Final Quantitative Analysis Research Articles

Safety of metabolic and bariatric surgery in obese patients with liver cirrhosis: a systematic review and meta-analysis.

With the pandemic of obesity and the growing experience in metabolic and bariatric surgery (MBS), the number of patients with obesity and liver cirrhosis undergoing MBS is increasing. To analyze the morbidity and mortality following MBS in patients with obesity and liver cirrhosis. Systematic review and meta-analysis. The published literature was systematically reviewed, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, for studies reporting outcomes of MBS among patients with liver cirrhosis. The predetermined endpoints were the overall complication after MBS, intraoperative complications, liver-related complications after MBS, all-cause 90-day mortality after MBS, and liver-related mortality post-MBS. The pooled weighted proportions for each of the endpoints was calculated using random effect meta-analysis. A total of 18 studies, including 471 patients with obesity and liver cirrhosis undergoing MBS, qualified for the final quantitative analysis. The mean age and mean body mass index (BMI) of the pooled patient cohort were 50.2 years and 47.2 kg/m2. The pooled weighted proportions of the overall post-MBS complications, intraoperative complications, liver-related complications, overall 90-day mortality, and liver failure related mortality post MBS were 22.14% (CI95%: 15.43%-29.55%), .08% (CI95%: 0%-1.02%), 4.62% (CI95%: 1.27%-9.30%), 0% (CI95%: 0%-.44%), .08% (CI95%: 0%-1.03%), respectively. Significantly lower postoperative complications were noted with sleeve gastrectomy (10.08% [95%CI: 5.14%-16%]) compared with Roux-en-Y gastric bypass (31.53% [95%CI: 18.62%-45.68%]; (P = .02). We found an overall low postoperative surgical and liver-related mortality post MBS among patients with obesity and liver cirrhosis. The overall postoperative complications and liver-related complications were higher among patients with liver cirrhosis than in noncirrhotic patients. Sleeve gastrectomy showed lower postoperative complications compared with Roux-en-Y gastric bypass.

Complications of Neck Drains in Thyroidectomies: A Systematic Review and Meta‐Analysis

Intraoperative placement of neck drains in thyroidectomy patients remains a widespread practice, despite prevailing evidence discouraging this practice. This systematic review and meta-analysis was conducted to update the currently available evidence base. Two independent investigators performed a comprehensive literature search to identify randomized control trials that evaluated postoperative complications associated with neck drains. This was conducted using four databases: Medline, Web of Science, EMBASE, and Cochrane. Identified articles were then screened using a strict eligibility criterion. Sixteen studies were included in the final quantitative analysis and assessed for risk of bias. All methods were in accordance with recommendations from the Cochrane Review Group, U.K. National Health Service Centre for Reviews and Dissemination, and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Our initial search yielded 743 articles. Of those, 16 were included for final quantitative synthesis. The overall analysis demonstrated that postoperative hematomas [pooled odds ratio (OR) = 2.09 (1.04, 4.21); P = .04] and surgical site infections [pooled OR = 3.85 (2.04, 7.28); P < .01] were significantly more likely in the drained group. Furthermore, hospital stays were longer in the drained group [pooled mean difference = 0.88 days (0.56, 1.20); P < .01]. There were no significant differences in fluid volumes within the thyroid bed between study groups [pooled mean difference = -2.30 mL (-4.82, 0.21); P = .07]. The drained patient group had overall higher odds of hematomas, surgical site infections, and longer hospital stays. Therefore, we recommend against this practice of neck drain insertions in patients who have undergone thyroidectomies. Laryngoscope, 131:690-700, 2021.

Comparison of the Antimicrobial Efficiency of Neem Leaf Extract and 17% Edta with 3% Sodium Hypochlorite against E. faecalis, C. albicans – An in vitro Study

Introduction: Candida albicans and Enterococcus faecalis are the most predominant microorganisms found in the canals of failed root canal treated teeth. Thorough debridement of an infected root canal and complete elimination of microorganisms are objectives of effective endodontic therapy. For thousands of years, humans have used herbs as the primary means to sort out health issues and illnesses. Not all herbs have shown to provide scientific evidence as medicine to illness. Neem is a Botanical herb that is truly remarkable with its scientific value, a tropical evergreen native to India. Although different agents have been suggested as root canal irrigants, sodium hypochlorite and EDTA are the most popularly used.&#x0D; Aim: To compare the antimicrobial efficacy of commercially available irrigants, 17% EDTA and a herbal product, neem leaf extract compared with 3% sodium hypochlorite as a control against Enterococcus faecalis and Candida albicans.&#x0D; Materials and Methods: The antimicrobial activity was determined using the agar well diffusion method. Freshly prepared neem leaf extracts, 17% EDTA, 3% Sodium hypochloriteStandard strain of E. Faecalis and C. Albicans were used in this study. These isolates were subcultured on to Brain heart infusion agar (BHI agar) and HI-chrome candidal differential media respectively. The agar well diffusion test was performed in brain heart infusion media and broth. The plates were incubated at 37°C for 24 hours and the zone of inhibition was recorded and analyzed statistically.&#x0D; Results: Zones of inhibition were present with Neem leaf extract suggestive of antimicrobial properties. Zones of inhibition were greater with Neem extract than 17% EDTA. Hence, further research should be directed towards the use of this herbal extract as an irrigant clinically with endodontic therapy.&#x0D; Conclusion: Within the limitation of this study, it was found that neem leaf extract had a significant antimicrobial effect against E. Faecalis and C. Albicans compared to EDTA and Sodium Hypochlorite. Since the study is a qualitative analysis, further testing needs to be done to final quantitative analysis of the antimicrobial activity of neem leaf extract.

Effectiveness of niacin supplementation for patients with type 2 diabetes: A meta-analysis of randomized controlled trials.

Lipid profiles and glycemic control play a critical role in subsequent atherosclerotic cardiovascular disease for patients with type 2 diabetes mellitus (T2DM). This study aimed to evaluate the effectiveness of niacin supplementation on lipid profiles and glycemic control for patients with T2DM. The PubMed, Embase, and the Cochrane Library databases were searched to identify randomized controlled trials (RCTs) that investigated the effects of niacin supplementation for patients with T2DM throughout December 2019. The weighted mean differences (WMDs) with 95% confidence intervals (CIs) were applied to calculate the pooled effect estimates using a random-effects model. Eight RCTs comprised a total of 2110 patients with T2DM who were selected for final quantitative analysis. The patients' niacin supplementation was associated with lower levels of total cholesterol (WMD, -0.28; 95% CI, -0.44 to -0.12; P = .001), triglyceride (WMD, -0.37; 95% CI, -0.52 to -0.21; P < .001), and low-density lipoprotein (WMD, -0.42; 95% CI, -0.50 to -0.34; P < .001). Moreover, the level of high-density lipoprotein was significantly increased when niacin supplementation (WMD, 0.33; 95% CI, 0.21 to 0.44; P < .001) was provided. However, niacin supplementation produced no significant effects on plasma glucose (WMD, 0.18; 95% CI, -0.14 to 0.50; P = .275) and hemoglobin A1c (HbA1c) levels (WMD, 0.39; 95% CI, -0.15 to 0.94; P = .158). This study found that niacin supplementation could improve lipid profiles without affecting the glycemic levels for patients with T2DM. Additional large-scale RCTs should be conducted to evaluate the long-term effectiveness of niacin supplementation.

Comparison of endoscopic third ventriculostomy with or without choroid plexus cauterization in pediatric hydrocephalus: a systematic review and meta-analysis.

Pediatric hydrocephalus is a significant contributor to infant morbidity and mortality, particularly in developing countries. The mainstay of treatment has long been shunt placement for CSF diversion, but recent years have seen the rise of alternative procedures such as endoscopic third ventriculostomy (ETV), which provides similar efficacy in selected patients. The addition of choroid plexus cauterization (CPC) to ETV has been proposed to increase efficacy, but the evidence of its utility is limited. This systematic review and meta-analysis aimed to determine the efficacy and safety of ETV+CPC in comparison to ETV alone for the treatment of pediatric all-cause hydrocephalus. MEDLINE, Embase, Cochrane CENTRAL, ClinicalTrials.gov, and ICRCTN databases were searched from conception through to October 2018 for comparative studies including both ETV+CPC and ETV in a pediatric population. The primary outcome was success rate, defined as no secondary procedure required for CSF diversion; secondary outcomes included time to failure, mortality, and complications. Data were pooled using random-effects models of meta-analysis, and relative risk (RR) was calculated. Five studies were included for final qualitative and quantitative analysis, including 2 prospective and 3 retrospective studies representing a total of 963 patients. Overall, there was no significant difference in success rates between ETV and ETV+CPC (RR 1.24, 95% CI 0.88-1.75, p = 0.21). However, a subgroup analysis including the 4 studies focusing on African cohorts demonstrated a significant benefit of ETV+CPC (RR 1.38, 95% CI 1.08-1.78, p = 0.01). There were no notable differences in complication rates among studies. This systematic review and meta-analysis failed to find an overall benefit to the addition of CPC to ETV; however, a subgroup analysis showed efficacy in sub-Saharan African populations. This points to the need for future randomized clinical trials investigating the efficacy of ETV+CPC versus ETV in varied patient populations and geographic locales.

The clinical effects of antibiotic prophylaxis for hysteroscopic procedures: A meta-analysis.

Background:Hysteroscopic procedures were widely applied but the clinical effects of antibiotic prophylaxis for these operations were not specifically addressed. In current study, we aimed to investigate the role of prophylactic antibiotics in hysteroscopic procedures by meta-analysis.Methods:We conducted literature retrieval in electronic databases, including MEDLINE, EMBASE, and Cochrane Central, to identify relevant randomized controlled trials (RCTs) investigating the clinical effects of antibiotic prophylaxis for hysteroscopic procedures. The postoperative infection rate was selected for pooled estimation. The I2 index statistic was used to assess heterogeneity. Publication bias was evaluated using funnel plots and Egger test. Sensitivity analysis based on different subcategories was conducted to examine the stability of the main results.Results:Four RCTs including 2221 patients were identified for the final quantitative analysis. Pooled estimation indicated no significant difference in infection rate between the antibiotic prophylaxis group and control group (test for OR: Z = 0.50, P = .616; 95% CI: 0.987–1.008). Sensitivity analysis based on surgical procedure, antibiotic application, follow-up time and administration time revealed similar results.Conclusion:Based on current objective evidence, we conclude that antibiotic prophylaxis exhibits no clinical benefit for hysteroscopic procedures. Therefore, it is not recommended. Meanwhile, more high-quality RCTs are needed to support our conclusion.

“Differential Visual Proteomics”: Enabling the Proteome-Wide Comparison of Protein Structures of Single-Cells

Proteins are involved in all tasks of life, and their characterization is essential to understand the underlying mechanisms of biological processes. We present a method called "differential visual proteomics" geared to study proteome-wide structural changes of proteins and protein-complexes between a disturbed and an undisturbed cell or between two cell populations. To implement this method, the cells are lysed and the lysate is prepared in a lossless manner for single-particle electron microscopy (EM). The samples are subsequently imaged in the EM. Individual particles are computationally extracted from the images and pooled together, while keeping track of which particle originated from which specimen. The extracted particles are then aligned and classified. A final quantitative analysis of the particle classes found identifies the particle structures that differ between positive and negative control samples. The algorithm and a graphical user interface developed to perform the analysis and to visualize the results were tested with simulated and experimental data. The results are presented, and the potential and limitations of the current implementation are discussed. We envisage the method as a tool for the untargeted profiling of the structural changes in the proteome of single-cells as a response to a disturbing force.

Comparison of Selected Shading Correction Methods

Abstract Shade effect is a defect of the images very often invisible for human vision perception but may cause difficulties in proper image processing and object detection especially if the aim of the task is to proceed detection and quantitative analysis of the objects. There are several methods in image processing systems or presented in the literature, however some of them introduce unexpected changes in the images, what may interfere the final quantitative analysis. In order to solve this problem, authors proposed a new method for shade correction, which is based on simulation of the image background based on analytical methods which return pixel values representing smooth grey level changes. Comparison of the effects of correction by applying standard methods and the method proposed are presented.

Is bromelain effective in controlling the inflammatory parameters of pain, edema, and trismus after lower third molar surgery? A systematic review and meta-analysis.

The aim of this systematic review was to evaluate the clinical evidences of the bromelain in minimizing inflammatory parameters such as pain, edema, and trismus after lower third molar surgeries. An electronic search was conducted in six databases through November 2017. The eligibility criteria included randomized and non-randomized clinical trials and/or comparative studies that used bromelain after lower third molar surgeries. The search strategy resulted in 117 articles. Following the selection process, seven studies were included in the systematic review and four in the meta-analysis. In terms of the risk of bias analysis, all the evaluated studies were classified as low or unclear risk of bias in the following criteria: selection bias, detection bias, and reporting bias. The final quantitative analysis of the variables showed that the use of bromelain resulted in greater reduction of pain levels (mean difference [MD]: -0.38; 95% confidence interval [CI; -0.66 to -0.09]), edema (MD: -0.34; 95% CI [ -0.68 to -0.01]), and trismus (MD: -2.01; 95% CI [ -3.99 to -0.02]) among the analyzed groups. The results suggest that the bromelain appears to be effective in the control of pain, edema, and trismus after lower third molar surgeries; however, further high-quality studies are needed to confirm this finding.

Long-Term Outcomes of Drug-Eluting Stents Versus Bare-Metal Stents in End-Stage Renal Disease Patients on Dialysis: A Systematic Review and Meta-Analysis.

There are no dedicated data to guide drug-eluting stent (DES) versus bare-metal stent (BMS) selection in patients with end-stage renal disease undergoing dialysis (ESRD-D). It is unclear whether long-term benefits of a specific stent type outweigh risks in this population at high risk for both bleeding and ischemic events. We performed a meta-analysis of nonrandomized studies extracted from PubMed, Scopus, and EMBASE, assessing the safety and effectiveness of DES versus BMS in ESRD-D patients. Odds ratios (OR) and 95% confidence intervals (CI) were computed with the Mantel-Haenszel method. Random-effects model was used for all analyses. A total of 17 nonrandomized studies (N = 63,157; 41,621 DES and 21,536 BMS) met the inclusion criteria and were included for the final quantitative analysis: median follow-up of 1 year (range: 9 months to 6 years). The use of DES in ESRD-D patients was associated with lower all-cause mortality (OR 0.75, 95% CI 0.64-0.89, P < 0.001) compared with BMS. The use of DES was also associated with lower rates of cardiovascular mortality (OR 0.75, 95% CI 0.60-0.99, P = 0.047) and target lesion/vessel revascularization (OR 0.78, 95% CI 0.64-0.94, P = 0.01). However, there were no differences in noncardiovascular mortality, myocardial infarction, stent thrombosis, stroke, or major bleeding in DES versus BMS. In this largest meta-analysis of long-term outcomes after percutaneous coronary intervention in ESRD-D patients, DES was associated with lower rates of all-cause mortality, target lesion/vessel revascularization, and cardiovascular death.

Impact of single nucleotide polymorphisms on P450 oxidoreductase and peroxisome proliferator-activated receptor alpha on tacrolimus pharmacokinetics in renal transplant recipients.

The P450 oxidoreductase (POR) and peroxisome proliferator-activated receptor alpha (PPARA) genes are associated with the activity of cytochrome P450 enzymes in vivo. We aimed to investigate the impact of single nucleotide polymorphisms (SNPs) in the POR and PPARA genes on the pharmacokinetics of tacrolimus (TAC) in renal transplant recipients. A total of 220 recipients were assessed and 105 recipients were included for final quantitative analysis. Blood samples were collected and DNA was extracted. Targeting sequencing based on next-generation sequencing was applied to detect the SNPs in the POR and PPARA genes. In addition, a systematic review and meta-analysis was performed to comprehensively evaluate the influence of POR and PPARA mutations on the TAC concentrations. A total of 81 SNPs were obtained. Three SNPs (POR*28, Chr7:75619677 and Chr7:75614288) were found to be significantly associated with the TAC pharmacokinetics at 3 months, 6 months, and more than 12 months. No significant association was observed in the combined effect analysis of CYP3A4*1G and CYP3A5*3 with three significant SNPs in the POR gene. Age, post-transplant duration, and the use of sirolimus were identified as the most important factors that influenced the TAC concentrations. A meta-analysis of four studies results and our cohort indicated that compared with recipients carrying the CT or TT genotypes, recipients carrying the CC genotypes of POR*28 showed significantly higher TAC concentrations. Our study suggested the positive influence of mutations in the POR gene on TAC exposure at 3 months after kidney transplantation.

Gemcitabine and cisplatin regimen facilitates prognosis of advanced nasopharyngeal carcinoma.

This study was conducted to assess the efficacy and adverse effects of GP (gemcitabine + cisplatin) regimen and FP (fluouracil + cisplatin) regimen in treatment of advanced nasopharyngeal carcinoma. Systematic online searches were performed in PubMed, Web of Sciences, China Knowledge Infrastructure and Weipu from the inception to November 15, 2017. Potential studies were assessed using the Cochrane risk of bias scale. Statistical analyses were performed on Stata 14.0 and RevMan 5.3. Finally, twelve studies entered final qualitative synthesis and quantitative analysis. The GP regimen compared with the FP regimen had significantly higher 1‐year survival rate (relative risk (RR) = 1.07, 95% confidence interval (CI): 1.01‐1.13), significantly better performance in the fixed‐effect model (RR = 1.16, 95%CI: 1.04‐1.30) and significantly higher remission rate (RR = 1.17, 95%CI: 1.05‐1.29). Significant differences between regimens were found in gastrointestinal effects (RR = 0.58, 95%CI: 0.45‐0.74). No significant differences between regimens were found in reduced hemoglobin rate (RR = 0.55, 95%CI: 0.36‐1.21), neutropenia (RR = 1.84, 95%CI: 0.93‐5.02), or reduced platelet (RR = 1.25, 95%CI: 0.85‐1.75) and mucosal inflammation (RR = 0.81, 95%CI: 0.57‐1.16). Sensitivity analysis indicated the results remained stable. The funnel plot indicated some publication bias. In conclusion, the GP regimen outperforms the FP regimen in treatment of advanced nasopharyngeal carcinoma with no difference in adverse effects. We may consider the GP regimen a better choice, but this conclusion should be confirmed by high‐quality trials.

47 Systematic review and meta-analysis of analgesic efficacy and safety profile of single injection fascia iliaca compartment blocks in the acute pre-operative pain management of hip fractures

BackgroundIt is hypothesised that a single injection fascia iliaca compartment block (FICB) administered in the pre-operative setting provides better analgesic control for traumatic hip fractures and is not associated with...

QuantGenius: implementation of a decision support system for qPCR-based gene quantification

BackgroundQuantitative molecular biology remains a challenge for researchers due to inconsistent approaches for control of errors in the final results. Due to several factors that can influence the final result, quantitative analysis and interpretation of qPCR data are still not trivial. Together with the development of high-throughput qPCR platforms, there is a need for a tool allowing for robust, reliable and fast nucleic acid quantification.ResultsWe have developed “quantGenius” (http://quantgenius.nib.si), an open-access web application for a reliable qPCR-based quantification of nucleic acids. The quantGenius workflow interactively guides the user through data import, quality control (QC) and calculation steps. The input is machine- and chemistry–independent. Quantification is performed using the standard curve approach, with normalization to one or several reference genes. The special feature of the application is the implementation of user-guided QC-based decision support system, based on qPCR standards, that takes into account pipetting errors, assay amplification efficiencies, limits of detection and quantification of the assays as well as the control of PCR inhibition in individual samples. The intermediate calculations and final results are exportable in a data matrix suitable for further statistical analysis or visualization. We additionally compare the most important features of quantGenius with similar advanced software tools and illustrate the importance of proper QC system in the analysis of qPCR data in two use cases.ConclusionsTo our knowledge, quantGenius is the only qPCR data analysis tool that integrates QC-based decision support and will help scientists to obtain reliable results which are the basis for biologically meaningful data interpretation.

Combined Chemohormonal Strategy in Hormone-Sensitive Prostate Cancer: A Pooled Analysis of Randomized Studies

BackgroundA meta-analysis of the efficacy of chemohormonal regimens versus standard therapy in the management of advanced hormone-sensitive prostate cancer was conducted. Materials and MethodsThe eligible studies included randomized studies evaluating chemohormonal regimens in the setting of high-risk localized or metastatic hormone-sensitive prostate cancer. ResultsThe search strategy yielded 900 potentially relevant citations from the searched databases. After exclusion of the ineligible studies, 10 studies were included in the qualitative analysis, among which 5 studies that had evaluated a docetaxel-hormonal therapy combination were included in the final quantitative analysis. For metastatic hormone-sensitive disease, the pooled hazard ratio (HR) for progression-free survival (PFS) was 0.63 (95% confidence interval [CI], 0.57-0.70; P < .00001), and the pooled HR for overall survival (OS) was 0.75 (95% CI, 0.65-0.86; P = .0001). For high-risk localized disease, the pooled HR for PFS was 0.68 (95% CI, 0.58-0.80; P < .00001), and the pooled HR for OS was 0.83 (95% CI, 0.61-1.13; P = .23). ConclusionThe results of the present meta-analysis have demonstrated that docetaxel-hormonal regimens are associated with superior OS and PFS in patients with metastatic disease and superior PFS but not OS in patients with high-risk localized disease. This option should be considered strongly in fit patients with adequate performance status.

Malocclusion Characteristics as Risk Factors for Temporomandibular Disorders: Lessons Learned from a Meta-Analysis

The objective of this meta-analysis was to evaluate the association of various malocclusion characteristics with temporomandibular disorders (TMDs). Two reviewers identified articles through database searches of MEDLINE (Ovid) and LILACS and hand searches of major orthodontic journals and selected references. Random-effects models were used to calculate weighted pooled odds ratio (OR) estimates of malocclusion exposures. Six articles qualified for inclusion in the final quantitative analysis. Our study found that static occlusal factors had no significant association with TMD. Of the dynamic occlusal factors assessed, only the absence of canine guidance, laterotrusive interferences, and retruded contact position to maximal intercuspation slide length ≥2 mm demonstrated significant ORs. These results should be viewed with caution, as reporting biases were difficult to assess, and heterogeneity estimates may have been underestimated due to the limited number of studies within each comparison. TMD is a term that encompasses a broad group of dysfunctions, and meta-analyses should only synthesize studies with similar diagnostic criteria. At the present, there is a paucity of studies available that could be properly synthesized to answer the research question posed. Individual studies have too much variability among their methods, and researchers need to clearly define and state their TMD factor definition.

Enablers for Competitiveness of Indian Manufacturing Sector: An ISM-Fuzzy MICMAC Analysis

Now a days global competitive scenario plays a critical role in success of Indian manufacturing sector. The present study argues that innovation can play a very important role in providing this competitiveness of Indian manufacturing sector. The study identifies 11 enablers for promotion of innovation in the Indian manufacturing sector. Based on the rigorous literature review 11 major innovation enablers (IEs) are obtained. The Delphi technique is applied as a potentially valuable tool for the grouping these enablers. The study, analyse the impact of innovation enablers (IEs) to enhance the manufacturing competitiveness and categories into three phases firstly, identification of innovation enablers, secondly, qualitative analysis of enablers and final quantitative analysis of the innovation enablers. The research theme has been categories into three segments, i.e. identifying the enablers from the literature, conduct interviews with directors of different departments and analysis of the manufacturing industries. The study involves 100 manufacturing companies across India and the data is gathered using a 5-point Likert scale. Interpretive Structural Modeling (ISM) has been used to analyse the relationships among these enablers as well as fuzzy MICMAC (Matriced’ Impacts Croise's Multiplication Appliquée a UN Classement) analysis used to find out driving and the dependence power of enablers. To identify the driving and the dependence power of various IEs the final outcomes of ISM are used as input to the fuzzy MICMAC analysis. This analysis serves to identify which (IEs) is performing as the most leading one to raise the competitiveness of manufacturing industries. This study plays a vital role to enhance the competitiveness of manufacturing industries in India.

Advanced analytical method of nereistoxin using mixed-mode cationic exchange solid-phase extraction and GC/MS

Nereistoxin(NTX) was originated from a marine annelid worm Lumbriconereis heteropoda and its analogue pesticides including cartap, bensultap, thiocyclam and thiobensultap have been commonly used in agriculture, because of their low toxicity and high insecticidal activity. However, NTX has been reported about its inhibitory neuro toxicity in human and animal body, by blocking nicotinic acetylcholine receptor and it cause significant neuromuscular toxicity, resulting in respiratory failure. We developed a new method to determine NTX in biological fluid. The method involves mixed-mode cationic exchange based solid phase extraction and gas chromatography/mass spectrometry for final identification and quantitative analysis. The limit of detection and recovery were substantially better than those of other methods using liquid–liquid extraction or headspace solid phase microextraction. The good recoveries (97±14%) in blood samples were obtained and calibration curves over the range 0.05–20mg/L have R2 values greater than 0.99. The developed method was applied to a fatal case of cartap intoxication of 74 years old woman who ingested cartap hydrochloride for suicide. Cartap and NTX were detected from postmortem specimens and the cause of the death was ruled to be nereistoxin intoxication. The concentrations of NTX were 2.58mg/L, 3.36mg/L and 1479.7mg/L in heart, femoral blood and stomach liquid content, respectively. The heart blood/femoral blood ratio of NTX was 0.76.

The correlation between high body mass index and survival in patients with esophageal cancer after curative esophagectomy: evidence from retrospective studies.

To investigate the predictive value of high body mass index (H-BMI) on the survival of patients with esophageal cancer (EC) after curative esophagectomy. Studies were systematically identified to investigate the relationship between overweight and obese (H-BMI) and clinical outcomes in EC patients treated with curative esophagectomy. Measured clinical outcomes were disease-free survival (DFS) and overall survival (OS). The pooled hazard ratio (HR) with 95% confidence interval (CI) was estimated. Subgroup analyses were performed according to tumour type and body mass index (BMI). Fourteen studies with 4823 cases were included in the final pooled quantitative analysis. In EC patients overall, H-BMI was associated with improved DFS (HR, 0.83; 95% CI: 0.75-0.90) and OS (HR, 0.79; 95 % CI: 0.73-0.85), as compared with normal BMI. The results were consistent with those who were overweight. Among patients with esophageal adenocarcinoma (EAC), a better prognosis, as reflected by OS, was observed with H-BMI (HR, 0.81; 95% CI: 0.73-0.89). The same results were also observed in EAC patients who were obese and overweight. In contrast, among patients with esophageal squamous cell carcinoma (ESCC), H-BMI was associated with a worse prognosis, as reflected by DFS (HR, 2.26; 95% CI: 1.29-3.24). H-BMI has distinctly different impacts on the postoperative survival of EAC and ESCC patients. H-BMI is a potential predictor for better prognosis in EC patients overall, and particularly in EAC patients, treated with curative esophagectomy. However, in ESCC patients, H-BMI is a potential predictor for a worse prognosis of postoperative survival.

Seasonal Influenza Vaccination at School

Influenza vaccination coverage for U.S. school-aged children is below the 80% national goal. Primary care practices may not have the capacity to vaccinate all children during influenza vaccination season. No real-world models of school-located seasonal influenza (SLV-I) programs have been tested. Determine the feasibility, sustainability, and impact of an SLV-I program providing influenza vaccination to elementary school children during the school day. In this pragmatic randomized controlled trial of SLV-I during two vaccination seasons, schools were randomly assigned to SLV-I versus standard of care. Seasonal influenza vaccine receipt, as recorded in the state immunization information system (IIS), was measured. Intervention and control schools were located in a single western New York county. Participation (intervention or control) included the sole urban school district and suburban districts (five in Year 1, four in Year 2). After gathering parental consent and insurance information, live attenuated and inactivated seasonal influenza vaccines were offered in elementary schools during the school day. Data on receipt of ≥1 seasonal influenza vaccination in Year 1 (2009-2010) and Year 2 (2010-2011) were collected on all student grades K through 5 at intervention and control schools from the IIS in the Spring of 2010 and 2011, respectively. Additionally, coverage achieved through SLV-I was compared to coverage of children vaccinated elsewhere. Preliminary data analysis for Year 1 occurred in Spring 2010; final quantitative analysis for both years was completed in late Fall 2012. Results are shown for 2009-2010 and 2010-2011, respectively: Children enrolled in suburban SLV-I versus control schools had vaccination coverage of 47% vs 36%, and 52% vs 36% (p<0.0001 both years). In urban areas, coverage was 36% vs 26%, and 31% vs 25% (p<0.001 both years). On multilevel logistic analysis with three nested levels (student, school, school district) during both vaccination seasons, children were more likely to be vaccinated in SLV-I versus control schools; ORs were 1.6 (95% CI=1.4, 1.9; p<0.001) and 1.5 (95% CI=1.3, 1.8; p<0.001). Delivering influenza vaccine during school is a promising approach to improving pediatric influenza vaccination coverage. ClinicalTrials.govNCT01224301.