Modeling the Trend Changes of Liver Cancer Mortality in the 6 WHO Regions

Background: There is little information about comparison of the mortality patterns in different regions. The current study aimed to assess the trend changes of liver cancer mortality in 6 WHO regions.Methods:The mortality rates of liver cancer in the 6 WHO regions during 1990 to 2017 were extracted from the Global Burden of Disease database. Growth mixture model was used to identify the latent patterns using a set of tools to handle both the within and between trajectory variations. All the modeling procedures were implemented in Mplus 7.4 software.Results:The mortality rate in Africa showed a slow decreasing trend throughout the observation period, but a slow increase was observed in the Eastern Mediterranean region, European region, region of the Americas, and South-East Asia region. The slope of the rise in liver cancer mortality rate for Western Pacific region was 3-4 times higher than the other regions. 2-pattern growth mixture model was estimated as the best model. The Western Pacific region with annual increase of 0.20 in the liver cancer mortality rate was in the first pattern and the other 5 regions including Africa region, Eastern Mediterranean region, European region, region of the Americas, and South-East Asia region with annual increase of 0.05 in liver cancer mortality rate belonged to the second pattern.Conclusion:Observed pattern in the Western Pacific region is not favorable. Taking into account a set of urgent prevention actions to control mortality rate of liver cancer in this region seems necessary.     

Green aspects of photocatalysts during corona pandemic: a promising role for the deactivation of COVID-19 virus

The selection of a facile, eco-friendly, and effective methodology is the need of the hour for efficient curing of the COVID-19 virus in air, water, and many food products. Recently, semiconductor-based photocatalytic methodologies have provided promising, green, and sustainable approaches to battle against viral activation via the oxidative capabilities of various photocatalysts with excellent performance under moderate conditions and negligible by-products generation as well. Considering this, recent advances in photocatalysis for combating the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are inclusively highlighted. Starting from the origin to the introduction of the coronavirus, the significant potential of photocatalysis against viral prevention and -disinfection is discussed thoroughly. Various photocatalytic material-based systems including metal-oxides, metal-free and advanced 2D materials (MXenes, MOFs and COFs) are systematically examined to understand the mechanistic insights of virus-disinfection in the human body to fight against COVID-19 disease. Also, a roadmap toward sustainable solutions for ongoing COVID-19 contagion is also presented. Finally, the challenges in this field and future perspectives are comprehensively discussed involving the bottlenecks of current photocatalytic systems along with potential recommendations to deal with upcoming pandemic situations in the future.

Photocatalysts are green, eco-friendly, clean and sustainable and could be a solution to combat COVID-19 because of potential features of various types of metal oxides against viral inactivation via the generation of reactive oxidative species.     

Measures of Perceived Neighborhood Food Environments and Dietary Habits: A Systematic Review of Methods and Associations

Access to healthy food is a necessity for all people. However, there is still a lack of reviews on the assessment of respondent-based measures of neighborhood food environments (perceived food environments). The aim of this systematic review was to evaluate the measurement tools for perceived food environments by five dimensions of food access and to obtain the overview of their associations with dietary habits among people aged 18 years and older in middle- and high-income countries. Observational studies using perceived food environment measures were identified through a systematic review based on two databases for original studies published from 2010 to 2020. A total of 19 final studies were extracted from totally 2926 studies. Pertaining to the five dimensions of food access, 12 studies dealt with accessibility, 13 with availability, 6 with affordability, 10 with acceptability, 2 with accommodation, and 8 with a combination of two or more dimensions. Perceived healthy food environments were positively associated with healthy dietary habits in 17 studies, but 8 of them indicated statistically insignificant associations. In conclusion, this review found accessibility and availability to be major dimensions of perceived food environments. The relationship between healthy food environments and healthy diets is presumably positive and weak.     

Altered Integration of Structural Covariance Networks in Young Children With Type 1 Diabetes

Type 1 diabetes mellitus (T1D), one of the most frequent chronic diseases in children, is associated with glucose dysregulation that contributes to an increased risk for neurocognitive deficits. While there is a bulk of evidence regarding neurocognitive deficits in adults with T1D, little is known about how early‐onset T1D affects neural networks in young children. Recent data demonstrated widespread alterations in regional gray matter and white matter associated with T1D in young children. These widespread neuroanatomical changes might impact the organization of large‐scale brain networks. In the present study, we applied graph‐theoretical analysis to test whether the organization of structural covariance networks in the brain for a cohort of young children with T1D (N = 141) is altered compared to healthy controls (HC; N = 69). While the networks in both groups followed a small world organization—an architecture that is simultaneously highly segregated and integrated—the T1D network showed significantly longer path length compared with HC, suggesting reduced global integration of brain networks in young children with T1D. In addition, network robustness analysis revealed that the T1D network model showed more vulnerability to neural insult compared with HC. These results suggest that early‐onset T1D negatively impacts the global organization of structural covariance networks and influences the trajectory of brain development in childhood. This is the first study to examine structural covariance networks in young children with T1D. Improving glycemic control for young children with T1D might help prevent alterations in brain networks in this population. Hum Brain Mapp 37:4034–4046, 2016. © 2016 Wiley Periodicals, Inc .     

A biomechanical study comparing plate fixation using unicortical and bicortical screws in transverse metacarpal fracture models subjected to cyclic loading

The use of bicortical screws to fix metacarpal fractures has been suggested to provide no added biomechanical advantage over unicortical screw fixation. However, this was only demonstrated in static loading regimes, which may not be representative of biological conditions. The present study was done to determine whether similar outcomes are obtained when cyclic loading is applied. Transverse midshaft osteotomies were created in 20 metacarpals harvested from three cadavers. Fractures were stabilised using 2.0 mm mini fragment plates fixed with either bicortical or unicortical screw fixation. These fixations were tested to failure with a three-point bending cyclic loading protocol using an electromechanical microtester and a 1 kN load cell. The mean load to failure was 370 N (SD 116) for unicortical fixation and 450 N (SD 135) for bicortical fixation. Significant differences between these two constructs were observed. A biomechanical advantage was found when using bicortical screws in metacarpal fracture plating.     

Prospective clinical trial to compare standard colon‐reflecting with transmesocolic laparoscopic pyeloplasty

Study Type – Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? Laparoscopic pyeloplasty has replaced open pyeloplasty as the new standard of care and we, among others, have even proven its applicability to redo surgery. The focus is now on limiting morbidity. One technical modification to this end is transmesocolic (TM) exposure of the PUJ. This randomized study pinpoints the objective benefits of TM exposure of the PUJ compared with standard colon reflection, and its results showed a 23% conservation in operating time.

OBJECTIVE

• ? To compare the efficacy and safety of colon‐reflecting (CR) and transmesocolic (TM) laparoscopic pyeloplasty approaches in a prospective randomized non‐selective setting.

PATIENTS AND METHODS

• ? Excluding only those patients with a history of abdominal surgery, all consenting patients scheduled for laparoscopic pyeloplasty of left‐sided pelvi‐ureteric junction (PUJ) obstruction between December 2004 and November 2007 were randomized into one of two groups: laparoscopic pyeloplasty using the standard CR approach or laparoscopic pyeloplasty through the TM aperture.
• ? All patients underwent dismembered repair by a single expert and were followed by diuretic renogram and urography at 4 months postoperatively and by annual diuretic renogram thereafter.
• ? Four discrete task phases were timed for comparison: trochar to PUJ, dismembering and spatulation, stenting and anastomosis.

RESULTS

• ? Sixty‐four patients were randomized into two groups, TM or CR, with 32 patients in each.
• ? The groups were similar, with no significant difference in sex, age, initial renal function or body mass index. Forty‐seven patients were ≤15 years old.
• ? The mean (sd ) operating time was 23% shorter in the TM group, owing mostly to the much shorter trochar to PUJ phase (5.0 [3.2] min in the TM group vs 35.8 [10.3] in the CR group; P < 0.001). The mean hospitalization time was shorter in the TM group than in the CR group (2.9 vs 3.6 days; P < 0.001).
• ? Thirty‐one of 32 patients in each group (96.9%) achieved a durable cure.

CONCLUSION

• ? Transmesocolic exposure of left‐sided PUJ obstruction is superior to standard CR exposure, in that it saves anaesthesia time, hospitalization time and has lower morbidity with no compromise in efficiency, and could be considered as the new standard approach.

     

Hepatitis B vaccination in human immunodeficiency virus-infected adults receiving hemodialysis

BACKGROUND: The Centers for Disease Control and Prevention (CDC) recommends hepatitis B virus (HBV) immunization for all hemodialysis (HD) patients because they are at high risk of infection. Several studies have shown that the development of protective antibody titers after HBV vaccination is much lower in HD patients. We hypothesized that human immunodeficiency virus (HIV) infection in patients with end-stage renal disease (ESRD) would further impair the immune response to hepatitis B vaccination. METHODS: We performed a retrospective cohort study of patients undergoing long-term hemodialysis from 1990 to 2002 at the United States-based dialysis facilities of Gambro Corporation, North America. The response rate defined as an increase in anti-HBs levels >/=10 mIU/L after a month of the third dose of HBV vaccination was determined in HIV-infected and a randomly selected group of ESRD patients. The demographic information, laboratory data, and hepatitis B surface antibody (anti-HBs) titers were recorded from the Gambro Corporation database on these patients. RESULTS: Of the 347 adult HIV ESRD patients, 116 received three doses of recombinant hepatitis B vaccination. Seventy percent were male, and the majority (86%) were black. Of the 116 patients who received three doses of HBV vaccination, 62 (53.4%) developed protective antibody titers. This was comparable to the response rate of 50.4% in the randomly selected 220 non-HIV hemodialysis patients. Among HIV ESRD patients, the mean hemoglobin (Hgb) was higher in patients who developed protective antibody titers (Hgb 11.61 +/- 2 vs. 10.55 +/- 1.86, P value <0.01). On multivariate logistic regression analysis, higher Hgb was associated with protective antibody titers (odds ratio: 1.34, 95% CI 0.99-1.72). Seventy percent of the HIV-infected responders maintained protective antibody titers 6 months after vaccination. CONCLUSION: Hepatitis B vaccination should be offered to all HIV-infected ESRD patients because over half of the patients with HIV and ESRD can develop protective antibodies.     

Role of pelvic drain and timing of urethral catheter removal following RARP: a systematic review and meta-analysis

Objectives

To assess the clinical value of routine pelvic drain (PD) placement and early removal of urethral catheter (UC) in patients undergoing robot-assisted radical prostatectomy (RARP), as perioperative management such as the necessity of PD or optimal timing for UC removal remains highly variable.

Methods

Multiple databases were searched for articles published before March 2022 according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Studies were deemed eligible if they investigated the differential rate of postoperative complications between patients with/without routine PD placement and with/without early UC removal, defined as UC removal at 2–4 days after RARP.

Results

Overall, eight studies comprising 5112 patients were eligible for the analysis of PD placement, and six studies comprising 2598 patients were eligible for the analysis of UC removal. There were no differences in the rate of any complications (pooled odds ratio [OR] 0.89, 95% confidence interval [CI] 0.78–1.00), severe complications (Clavien–Dindo Grade ≥III; pooled OR 0.95, 95% CI 0.54–1.69), all and/or symptomatic lymphocele (pooled OR 0.82, 95% CI 0.50–1.33; and pooled OR 0.58, 95% CI 0.26–1.29, respectively) between patients with or without routine PD placement. Furthermore, avoiding PD placement decreased the rate of postoperative ileus (pooled OR 0.70, 95% CI 0.51–0.91). Early removal of UC resulted in an increased likelihood of urinary retention (OR 6.21, 95% CI 3.54–10.9) in retrospective, but not in prospective studies. There were no differences in anastomosis leakage and early continence rates between patients with or those without early removal of UC.

Conclusions

There is no benefit for routine PD placement after standard RARP in the published articles. Early removal of UC seems possible with the caveat of the increased risk of urinary retention, while the effect on medium-term continence is still unclear. These data may help guide the standardisation of postoperative procedures by avoiding unnecessary interventions, thereby reducing potential complications and associated costs.     

Prospective randomized evaluation of emergency extracorporeal shock wave lithotripsy (ESWL) on the short-time outcome of symptomatic ureteral stones

OBJECTIVE: Here, we report the results of a randomized controlled trial (RCT) assessing the efficacy of emergency ESWL (eESWL) on the short-term outcome of symptomatic ureteral stones. MATERIAL: The trial enrolled 100 patients admitted in emergency room for renal colic caused by a ureteral radioopaque [corrected] stone. Patients were randomized to medical therapy alone or combined with eESWL. eESWL was performed within 6 hours of the onset of renal colic without specific analgesia on a Lithostar lithotripter (Siemens Medical, Munich, Germany). The primary endpoints were the proportion of patients stone free rate after 48 hours (SF-48) and the cumulative proportion of patients discharged from the hospital after 48 and 72 hours. RESULTS: Ureteral stone's location was proximal and distal in respectively 46% and 54% of the patients; stone's mean size was 5.5 mm (range 2-10 mm). Median hospital stay was 3 days, ranging from 1 to 14 days. SF-48 in the control group varied from 76% for distal stones <5 mm to 28.6% for proximal stones >5 mm, averaging at 61%. On average, eESWL increased SF-48 by 13% (p: 0.126), the gain strictly depending on stone size and location. SF-48 increase ranged from 40% for proximal stones >5 mm to 1.8% for distal stone <5 mm. On average, eESWL increased the median duration of hospital stay by one day. This mean negative impact results from ESWL increasing significantly the duration of hospital stay in case of distal stone, while slightly shortened it for stones located proximally. CONCLUSION: This study demonstrated for the first time that rapidly performed ESWL is a valuable therapeutic option to improve elimination of ureteral stones and shorten duration of hospital stay, proven that the stone is located proximally to the iliac vessels.