAR)-T cells have transformed the treatment of relapsed/refractory B-cell malignancies. Although the earliest success of CAR-T cell therapy was in CLL, the clinical application of this modality has lagged until the recent approval of the first CAR-T cell product for CLL. In this review, we describe the current treatment options for upfront and subsequent therapies and the unmet need for novel agents highlighted by the burgeoning role and challenges of CAR-T cell therapy.

Novel Approaches to Decomposing Hydrocarbon Pollutants from the Environment

In the modern era, petrochemical industries' production of hydrocarbon pollution is a significant environmental problem that causes biodiversity loss. Alkanes constitute a substantial proportion of crude oil, and refined fuels are found in small amounts in various uncontaminated environments. They are prevalent in underground fossil fuel reserves and shallow subsurface habitats polluted with hydrocarbons, such as aquifers. Using microorganisms to break down alkane hydrocarbon pollutants in environmental areas has great potential. Considerable advancements have been achieved in identifying microorganisms and metabolic processes responsible for the breakdown of alkanes in both oxygen-free and oxygen-rich conditions in the last two decades. A wide range of prokaryotic and eukaryotic organisms have been identified and observed to possess the ability to utilize various carbon and energy sources as substrates. Bioremediation is essential for environmental safety and management; various methods have been established for petroleum hydrocarbon bioremediation. Numerous microbial species have been employed to investigate the bioremediation of petroleum hydrocarbons, highlighting the crucial functions of varied microbial communities. Phytoremediation is an environmentally sustainable method that may effectively rehabilitate heavy metal- contaminated soil cost-efficiently. This manuscript provides an overview of prevalent alkane hydrocarbon pollutants, microorganisms capable of degrading hydrocarbons, key pathways and enzymes involved in hydrocarbon degradation, factors influencing hydrocarbon degradation, and various strategies employed to harness the degrading capabilities of microbes for remedial purposes.

Human Trafficking, Beautiful Women, the Land of the Cockaigne, and Burmese Bells: The Significance of the Sexual Reminiscences of the Florentine Merchant Francesco Carletti (1573–1636) in Ragionamenti del mio viaggio intorno al mondo [Chronicles of My Voyage Around the World

Abstract Ragionamenti del mio viaggio intorno al mondo [Chronicles of my voyage around the world] by Francesco Carletti (1573–1636), a Florentine slave merchant and the first private individual to circumnavigate the globe, is a rich source of information about human trafficking from Africa to Spanish America. Carletti writes in detail about his encounters beginning in 1594 in Africa, America, and Asia, including the Philippines, Japan, Macao, Malacca, and Goa, before returning to Europe via the Cape of Good Hope in 1602. But what makes Carletti's record extraordinary are his reports about the sexuality of the peoples he observes in these locations. Following the publications of earlier Italian travel writers Niccolò dei Conti (1395–1469) and Antonio Pigafetta (1491–1531) about the practice of Asian men purposely piercing their genitalia to insert studs and other objects to gratify their female sexual partners, Carletti investigates this phenomenon, concludes its verity, and attributes its existence to the dominance of women's agency in Asia. Carletti's recollections of his voyage are testimony to how exploration during the early modern era catalyzed a transformation in racial discourses and the appreciation of erotic desire in foreign cultures.

Lower Semen Quality Among Men in the Modern Era—Is There a Role for Diet and the Microbiome?

The prevalence of infertility is increasing worldwide; poor nutrition, increased sedentary lifestyles, obesity, stress, endocrine-disrupting chemicals, and advanced age of childbearing may contribute to the disruption of ovulation and influence oocyte and sperm quality and overall reproductive health. Historically, infertility has been primarily attributed to female factors, neglecting the importance of male fertility; this has resulted in an incomplete understanding of reproductive health. Male factors account for 40–50% of infertility cases. In half of these cases, the proximal cause for male infertility is unknown. Sperm contributes half of the nuclear DNA to the embryo, and its quality is known to impact fertilisation rates, embryo quality, pregnancy rates, risk of spontaneous miscarriage, de novo autosomal-dominant conditions, psychiatric and neurodevelopment conditions, and childhood diseases. Recent studies have suggested that both the microenvironment of the testes and diet quality may play an important role in fertility; however, there is limited research on the combination of these factors. This review summarises current known causes of male infertility and then focuses on the potential roles for diet and the seminal microbiome. Future research in this area will inform dietary interventions and health advice for men with poor semen quality, potentially alleviating the need for costly and invasive assisted reproduction treatments and allowing men to take an active role in the fertility conversation which has historically focussed on women individually.

Cervical dysplasia in women with HIV in the modern treat-all era: Elevated risk remains despite long-term ART and normal CD4 count.

To evaluate the impact of ART duration and CD4 count on risk for high grade cervical dysplasia in women with HIV (WWH) compared to women without HIV in the treat-all era with integrase strand inhibitors (INSTIs). Prospective longitudinal cohort study in Botswana. From February 2021 to August 2022, baseline HPV self-sampling was offered to women with and without HIV. Those HPV+ underwent biopsy for histopathological diagnosis. Using women without HIV as reference, risk ratios (RRs) were calculated for HPV, cervical intraepithelial neoplasia (CIN) 2 or worse (CIN2+), and CIN3+, stratified by ART duration and CD4 cell counts. Of 3000 women enrolled, 2953(98.4%) underwent HPV testing, which was positive in 823(55.7%) WWH and in 654(44.3%) women without HIV. Histopathology was available for analysis in 1291(87.4%) women (709 WWH, 582 women without HIV). Over 99% of WWH had detectable HIV viral load and 94.4% were on a dolutegravir-based ART regimen. WWH had a higher risk of HPV (RR1.27,95%CI:1.18,1.37), CIN2+ (RR1.52,95%CI:1.16,1.98) and CIN3+ (RR1.75,95%CI:1.25,2.45) compared to women without HIV. There was attenuation of risk for CIN2+ with higher recent CD4 cell count, and those with higher nadir CD4 count had similar risk to those without HIV (nadir CD4≥500 CIN2+ RR1.15[95%CI:0.56,2.37], CIN3+ RR1.81[95% CI:0.86,3.79]; nadir CD4 350-499 CIN2+ RR1.23[95% CI:0.71,2.12], CIN3+ RR1.34[95%CI:0.68,2.64]). Although some attenuation of risk for CIN2+ was observed with higher recent and nadir CD4 cell counts, WWH continue to have a higher risk of CIN2+/CIN3+ compared to women without HIV. These findings support tailored cervical screening algorithms for WWH.

Transformasi Digital dan Pertumbuhan E-Commerce: Dampak, Peluang, dan Tantangan di Era Modern

Digital transformation has brought changes in the business world, especially in the e-commerce sector which is experiencing rapid growth. The existence of e-commerce supports operational efficiency, accelerates transactions, and expands market access. By 2022, this sector will contribute 64.5% to Indonesia's total digital economy. However, digital transformation also poses challenges. This study aims to explore the impact, opportunities and challenges commonly faced by businesses in facing this modern era of digitalization. This research uses a qualitative approach, secondary data obtained from various sources such as scientific journals, industry reports, and publications and then analyzed inductively with content analysis techniques. The results show that digitalization provides great opportunities for businesses to reach a wider market, optimize operational efficiency, and increase customer engagement. However, there are also challenges such as data security issues, intensified competition, and the need for large technology investments. This research is expected to provide insights for businesses and relevant stakeholders in adopting the right strategies to maximize digital opportunities while overcoming various challenges.

Clarity unveiled: A journey through time in cataract surgery.

This historical research article offers a comprehensive examination of the evolution of cataract surgery from ancient practices to modern innovations. The historical trajectory of cataract treatment will be explored, beginning with ancient techniques such as couching in ancient civilisations and progressing through critical milestones in surgical advancement. The research delves into the challenges faced by early practitioners, the emergence of novel techniques and the pivotal contributions of pioneering surgeons throughout history. From the rudimentary procedures of antiquity to the sophisticated technologies of the present day, the journey through time reveals medical professionals' remarkable ingenuity and perseverance in their quest to restore vision and improve the quality of life for patients afflicted by cataracts. Drawing upon historical sources, medical texts and scholarly research, this article provides insights into the social, cultural and technological factors that shaped the development of cataract surgery over millennia. It also examines the impact of crucial innovations such as extracapsular and intracapsular extraction, the advent of intraocular lens implants and the introduction of minimally invasive surgical techniques. Moreover, this research highlights the transformative effect of cataract surgery on individuals and societies from the ancient to the modern era. Hopefully, this research offers a compelling narrative of human ingenuity, scientific progress and the quest for clarity in treating cataracts.

ANALYSIS OF DIGITAL TECHNOLOGY ON DA'WAH COMMUNICATION STRATEGIES IN THE MODERN ERA

The use of social media and digital platforms is increasing in da'wah activities, there are still many studies that have not explored how this technology can be used optimally by da'wah practitioners to reach a wider and more diverse audience, and face digital challenges such as disinformation, the digital divide, and the technical skills needed in content creation. This study explores the influence of digital technology on da'wah communication strategies in the modern era. Using a qualitative approach and case study method. Data collection through in-depth interviews, participant observation, and documentation analysis from various digital platforms. The research findings show that social media, video platforms, and podcasts have changed the way da'wah preachers preach, allowing da'wah to reach a wider and more diverse audience with more interesting and interactive content. This study shows that the use of analytical tools to understand audience demographics is essential in increasing the effectiveness of message delivery. However, challenges such as the digital divide and the need for technical skills in content creation are also identified. The results of this study emphasize the need for digital skills training for da'wah so that messages can be delivered professionally and attractively. In addition, this study provides practical recommendations to optimize the use of technology in da'wah activities, including content creation strategies and how to deal with challenges such as misinformation. Thus, this study contributes to a better understanding of da'wah strategies in the digital era and the challenges faced in their implementation

A CLINICAL STUDY ON THE EFFICACY OF VARISARA DHAUTI (SHANKHA PRAKSHALANA) IN IMPROVING THE QUALITY OF LIFE AMONG APPARENT-LY HEALTHY INDIVIDUALS

Relevance: In this modern era, faulty dietary habits such as increased intake of processed food, low-fibre diet, and sedentary lifestyle, along with increasing stress and anxiety, can lead to a harmful impact on quality of life. Thus, Varisara Dhauti (Shankha Prakshalana) may be helpful because it helps in the natural cleansing of the gastrointestinal tract. Also, it is a costless procedure because only warm saline water is required. Aim: To study the efficacy of Varisara Dhauti or Shankhaprakshalana in improving the quality of life of apparently healthy in-dividuals. Materials and Methods: The WHOQOL-BREF questionnaire was adopted to evaluate the effective-ness of Varisara Dhauti (Shankha Prakshalana) in improving the Quality of life among 100 healthy individuals. One hundred healthy individuals were equally divided into two groups, 50 in each. In Group I, Varisara Dhauti (Shankha Prakshalana) was performed, and the procedure was repeated every 4 weeks for 8 weeks. In Group II, study subjects were observed for general health profiles. Results: In Group I, improvement in Domain 1(Physical Health) and Domain 2 (Psychological) was highly significant (p<0.001), improvement in Domain 3 (Social relationships) was moderately significant (p=0.001), and the quality of life of all the three domains im-proved from moderate to good. Improvement in Domain 4 (Environment) was insignificant (p=0.080), and there was no change in quality of life. Discussion: It was found that after the procedure, an excellent response was found in Domain 2 (Psychological).

Exploring the Potential of Arabic Keyboard for Learning Arabic Writing / Maharah Kitabah with Mnemonic Approach at UII Darullughah Wadda’wah.

In the modern era, the term "illiteracy" does not refer to the inability to read and write; instead, it now refers to those who are unable to operate a computer, particularly the basic skill of typing. However, many students still experience difficulties when typing using the Arabic keyboard. This study aims to explore the effectiveness of using the Arabic Keyboard with a mnemonic approach to enhance Arabic writing skills at UII Darullughah Wadda’wah. Based on years of experience in using and teaching the Arabic Keyboard, this research shows that students can master basic typing skills in one to three days with three sessions while typing fluency can be achieved within a week or more. This research is expected to produce proficient writers in using the Arabic Keyboard, thereby increasing efficiency in the writing process. The results of this study are also supported by interviews with students and their typing practice outcomes.

COMPARATIVE CLINICAL EVALUATION OF VAMANA KARMA ALONE AND ALONG WITH PANCHAKOLA PHANTA IN HYPOTHYROIDISM (AGNIMAN-DYA)

Background: The sedentary lifestyle and stress-filled modern era have led to alterations in the activities of the neuro-endocrine system, causing newer health challenges like thyroid disorder. Hypothyroidism is one of the lifestyle and endocrinal disorders. There is no direct reference to the thyroid in Ayurveda classics, but all the metabolic processes of the body are under the control of Agni. Vamana Karma, followed by Panchakola Phanta, can treat Agnimandya. Aim: To compare the efficacy of Vamana Karma alone and along with Panchakola Phanta in Hypothyroidism (Agnimandya). Materials and Methods: A total of 40 patients of Hypothyroidism in the age group of 20 to 60 years fulfilling the inclusion criteria were selected for trial & randomly distributed in Group A and Group B. Results: Statistically, Group B was found more effective than Group A in the management of symptoms of Hypothyroidism (Agnimandya). Discussion: Panchakola having Ushna, Tikshna, Laghu, Ruksha Guna, Katu Rasa, Katu Vipaka and Ushna Virya. It has Kaphavata Shamaka, Deepana, Pachana, Rochana, Lekhana, Sroto-Vishodhana and Shothahara properties. Panchakola is regarded as one of the most effective medications for treating Mandagni. In Agnimandya, Panchakola Phanta is useful for Amapachana and to increase the Agni.

Landscape of Cyclic Vomiting Syndrome: From Bedside to Bench, Past to Present.

Investigations into mechanisms of cyclic(al) vomiting syndrome (CVS) began at the bedside more than a century ago. The modern era started with the formation of the Cyclic Vomiting Syndrome Association in 1993 that helped initiate robust efforts in education, advocacy, family physician conferences, scientific symposia, dedicated clinical programs, therapeutic guidelines, and research. Even today, bedside clues continue to emerge with the recent description of cannabinoid hyperemesis syndrome (CHS) and subsequent evidence of a perturbed endocannabinoid system. The clinical picture of CVS has evolved from that of a straightforward emetic disorder related to migraine requiring short-term antiemetics or prophylactic anti-migraine therapy, to a complicated, heterogenous one with multiple comorbid associations (anxiety, dysautonomia) and endophenotypes (migraine, Sato, CHS). This expanded view has important therapeutic implications which necessitate managing the comorbidities which can in turn impact the disease itself and proffered promising evidence that behavioral management (meditation) and vagal neuromodulation appear efficacious with few untoward effects, perhaps by reestablishing autonomic (parasympathetic) balance. The pathophysiologic picture now appears to be inscribed on an autonomic polyvagal design but multiple additional pathways interact, some confirmed (NK1, CB1, HPA axis, PPM1D gene, biological calendar, estrogen), and others, possible (TRPV-1, CGRP, GDF-15, mitochondrial dysfunction, impaired cation transport). CVS and its cousin CHS continue to challenge clinicians and perplex investigators and in the current era require not only a critical mass of specific pathway expertise but also syncretic biopsychosocial thinking to integrate these disparate threads. We may have reached such a tipping point at this Symposium.

The impact of neoadjuvant therapy on the prognostic value of preoperative neutrophil-to-lymphocyte ratio for colorectal liver metastases: a multi-center cohort study

BackgroundNeutrophil-to-lymphocyte ratio (NLR) is a promising prognostic marker for patients undergoing hepatectomy for colorectal liver metastases (CRLM). However, its prognostic value in patients receiving neoadjuvant therapy (NAT) has not been sufficiently addressed.MethodsFrom 2013 to 2023, a cohort of 692 patients with CRLM receiving hepatectomy were enrolled in five centers. Clinicopathological characteristics were obtained from a prospectively maintained multi-center database. The effect of NLR (> 2 versus ≤ 2) on overall survival (OS) and recurrence-free survival was estimated by Kaplan–Meier analysis. Univariable and multivariable Cox regression analysis was applied to investigate the influence of individual clinicopathological parameters on OS.ResultsIn the entire cohort, the median NLR level was 2.11 (0.30–16.33). There were 307 (44.4%) patients receiving NAT followed by hepatectomy, while 385 (55.6%) patients undergoing upfront surgery. Notably, patients in the NAT group showed significantly lower NLR level than those in the upfront surgery group (1.83 versus 2.32, P < 0.001). In the upfront surgery group, high NLR was significantly associated with worse OS, independent of other factors (HR = 1.49, 95% CI 1.08–2.05, P = 0.02). In the NAT group, there was no significant difference in OS between the high NLR and low NLR group.ConclusionThe prognostic value of NLR in surgically resected CRLM is potentially influenced by NAT in the modern era.