Higher Survival Rate Research Articles

Inertial and Deterministic Lateral Displacement Integrated Microfluidic Chips for Epithelial-Mesenchymal Transition Analysis.

With the aim of efficiently sorting rare circulating tumor cells (CTCs) from blood and minimizing damage to CTCs during isolation, we constructed an inertia-assisted single-cell focusing generator (I-SCF) and a water droplet deterministic lateral displacement cell sorting (D-DLD) microfluidic system (IDIC) based on different sizes, the device is initially sorted by a continuous fluid swing and Dean flow-assisted helical micromixers, then flows through a droplet shaped DLD region, enabling single-cell focused sequencing and precise separation, improving cell separation efficiency (>95%) and purity, while ensuring a high single cells survival rate of more than 98.6%. Subsequently, breast cancer cell lines were run through our chip, and then the downstream epithelial-mesenchymal transition (EMT) process induced by TGF-β was detected, and the levels of three proteins, EpCAM, PD-L1, and N-cadherin, were analyzed to establish the relationship between PD-L1 and the EMT process. Compared with other analytical techniques such as the filtration method, the enrichment method and immunoaffinity capture methods, this method not only ensures the separation efficiency and purity, but also ensures the cell activity, and avoids missing the different results caused by the heterogeneity of CTCs due to the isolation of high purity (84.01%). The device has a high throughput processing capacity (5 mL of diluted whole blood/∼2.8 h). By using the chip, we can more easily and conveniently predict tumor stage and carry out cancer prevention and treatment in advance, and it is expected to be further developed into a clinical liquid biopsy technology in the future.

Investigation of the Use of Hops (Humulus lupulus) and Calendula (Calendula officinalis) As Disinfectants on the Hatching Efficiency of Rainbow Trout (Oncorhynchus mykiss)

This study investigates the potential application of plant-based resources with antimicrobial properties, namely hops (Humulus lupulus) and calendula (Calendula officinalis), as viable alternatives to commercial disinfectants for the prevention of fungal growth during the incubation period of rainbow trout (Oncorhynchus mykiss) eggs. Fertilized eggs were examined with daily 20-minute baths in 0.25 mg, 0.5 mg, and 1 mg concentrations throughout the incubation period (33-35 days). Control group, commercial formaldehyde, hops, and calendula groups were examined in triplicate for each concentration. As a result, the lowest hatching ratio was observed in the control group with 84.77%, while the hatching ratios in the other groups were as follows: commercial disinfectant group with 86.22%, hops group with 87.44% (0.25 mg), calendula group 88% with (0.25 mg), calendula group with 89% (0.5 mg), calendula group with 89.33% (1 mg), hops group with 89.55% (0.5 mg), and the highest hatching ratio was found in the hops group with 90.66% (1 mg). The lowest survival rate was observed in the control group with 85.22%, with the survival rates of the other groups were 86.44% in the commercial disinfectant group, 87.55% (0.25 mg) in the hops group, 88.55% (0.25 mg) in the calendula group, 88.88% (0.5 mg) in the calendula group, 89.33% (1 mg) in the calendula group, 89.55% (0.5 mg) in the hops group, and the highest survival rate was 90.11% (1 mg) in the hops group. In conclusion, it was specified that plant-based by-products (hops and calendula) could be used as alternative disinfectants to commercial chemicals in the disinfection of rainbow trout eggs and fry, and the most appropriate concentration was 1 mg.

Pharmaceutical Company's Choices of Indication for the First Clinical Projects in Oncological Drug Development in the United States.

We analyzed factors shaping the choice of the lead indication (i.e., cancer type) in the first clinical development projects of new oncological drugs in the United States (US), and how the type of pharmaceutical company is related to this choice. We selected 576 new clinical development projects in the US since 2000 for analysis. These projects were characterized according to three potential perspectives detected by multiple correspondence analysis: the morbidity of the cancer type which corresponds to market size of each cancer type, the company's previous experience with the cancer type, and the company's attitude to development risks. Mega firms tend to choose cancer types with higher morbidity (and large-market), previously experienced cancer types, while diverse small firms choose both major and rare cancers and both high- and low-risk projects, indicating that different sizes of firms utilize different development entry patterns. Common tendencies concerning the choice of lead indication were found across all companies. Cancer types the company had developed and launched in the past were more likely to be chosen; cancer types with high five-year survival rates and those with high competition were less likely to be chosen. The study showed that pharmaceutical companies seem to enter clinical development from cancer types where they can demonstrate their strengths and advantages through experience, depending on each cancer type's different market sizes and development difficulties. The results could provide clues for considering what support measures and incentives are appropriate to balance the efficiency of industrial development and the fulfillment of society's unmet medical needs.

Crossbreeding and Backcrossing in the Pyrethroid-Resistant Ladybird Beetle Eriopis connexa (Germar) Determines Resistance in Offspring

The conservation of the predatory ladybird beetle, Eriopis connexa (Germar) after its release also relies on its resistance and the performance of its progenies. When resistant individuals are released or evolve in the field through mating with susceptible pairs, we anticipate that they will generate a resistant progeny, inheriting the resistance to lambda-cyhalothrin through an autosomal mechanism. The susceptibility of a field-collected population (EcGA) was characterized and determined by the performance of their progenies generated through mating with a resistant parent (EcViR). We paired virgin adults from the EcGA and EcViR populations, observing how their progenies developed, reproduced, and survived when exposed to dried lambda-cyhalothrin residues applied at field rates. Adults from the EcGA population were ~200-fold more susceptible than those of the EcViR population. Developmental times from larva to adult emergence for EcGA individuals were delayed by approximately 6 days and generated smaller adults compared to EcViR and their progenies. The egg production did not differ across parents and progenies, but females from EcGA and EcGA × EcViR progenies produced 130 more eggs in comparison to EcViR females during the 35-day evaluation period. Exposure to lambda-cyhalothrin resulted in 77.4 to 100% survival for adults from EcViR × EcGA progenies and EcViR parents, while EcGA and the population standard for susceptibility maintained in the laboratory (EcFM) did not survive the insecticide exposure. These findings indicate that field crosses between EcViR and EcGA will improve their progenies’ biological performance compared to the EcViR parents and will maintain a high lambda-cyhalothrin survival rate.

Recurrent somatic mutations of FAT family cadherins induce an aggressive phenotype and poor prognosis in anaplastic large cell lymphoma.

Anaplastic Large Cell Lymphoma (ALCL) is a rare and aggressive T-cell lymphoma, classified into ALK-positive and ALK-negative subtypes, based on the presence of chromosomal translocations involving the ALK gene. The current standard of treatment for ALCL is polychemotherapy, with a high overall survival rate. However, a subset of patients does not respond to or develops resistance to these therapies, posing a serious challenge for clinicians. Recent targeted treatments such as ALK kinase inhibitors and anti-CD30 antibody-drug conjugates have shown promise but, for a fraction of patients, the prognosis is still unsatisfactory. We investigated the genetic landscape of ALK + ALCL by whole-exome sequencing; recurring mutations were characterized in vitro and in vivo using transduced ALCL cellular models. Recurrent mutations in FAT family genes and the transcription factor RUNX1T1 were found. These mutations induced changes in ALCL cells morphology, growth, and migration, shedding light on potential factors contributing to treatment resistance. In particular, FAT4 silencing in ALCL cells activated the β-catenin and YAP1 pathways, which play crucial roles in tumor growth, and conferred resistance to chemotherapy. Furthermore, STAT1 and STAT3 were hyper-activated in these cells. Gene expression profiling showed global changes in pathways related to cell adhesion, cytoskeletal organization, and oncogenic signaling. Notably, FAT mutations associated with poor outcome in patients. These findings provide novel insights into the molecular portrait of ALCL, that could help improve treatment strategies and the prognosis for ALCL patients.

Three-Dimensional Scaffolds Designed and Printed Using CAD/CAM Technology: A Systematic Review

The objective of this work is to review the literature on the use of three-dimensional scaffolds obtained by printing for the regeneration of bone defects in the maxillofacial area. The research question asked was: what clinical experiences exist on the use of bone biomaterials manufactured by CAD/CAM in the maxillofacial area? Prospective and retrospective studies and randomized clinical trials in humans with reconstruction area in the maxillofacial and intraoral area were included. The articles had to obtain scaffolds for bone reconstruction that were designed by computer processing and printed in different materials. Clinical cases, case series, in vitro studies and those that were not performed in humans were excluded. Six clinical studies were selected that met the established inclusion criteria. The selected studies showed heterogeneity in their objectives, materials used and types of regenerated bone defects. A high survival rate was found for dental implants placed on 3D-printed scaffolds, with rates ranging from 94.3% to 98%. The materials used included polycaprolactone, coral-derived hydroxyapatite, biphasic calcium phosphate (BCP) and bioceramics. The use of CAD/CAM technology is seen as key for satisfying variations in the shapes and requirements of different fabrics and size variations between different individuals. Furthermore, the possibility of using the patient’s own stem cells could revolutionize the way bone defects are currently treated in oral surgery. The results indicate a high survival rate of dental implants placed on 3D-printed scaffolds, suggesting the potential of this technology for bone regeneration in the maxillofacial mass.

Antithrombotic treatment in univentricular heart

Abstract Background Univentricular heart (UVH) corrected with Fontan surgery may be associated with an increased risk of thrombosis. Data regarding optimal thrombotic prevention strategy after Fontan surgery in patients with UVH is scarce, and guidelines for antithrombotic treatment are not yet available. Purpose The aim was to evaluate the prevalence of antithrombotic treatments and their relation to mortality in patients with Fontan circulation. Methods A total of 5,075 patients with UVH were identified using data from the Swedish National Patient Register, the Cause of Death Register, and the National Prescribed Drug Register. Patients with UVH born in Sweden between 1970 and 2017 who underwent Fontan surgery were included. The study population was divided into three groups based on medication: anticoagulation therapy, antiplatelet therapy, and no therapy. Incidence rate (IR) was reported per 1000 person-years and calculated as the total number of deaths divided by total follow-up time. Confidence interval (CIs) for IR was estimated with Poisson regression. Kaplain-Meier was used to estimate the survival probability of 95% for UVH. The Stratified Cox proportional hazards model was used to estimate hazard ratios (HR) with 95% CI. Results The total cohort consisted of 864 patients of which 280 individuals (32%) had hypoplastic left heart syndrome (HLHS). The median follow-up time was 14.4 (IQR 3.9;24.9) years, maximum follow-up time was 47 years. Out of all the patients, 36% received no anticoagulation or antiplatelet therapy. Among those who did receive therapy, 75% were treated with antiplatelets. The patients who had no therapy had a higher mortality rate. During long-term follow-up, patients with UVH had higher survival rates when treated with antiplatelets. Conclusion Antithrombotic therapy, in particular antiplatelet therapy, was associated with the highest survival in patients with UVH as compared to no treatment. Our data suggest that antithrombotic treatment, and in particular antiplatelet treatment, could be considered in patients with UVH.Survival with Antithrombotic treatment

Clinical Outcomes of Bulk-Fill Resin Composite Restorations: A 10-Year Mapping Review and Evidence Gap Map.

To map the evidence regarding the clinical performance of posterior restorations with bulk-fill resin composites and identify research gaps. This mapping review was conducted following PRISMA-ScR guidelines for scoping reviews, and its protocol was registered on the Open Science Framework platform. Systematic searches were conducted, considering studies published between 2013 and February 2024 in the PubMed, Embase, and Cochrane databases. Clinical studies investigating the performance of bulk-fill resin composite restorations in class I and/or class II preparations with increments of 4 to 5 mm were included. A total of 147 articles were identified, and based on the eligibility criteria, 26 studies were selected for descriptive analysis. Of the reviewed studies, 73% (n = 19) investigated high-viscosity bulk-fill composites, while 30% (n = 8) focused on low-viscosity bulk-fill composites. Evaluation periods ranged from 1 week to 10 years. Reported annual failure rates varied from 0% to 3%, with survival rates between 78.9% and 100%. Bulk-fill resin composites of high viscosity were the most analyzed in the published studies, with evaluation periods of up to 10 years. The review of available scientific evidence showed clinically acceptable performance for composite bulk-fill restorations, with high survival rates and minimal annual failure rates. There is a need for long-term clinical studies on bulk-fill resin composites. This review demonstrates that both high and low-viscosity bulk-fill resin composites exhibit satisfactory clinical performance, which can help clinicians optimize chairside time. However, it is important to highlight the need for further studies with longer follow-up periods.

REPORT OF PRACTICAL CLASS IN AGRICULTURAL AREA WITH THE BACHELOR CLASS IN AGRONOMY IN THE MUNICIPALITY OF TRACUATEUA-PA

Cassava (Manihot esculenta Crantz) is a highly consumed root and a significant source of carbohydrates in Brazil and around the world. In the state of Pará, cassava is vital to the local economy, especially in the municipality of Tracuateua. The culture involves family farmers and serves as an important source of income and subsistence. Different cultivars are used, such as BRS Tapioqueira and BRS Verdinha, which exceed 70 thousand kg/ha with good management. Adequate fertilization, pest control and weed management are essential for high productivity. Irrigation can significantly increase production. On the property of Mr. Benedito Dutra, member of the RENIVA project, the production of seed cassava and cowpea is highlighted. It uses cultivars developed by Embrapa, such as BRS Kiriris, BRS Formosa and BRS Novo Horizonte, which are recommended for industrial use. Dutra also grows cowpeas, using varieties such as BRS Guirá and BRS Natalina, which are highly productive and adapted to local conditions. The property has an irrigated area of ​​23 hectares per central pivot, ensuring crop hydration during dry periods. During the field visit, several areas of experimentation were observed. The experimental plots of cassava and cowpea showed good performance, with a high survival rate and resistance to pests. The integration of advanced soil management, pest control and irrigation practices highlighted the property as an example of innovative agriculture. The experience on Mr. Dutra’s property demonstrated the importance of innovation and adoption of advanced agricultural practices for sustainable and productive agricultural production.

The efficacy of prebiotic supplementation in mitigating heat stress and improving the survival of antibiotic-free broilers’ production in hot climates

BackgroundBangladesh is a hot tropical country, and various antibiotics have been included in broiler feed for many years to manage, prevent, and treat illnesses and improve production performance, like many other developing countries. This study mainly evaluates the efficacy of prebiotic supplementation in mitigating heat stress and improving the survival of antibiotic-free broiler production in hot climates.Materials and methodsA cocktail of banana peel, papaya peel, and watermelon rind was used as a prebiotic. A total of 350 one-day-old chicks (Ross-308) were allotted into five treatment groups each with 7 replicates: T1 (prebiotics, 15 ml/L), T2 (commercial probiotics Lactolase P, 1 g/L), T3 (synbiotics, 7.5 ml/L prebiotics + 0.5 g/L probiotics), T4 (freshwater), and T5 (antibiotics, 1 g/L). Besides other treatments, the aqueous extracts of banana peels, papaya peels, and watermelon rinds were prepared as prebiotics, and these were provided to the experimental birds through drinking water from 5 to 32 days of age.ResultsThe findings revealed nonsignificant (P > 0.05) variations in water intake, feed intake, feed conversion ratio (FCR), dressing weight, dressing percentage, heart and gizzard weights, and thigh meat yield. Significant (p < 0.05) differences were observed in body weight, body weight gain, and breast meat yield. It was observed that birds consumed five times more water than feed when the environmental temperature was above 38 °C. Significant (p < 0.05) differences in the survival rates of birds were observed among treatment groups. The highest rate of survival was obtained in T1 (100%), followed by T2 (93.3%), and T3 (90%), and the lowest percentage was recorded in T4 (66.6%) and T5 (73.3%).ConclusionPrepared prebiotics could mitigate heat stress, promote growth rate under hot climates, and be used as substitutes for antibiotics to safely produce broilers in hot climates.

Tax Evasion and Company Survival: A Brazilian Case Study

Enterprises face significant growth and survival challenges in highly competitive markets. Many companies fail to meet their tax obligations, which deprives society of essential resources and often results in tax penalties. This article examines whether companies that receive tax fines for evasion have a longer or shorter life expectancy compared to those that consistently comply with tax regulations. To analyze survival rates, the Kaplan–Meier estimator and Cox regression model were applied, considering factors such company size, sector, location, and tax evasion fines. The study included data from 11,297 firms established in 2017, in Rio Grande do Sul, Brazil. The findings indicate that companies fined for tax evasion had a higher survival rate (69%) compared to those without fines (38%) by 2023. This suggests that fines might serve as a corrective measure, helping companies realign and improve their chances of survival. Additionally, the study shows that medium-sized enterprises face significant challenges, possibly due to exceeding the limits of a simplified tax regime. This study highlights the importance of continued research across different regions and countries to validate these findings and enhance tax administration strategies.

VENO-VENOUS EXTRACORPOREAL MEMBRANE OXYGENATION IMPROVES OUTCOMES IN TRAUMA PATIENTS SUFFERING RESPIRATORY FAILURE.

Veno-venous extracorporeal membrane oxygenation (VV ECMO) improves hypoxemia and carbon dioxide clearance in patients with severe respiratory derangements. A greater understanding of the potential benefits of VV ECMO in trauma patients could lead to broader adoption. We hypothesize that trauma patients who receive VV ECMO have improved mortality outcomes when compared to those receiving conventional ventilator management given the rapid stabilization VV ECMO promotes. We performed a single center, propensity score matched cohort study. All trauma patients from January 1, 2014, to October 30, 2023, who were placed on VV ECMO or who would have met institutional guidelines for VV ECMO but were managed with conventional ventilator strategies were matched 1:1. The primary outcome analysis was survival at hospital discharge. Significance was defined as p < 0.05. Eighty-one trauma VV ECMO patients and 128 patients who received conventional management met criteria for inclusion. After matching, VV ECMO and conventional treatment cohort characteristics were similar in age and MOI. Matched ISS, SI, lactate levels, and frequency of TBI were also similar. Finally, respiratory parameters including pre-intervention, pH, partial pressure of carbon dioxide (PaCO2), lactate levels, and oxygen saturation were similar between matched groups. VV ECMO patients had higher survival rates at discharge when compared to the matched conventional treatment group (70% v 41%, p < 0.001). Corresponding hazard ratio for VV ECMO use was 0.31 (95%CI 0.18-0.52; p < 0.001). The odds ratio of mortality in matched trauma patients who receive VV ECMO versus conventional treatment was 0.29 (95%CI 0.14-0.58; p < 0.001). VV ECMO may represent a safe, alternative treatment approach for appropriately screened trauma patients with acute respiratory failure, however further studies are warranted.

Splicing dysregulation in glioblastoma alters the function of cell migration-related genes.

Glioblastoma (GBM) has a poor prognosis with a high recurrence and low survival rate. Previous RNA-seq analyses have revealed that alternative splicing (AS) plays a role in GBM progression. Here, we present a novel AS analysis method (Semi-Q) and describe its use to identify GBM-specific AS events. We analyzed RNA-seq data from normal brain (NB), normal human astrocytes (NHAs) and GBM samples, and found that comparison between NHA and GBM was especially informative. Importantly, this analysis revealed that genes encoding cell migration-related proteins, including filamins (FLNs) and actinins (ACTNs), were among those most affected by differential AS. Functional assays revealed that dysregulated AS of FLNA, B and C transcripts produced protein isoforms that not only altered transcription of cell proliferation-related genes but also led to enhanced cell migration, resistance to cell death and/or mitochondrial respiratory function, while a dysregulated AS isoform of ACTN4 enhanced cell migration. Together, our results indicate that cell migration and actin cytoskeleton-related genes are differentially regulated by AS in GBM, supporting a role for AS in facilitating tumor growth and invasiveness.

Surprisingly wide climatic niche breadth of a relict mountain species raises hope for survival under climate change

AbstractAimsWe assessed the juvenile climatic niche breadth of a relict mountain species by comparing field observations and transplant experiments within and beyond the elevational limits of its distribution range.LocationLebanon – Near East – Mediterranean region.MethodsWe studied the survival and growth of the Cedar of Lebanon (Cedrus libani) to determine the lower and upper elevational range limits of its juvenile stage through an experimental setup with and without water supplementation and with potentially competing species as a control. The experiment included eight common gardens at elevations ranging from 110 to 2330 m, within and far beyond the warm and cold limits of Cedar distribution observed under natural conditions.ResultsWe observed unexpectedly high survival and growth rates of Cedar at elevations well below the range of its natural distribution in Lebanon. Below the observed warm limit, water stress at very low elevations and competition at low and medium elevations limited juvenile survival. In contrast, cold temperature and water stress limited survival at elevations slightly above the observed upper natural limit. The experimental setup demonstrated that the elevation range suitable for Cedar growth and survival was twice as wide as the range within which Cedar is observed under natural conditions.Main ConclusionsHigh survival rates experimentally observed beyond the warm limit of the natural distribution range of the Cedar of Lebanon raise hope for its resilience to ongoing climate warming. If this pattern were frequent among montane species, it would challenge predictions of massive extinction with climate change and pave the way for promoting adaptive actions such as competition management to improve their survival.

Evaluating the Effect of Maggot Flour Protein as a Substitute for Fishmeal on the Growth Performance and Survival Rate of Common Carp (Cyprinus carpio)

This research aims to know the role of maggot flour protein as a fishmeal protein source replacement on growth performance and survival of common carp (Cyprinus carpio) and the optimum dose from artificial maggot flour feed. This research take a place at Aquaculture Laboratorium of Diponegoro University in 23 January – 6 March 2023. The experimental method using complete randomized design (RAL) consisting of 4 treatments 3 repetitions. The treatment is applied with percentage maggot flour substitution 0%, 10%, 20%, and 30% per gram of feed. The substitution set according to carp protein sufficient (30 – 35%), so that carp does not having excess protein that can effect on growth performance. The test fish used was common carp with an average size of 4.54 ± 0.23 cm with an average weight of 0.75 ± 0.03 gr/head. The experimental containers using a aquarium tank with size of 45cm x 30cm x 22.5cm. Stocking density per aquarium is 0.5 fish/liter with a maintenance period of 42 days. The experimental using feeding methods 5% of biomass with a frequency 3 times/day. The experimental results showing that substitution of artificial maggot flour feed for common carp is significantly influential (P&lt;0.05) on specific growth rate (SGR), feed conversion ratio (FCR), and survival rate (SR) of common carp. Based on experimental, the best dose substitution artificial maggot flour feed has been shown in treatments C (20%) and D (30%). Treatment C produced SGR 1.93 ± 0.04 and FCR 2.41 ± 0.07 and treatment D produced SGR 1.97 ± 0.09% and FCR 2.34 ± 0.12. The results of observations during the research showed that common carp fed with the experimental feed (substitution of maggot flour for artificial feed 0%, 10%, 20%, 30%) had a high survival rate with an average survival rate above 90%.

Outcome of childhood ALK-positive anaplastic large cell lymphoma relapses: Real-life experience of the French Society of Pediatric Oncology (SFCE) cohort of 75 French children.

To describe treatments and outcomes of French children treated for relapsed/refractory anaplastic lymphoma kinase-positive anaplastic large cell lymphoma (ALK+ ALCL). We conducted the analysis of a series of 75 French children treated for a first relapsed/refractory ALK+ ALCL between 1999 and 2017. The median time to first relapse was 8.1months from initial diagnosis (2.9 after end of treatment), with 12 relapses during frontline treatment or within 1month of the end of treatment. Treatment of the first relapse varied according to the period of time and risk factors: 48 received multiagent chemotherapy, including 21 and 19 consolidated with allogeneic stem cell transplantation (SCT) and autologous-SCT, respectively. Twenty-one patients received weekly vinblastine, and six received ALK inhibitors (ALKi). Overall, 64/75 patients reached a second complete remission (CR2). Eight out of 11 patients who did not reach CR2 died and the other three were rescued with ALKi, vinblastine, and nivolumab. With a median follow-up of 8.2years, 60 patients are alive, 43 in CR2, 15 in CR3, two in CR4; and 15 patients died, six from toxicity and nine from disease progression. The 5-year event-free survival and overall survival after first relapse were 51.7% (95% confidence interval [CI]: 39.6%-62.6%) and 80.7% (95% CI: 69.6%-88.1%), respectively. Time to relapse greater than 12months from initial diagnosis was proven to be a prognostic factor in relapsed/refractory ALK+ ALCL. In relapsed ALK+ ALCL, high survival rate can be reached with various therapeutic strategies. The main challenge remains to prevent subsequent relapses, and to lower long-term morbidity.

Association between postoperative atrial fibrillation after coronary artery bypass grafting and short-term clinical outcomes

BackgroundDespite advances in prevention and treatment, postoperative atrial fibrillation (POAF) is the most common type of complication undergoing cardiac surgery. This study aimed to identify the relationship between POAF and clinical outcomes after coronary artery bypass graft.MethodsIn this cross-sectional study, we retrospectively reviewed the medical records of 324 patients who had undergone coronary artery bypass grafting in an intensive care unit between 2010 and 2019 at a tertiary hospital in Korea. Propensity score matching was used to estimate a 1:1 match (without: with POAF) using seven covariates to overcome selection bias. Kaplan–Meier survival analysis and Cox proportional hazards modeling were performed to determine the effect on intensive care unit readmission and length of hospital stay.ResultsAfter controlling for covariates, 1:1 matching was performed for 91 patients in each group. The occurrence of postoperative atrial fibrillation was found to increase the probability of readmission to the intensive care unit, with a 23% reduced probability of readmission for every 10% increase in left ventricular ejection fraction. Multivariate analysis indicated that postoperative atrial fibrillation, chronic obstructive pulmonary disease as a comorbidity, and preoperative hemoglobin were factors affecting the length of hospitalization after surgery. The Kaplan–Meier survival analysis results indicated that the without POAF group had a higher survival rate than the with POAF group.ConclusionsHealthcare professionals should recognize negative factors such as postoperative atrial fibrillation and abnormal hematologic parameters that impact major clinical outcomes in patients and may require closer monitoring before and after coronary artery bypass grafting.

Effectiveness of tolvaptan on renal replacement therapy in patients with autosomal dominant polycystic kidney disease: a retrospective cohort study from the TriNetX global collaborative network

Background and hypothesis Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a major genetic contributor to end-stage kidney disease (ESKD). Current evidence on tolvaptan primarily focuses on slowing estimated glomerular filtration rate (eGFR) decline and kidney volume growth. However, direct confirmation of its effectiveness in reducing the need for hemodialysis in ESKD remains limited. Methods We included ADPKD patients aged ≥18 years using TriNetx data from Sep 2, 2018, to Sep 3, 2023. Propensity score matching (PSM) ensured baseline comparability (standardized mean difference (SMD) <0.1). Hazard ratios (HRs) with 95% confidence intervals (CIs) evaluated outcomes, and subgroup analyses were performed. Results After 1:1 PSM, both groups comprised 673 patients. The average age was 45, with generally good health (3–5% diabetes, 2-3% ischemic heart disease). Baseline eGFR averaged ∼55 ml/min/1.732m2. Post-matching, all SMDs were <0.1, indicating successful matching. Tolvaptan users exhibited lower eGFR (51.45 ± 30.09 vs. 57.37 ± 33.65, p < 0.001) and higher risk of stage 4-CKD (HR: 2.436, 95% CI:1.649, 3.599) compared to non-users. However, tolvaptan users showed significantly reduced chances of initiating hemodialysis (HR:0.362, 95%CI:0.176, 0.745), experiencing urinary tract infections (HR:0.581, 95%CI:0.354, 0.956), and all-cause mortality (HR:0.355, 95% CI:0.180, 0.700). Kaplan-Meier curves for hemodialysis initiation indicated higher survival rates among tolvaptan users across age and number of medication refill subgroups. Conclusions This real-world study, employing precise matching, reveals tolvaptan’s role in reducing hemodialysis initiation risk in ADPKD, despite initial hemodynamic-induced lower eGFR.

Comprehensive analysis of the expression level, prognostic value, and immune infiltration of cuproptosis-related genes in human breast cancer.

As a novel cell death form, cuproptosis results from copper combining with lipidated proteins in the tricarboxylic acid cycle. To the best of our knowledge no study has yet comprehensively analyzed the relationship between cuproptosis-related genes and breast cancer. The expression, prognostic value, mutations, chemosensitivity, and immune infiltration of cuproptosis-related genes in breast carcinoma patients were analyzed, PPI networks were constructed, and enrichment analyses were performed based on these genes. TIMER, UALCAN, Kaplan-Meier plotter, Human Protein Atlas, cBioPortal, STRING, GeneMANIA, DAVID, and R program v4.0.3 were used to accomplish the analyses above. Compared to normal breast tissues, FDX1, LIAS, LIPT1, DLD, DLAT, PDHA1, MTF1, and GLS were down-regulated in breast cancer tissues, while CDKN2A was up-regulated. High expression of FDX1, LIAS, DLD, DLAT, MTF1, GLS, and CDKN2A were associated with favorable overall survival. Cuproptosis-related genes showed a high alteration rate (51.3%) in breast cancer, contributing to worse clinical outcomes. The expression levels of FDX1, LIPT1, DLD, DLAT, PDHA1, PDHB, MTF1, GLS, and CDKN2A were associated positively with 1 or more immune cell infiltrations in breast cancer. Patients with high levels of B cell, CD4+ T cell, CD8+ T cell, and dendritic cell infiltration had a higher survival rate at 10 years. This study comprehensively investigated relationships between cuproptosis and breast cancer by bioinformatic analyses. We found that cuproptosis-related genes were generally lowly expressed in breast carcinoma tissue. As the critical gene of cuproptosis, high expression of FDX1 was related to favorable prognoses in breast cancer patients; thus, it might be a potential prognostic marker. Moreover, genes associated with cuproptosis were linked to immune infiltration in breast cancer and this relationship affected the prognosis of breast cancer.

Video-assisted thoracoscopic surgery versus open thoracotomy for resection of lung metastasis-A meta-analysis of reconstructed time-to-event data.

This study aimed to conduct a systematic review and meta-analysis comparing video-assisted thoracoscopic surgery (VATS) and open thoracotomy (OT) in the context of pulmonary metastasectomy. Three databases were assessed. The primary outcome was overall survival. The secondary outcomes were recurrence-free survival, ipsilateral recurrence, and hospital length of stay (LOS). Hazard ratios (HRs), odds ratios (ORs), and mean difference (MD) with 95% confidence intervals (CIs) were calculated. Reconstruction of time-to-event data and sensitivity analyses were performed for the primary endpoint. After screening, 11 studies were included encompassing 2159 patients undergoing lung metastasectomy (VATS: 827; OT: 1332). Compared to OT, patients who underwent VATS had higher overall survival rates (HR 0.75; 95% CI 0.67-0.85; p < 0.01), no significant difference in recurrence-free survival (HR 1.07; 95% CI 0.88-1.29; p = 0.48), shorter hospital LOS (MD -1.99 days; 95% CI -2.59 to -1.39; p < 0.01), and no significant difference in ipsilateral recurrence rates (OR 0.86; 95% CI 0.52-1.42; p = 0.56). For patients undergoing pulmonary metastasectomy, VATS strategy is associated with higher survival rates and reduced hospital LOS when compared with OT. Moreover, metastasis recurrence does not seem to be associated with long-term mortality in this population.